Compatibility «Pantoprazole» and «Acetylsalicylic acid+Clopidogrel»

• Interactions Pantoprazole with Acetylsalicylic acid+Clopidogrel

  • Dangerous interactions
    • ⓘ Patients taking nicorandil and NSAIDs at the same time, including ASA and lysine acetylsalicylate, have an increased risk of severe complications, such as ulceration and perforation in the gastrointestinal tract and gastrointestinal bleeding (see 'Special instructions').
    • ⓘ There is a potential increased risk of gastrointestinal bleeding when used concomitantly with NSAIDs.
  • Negative interactions
    • ⓘ Concomitant use with clopidogrel of proton pump inhibitors that are strong or moderate inhibitors of the CYP2C19 isoenzyme (e.g. omeprazole, esomeprazole) is not recommended.
    • ⓘ If the patient still needs to use proton pump inhibitors simultaneously with taking the drug Clopidogrel Plus, then proton pump inhibitors with little effect on the activity of the CYP2C19 isoenzyme, such as pantoprazole or lansoprazole, should be used.
    • ⓘ If the patient still needs to use proton pump inhibitors simultaneously with taking clopidogrel, then proton pump inhibitors with little effect on the activity of the CYP2C19 isoenzyme, such as pantoprazole or lansoprazole, should be used.
    • ⓘ In a cross-sectional clinical study, 66 healthy volunteers were administered clopidogrel (a shock dose of 300 mg, followed by 75 mg/ day) separately and with pantoprazole (80 mg simultaneously with clopidogrel) for 5 days.
    • ⓘ On day 5, the average AUC of the active metabolite of clopidogrel decreased by about 14% (the geometric mean ratio was 86% at 90% CI from 79 to 93%) when pantoprazole was administered simultaneously with clopidogrel, compared with clopidogrel administered separately.
    • ⓘ Pharmacodynamic parameters were also measured, which demonstrated that a change in inhibition of platelet aggregation (induced by 5 µm ADP) correlated with a change in exposure to the active metabolite of clopidogrel.
    • ⓘ 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
    • ⓘ The effect of the active metabolite and platelet inhibition in the combined use of clopidogrel and proton pump inhibitors.
  • Positive interactions
    • ⓘ The study was conducted using clopidogrel (a loading dose of 300 mg, then 75 mg/day) and a high dose (80 mg/day) of pantoprazole, a weak CYP2C19 inhibitor.
  • Unclear interactions
    • ⓘ Also a substrate of CYP3A4), phenytoin (also an inducer of CYP3A4) and clopidogrel), CYP3A4 (nifedipine, midazolam and clarithromycin), CYP2D6 (metoprolol), CYP2C9 (naproxen and piroxicam) and CYP1A2 (theophylline).
    • ⓘ Clopidogrel.
    • ⓘ Clopidogrel is partially metabolized to the active metabolite by CYP2C19.
    • ⓘ Proton pump inhibitors.
    • ⓘ Clopidogrel + pantoprazole (80 mg).

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

• Kiberis checks interactions and evaluates drug compatibility for free online right in the instructions thanks to the latest artificial intelligence technologies. The accuracy of finding is more than 95%, the accuracy of the hazard assessment is more than 80%. The online medical service takes into account all the drug groups of the selected drugs and all their components. And since the database contains 25,000 drugs with detailed instructions, not every pharmacologist can compete with our artificial intelligence. List of popular interactions.
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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