This review on the interaction between proton pump inhibitors (PPIs) and clopidogrel addresses the following questions and topics:

• What is the role of clopidogrel in cardiovascular disease?

• What is the risk of GI bleeding with clopidogrel?

• Do PPIs decrease GI bleeding in patients taking clopidogrel?

• Clopidogrel metabolism

• PPI metabolism

• Do PPIs influence clopidogrel's pharmacodynamic effects?

• Do PPIs influence clopidogrel's clinical efficacy?

• Recommendations to health-care providers

The authors conclude “the current evidence does not justify the conclusion that PPIs decrease the clinical efficacy of clopidogrel. Nonetheless, until further reliable data become available, wide separation of PPI and clopidogrel dosing should in theory minimise any potential, though unproven, clinical interaction between these two widely used medications.”