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Plavix/PPI interactions linked to heart attacks

This article was originally published in The Tan Sheet

Executive Summary

FDA says Jan. 26 it is looking at evidence that the Sanofi-Aventis/Bristol-Myers Squibb antiplatelet drug Plavix(clopidogrel) may be less effective when used with proton pump inhibitors, including Prilosec OTC (omeprazole). A study published in the Canadian Medical Association Journal Jan. 28 finds PPIs may inhibit the enzyme that converts clopidogrel to the active drug form. Researchers led by David Juurlink, with the Sunnybrook Health Sciences Center in Toronto, estimate 5 percent to 15 percent of readmissions for heart attacks among patients taking clopidogrel could result from an adverse reaction with some types of PPIs. They did not find evidence that H2 blockers, including Zantac and Pepcid, or antacids interfere with Plavix. The drugmakers and FDA will conduct additional studies on how other drugs affect clopidogrel, the agency adds. An FDA MedWatch notice asks health care providers to reevaluate their treatment of patients with both Plavix and a PPI, in light of the existing data

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