In this review, the authors examine the recent evidence of a potential interaction between clopidogrel and proton pump inhibitors (PPIs). They note that the available evidence come from one small, short-term, randomised, double-blind trial evaluating platelet aggregation and several observational studies suggesting that there is a potential for a clinically significant interaction. In addition, a post hoc analysis of a large, randomised, double-blind trial found no evidence of a clinically significant drug interaction at 28 days, though a significant difference was observed at one year. The authors conclude that the data are limited and recommend that “until further studies are completed to delineate the specifics of the interaction between clopidogrel and PPIs, the risks and benefits of concomitant treatment should be carefully weighed to determine the most appropriate treatment for each individual patient.”

Advice from the MHRA, reiterating that of the EMEA, on the concomitant use of these agents is available from the NeLM link below.