Drug interaction of proton pump inhibitors and clopidogrel taken together

: Current clinical practice lays special emphasis on drug interactions. High rates of cardiovascular morbidity and acid-dependent diseases dictates the necessity of antiaggregation and antisecretory therapy. The former uses a variety of medicines with acetylsalicylic acid (ASA) and clopidogrel being the most popular ones. Therapy using drugs with different mechanisms of action on the thrombocytic component of homeostasis appears to be especially promising as having synergic antiplatelet effect. The most common variant of antiplatelet therapy is a combination of ASA and clopidogrel usually referred to as double antiplatelet therapy (DAP). Current consensus recommends intake of proton pump inhibitors (PPI) during DAP to reduce the risk of gastrointestinal complications. However, recent studies showed that this approach is fraught with severe cardiovascular disorders, such as myocardial infarction, stroke, unstable angina, necessity of repeat coronary interventions, and coronary death. Hence, the importance of differential application of PPI in patients treated with ASA and clopidogrel. A comprehensive review of this problem is presented along with results of investigations of PPI action on clinical outcome of clopidrogel therapy.