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lüll Proton pump inhibitors and clopidogrel Gaglia MA Jr; Waksman RCardiovasc Ther 2010[Jun]; 28 (3): 169-76Proton pump inhibitors are often prescribed for patients on clopidogrel to prevent gastrointestinal bleeding complications. Recent data suggest higher rates of adverse cardiovascular events in patients on proton pump inhibitors and clopidogrel, in comparison to patients on clopidogrel only. Both drugs are metabolized by similar pathways of the cytochrome P450 system, so proton pump inhibitors may inhibit the metabolism of clopidogrel to its active metabolite. This article reviews the pharmacodynamic and clinical evidence for this phenomenon.|Aryl Hydrocarbon Hydroxylases/genetics/metabolism[MESH]|Biotransformation[MESH]|Clopidogrel[MESH]|Cytochrome P-450 CYP2C19[MESH]|Drug Interactions[MESH]|Evidence-Based Medicine[MESH]|Gastrointestinal Hemorrhage/chemically induced/*prevention & control[MESH]|Humans[MESH]|Platelet Aggregation Inhibitors/adverse effects/pharmacokinetics/*therapeutic use[MESH]|Platelet Aggregation/*drug effects[MESH]|Proton Pump Inhibitors/adverse effects/pharmacokinetics/*therapeutic use[MESH]|Risk Assessment[MESH]|Ticlopidine/adverse effects/*analogs & derivatives/pharmacokinetics/therapeutic use[MESH] |