Using Clopidogrel with Proton Pump Inhibitors Essay

Using Clopidogrel with Proton Pump Inhibitors Essay

Using clopidogrel with proton pump inhibitors Essay

Hi, the current discussion required that one selects a drug that interacts with proton pump inhibitors or antacids. It is interesting to learn from your post that clopidogrel is among the drugs that interact with omeprazole, a proton pump inhibitor. Omeprazole is commonly prescribed to patients with PUD, H. pylori infection, or GERD. On the other hand, clopidogrel is an antiplatelet used to prevent heart attack and stroke (Demcsák et al., 2018). Therefore, hypertensive patients are most likely to be prescribed the two medications. Understanding the drug interactions helps the prescriber to understand how to modify their prescriptions to minimize the adverse outcomes in their patients. As evident in your post, the drug interactions cause problematic pathological outcomes and could worsen the patient’s condition (Demcsák et al., 2018). I agree with you that many patients do not count on-the-counter medications given to them. Also, they may not be able to inform the pharmacists that they are on specific medications so that the possible drug interactions are considered.

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There is a need to explore the possible measures to reduce the adverse outcomes of polypharmacy. The drug interactions between clopidogrel and omeprazole indicate why the nurses and healthcare providers should offer relevant education to the patients on why they take specific drugs and their mode of actions and interactions. Omeprazole is commonly purchased over the counter and with such low regulations, there are possibilities of patients suffering from undesired consequences. The current discussion helps in understanding why proper considerations have to be made before prescribing a given medication to a patient. The ultimate goal in the therapeutic administration is to improve the health status of the patients.

References

Demcsák, A., Lantos, T., Bálint, E. R., Hartmann, P., Vincze, Á., Bajor, J., Czopf, L., Alizadeh, H., Gyöngyi, Z., Márta, K., Mikó, A., Szakács, Z., Pécsi, D., Hegyi, P., & Szabó, I. L. (2018). PPIs are not responsible for elevating cardiovascular risk in patients on Clopidogrel—A systematic review and meta-analysis. Frontiers in Physiology9https://doi.org/10.3389/fphys.2018.01550

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Clopidogrel has a drug-drug interaction with omeprazole, a proton pump inhibitor. Omeprazole blocks the enzyme CYP2C19 which is needed to activate clopidogrel. With this occurrence decreased levels of Plavix are found, of course indicating little or no therapeutic effect. Concomitant use of omeprazole and clopidogrel showed an increase in platelet reactivity as a result of the inhibition of CYP2C19. So not only does it reduce the effectiveness of the medication, it actually increases the problematic pathology attempting to be remediated.I find this interaction to be especially problematic as omeprazole is bought over the counter. I could not find exact numbers on this but I venture to guess majority of people do not consult the retail pharmacist about their over-the-counter medications and potential interactions that may occur with their other prescribed medications. I have personally found that many patients do not even count over the counter medications when asked what medications they take. It is one thing for someone not to report that they take a tums from time to time, but medications like omeprazole are generally taken with consistent frequency, and should be reported to the provider and pharmacist. This of course is continued education with the patient. I would suggest that if a patient report taking both clopidogrel and omeprazole, that they discontinue the omeprazole. Clopidogrel has much greater significance to the patients’ health and well-being, helping to prevent potentially fatal blood clots. There are other therapeutic medications that can help to reduce stomach acid such as the H2 blockers Zantac, Pepcid, Axid, but excluding Tagamet. These specific H2 blockers do not have an interaction and can be taken safely by a patient who is taking clopidogrel for stroke and heart attach prevention.

Harmsze, A. M., de Boer, A., Boot, H., Deneer, V. H., Heringa, M., Mol, P. G., Schalekamp, T., Verduijn, M. M., Verheugt, F. W., & le Comte, M. (2011). Interactie tussen clopidogrel en protonpompremmers [Interaction between clopidogrel and proton pump inhibitors]. Nederlands tijdschrift voor geneeskunde, 155(28), A2442.

 

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