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Revista Colombiana de Gastroenterologia

Print version ISSN 0120-9957


MARTINEZ, Ingrid; COY, Vivian  and  OTERO, William. Proton pump inhibitors and clopidogrel: Evidence of a Pharmacological interaction of great clinical impact. Rev Col Gastroenterol [online]. 2010, vol.25, n.1, pp.68-75. ISSN 0120-9957.

Clopidogrel, a thienopyridine, is an antiplatelet drug which currently represents the cornerstone for the treatment of acute coronary events. It is a pro-drug that must be converted at hepatic level into its active form by the CYP2C19 isoenzyme. Recently the interaction between proton pump inhibitors and clopidogrel has been widely brought to attention. The competitive inhibition that these generate on the hepatic enzymatic system probably activates clopidogrel, thus causing a decrease in its effectiveness as an antithrombotic. Nevertheless, evidence is contradictory, and until now no clinical trials have been performed to clear up doubts. If a PPI is to be used on patients who take clopidogrel, the use of Pantoprazole or Esomeprazole is recommended because they exert minimal inhibition on CYP2C19.

Keywords : Proton pump inhibitors; clopidogrel; P450; thrombosis.

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