Compatibility «Omeprazole» and «Clopidogrel»

• Interactions Omeprazole with Clopidogrel

  • Dangerous interactions
    • ⓘ There is a potential increased risk of gastrointestinal bleeding when used concomitantly with NSAIDs.
  • Negative interactions
    • ⓘ Simultaneous use of omeprazole at a dose of 80 mg leads to a decrease in the concentration of the active metabolite of clopidogrel in blood plasma and inhibition of platelets.
    • ⓘ Concomitant use of omeprazole and clopidogrel should be avoided.
    • ⓘ Adequate combined studies of a lower dose of omeprazole or a higher dose of clopidogrel compared to the recommended dose of clopidogrel have not been conducted.
    • ⓘ With the simultaneous use of omeprazole, the effect (C_max and AUC) of the active metabolite of clopidogrel and platelet inhibition were significantly reduced (Table 14).
    • ⓘ A similar decrease in the effect of the active metabolite of clopidogrel and platelet inhibition was observed with the simultaneous use of clopidogrel and omeprazole at an interval of 12 hours.
    • ⓘ There are no adequate studies using a lower dose of omeprazole or a higher dose of clopidogrel.
    • ⓘ The concentration of the active metabolite of clopidogrel in blood plasma and the degree of platelet inhibition were lower than those observed with the use of clopidogrel in monotherapy, but higher than with the simultaneous use of omeprazole 80 mg with a loading dose of 300 mg and subsequent use of clopidogrel at a dose of 75 mg / day.
    • ⓘ Some non-randomized observational studies have shown that the simultaneous use of clopidogrel and proton pump inhibitors was associated with a higher incidence of adverse cardiovascular events, however, according to randomized clinical trials, no significant association was observed.
    • ⓘ If necessary, the use of a proton pump inhibitor with a lower ability to inhibit the activity of CYP2C19, such as pantoprazole, should be considered.
  • No interactions
    • ⓘ In a cross-sectional clinical study, clopidogrel (loading dose of 300 mg, then 75 mg / day) was used as monotherapy and in combination with omeprazole (80 mg) for 5 days.
    • ⓘ The effect of the active metabolite and platelet inhibition in the combined use of clopidogrel and proton pump inhibitors.
  • Unclear interactions
    • ⓘ Clopidogrel.
    • ⓘ Clopidogrel is metabolized to its active metabolite partially by CYP2C19.
    • ⓘ Proton pump inhibitors.
    • ⓘ Clopidogrel + omeprazole (80 mg)³.
    • ⓘ CYP2C19 inhibitors (e.g. omeprazole).
    • ⓘ CYP2C19 inhibitors include, but are not limited to omeprazole, esomeprazole, lansoprazole, cimetidine, ticlopidine, fluvoxamine, fluoxetine, moclobemide, felbamate, chloramphenicol, ketoconazole.

Decoding the colors of interactions and contraindications

Dangerous	—	a pronounced negative interaction or contraindication.
Negative	—	negative interaction or side effect that may reduce effectiveness.
Positive	—	the interaction can SOMETIMES be used as a positive (often a dose adjustment is needed), or it is an indication of the drug.
No	—	the drugs do NOT interact, which is separately indicated in the instructions.
Unclear	—	the system failed to pre-assess the danger.

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Additional information

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• The use of information about interactions is only possible as an introduction. This information should not be used to adjust therapy without consulting a specialist.
• The article is written: artificial intelligence Kiberis
• Sources: official instructions for medicines and their active substances, as well as inter-group interactions described in medical studies and textbooks.
• Total analyzed: 169,994,378 possible combinations of drugs and their components were found 412,530 interacting combinations.
• Medicine section: Standard evidence-based medicine
• The date of the last update of the interaction database: 2024-12-19

Category - medicine