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Clopidogrel and proton pump inhibitors
Clopidogrel is a P2Y12 inhibitor that reduces platelet aggregation, but proton pump inhibitors impair its activation, reducing its antiplatelet efficacy.
Clopidogrel is a P2Y12 inhibitor that reduces platelet aggregation, but proton pump inhibitors impair its activation, reducing its antiplatelet efficacy. Used for Acute coronary syndrome, Percutaneous coronary intervention with stent placement, Stroke prevention in patients with recent myocardial infarction or stroke.
At a glance
| Generic name | Clopidogrel and proton pump inhibitors |
|---|---|
| Also known as | clopidogrel, rabeprazole, pantoprazole, esomeprazole |
| Sponsor | National Taiwan University Hospital |
| Drug class | Antiplatelet agent (thienopyridine) with drug-drug interaction study |
| Target | P2Y12 receptor (clopidogrel); CYP2C19 enzyme (PPI interaction) |
| Modality | Small molecule |
| Therapeutic area | Cardiovascular |
| Phase | FDA-approved |
Mechanism of action
Clopidogrel is a prodrug that requires hepatic metabolism via CYP3A4 and CYP2C19 to become active. Proton pump inhibitors (PPIs) are potent CYP2C19 inhibitors that significantly reduce clopidogrel's conversion to its active metabolite, thereby diminishing its antiplatelet effect. This drug-drug interaction is a recognized clinical concern that may increase thrombotic risk in patients requiring dual antiplatelet therapy.
Approved indications
- Acute coronary syndrome
- Percutaneous coronary intervention with stent placement
- Stroke prevention in patients with recent myocardial infarction or stroke
Common side effects
- Bleeding
- Dyspepsia (when combined with PPI)
- Thrombotic events (due to reduced clopidogrel efficacy)
Key clinical trials
- Treatment of Post-STEMI Left Ventricular Thrombus With Optimized Anticoagulant (PHASE3)
- Drug-drug Interactions Between DWP14012 and DWC202202 in Healthy Subjects (PHASE1)
- Prevention of Post-STEMI Left Ventricular Thrombus With Optimized Anticoagulant (EARLYmyo-LVT Ⅱ) (PHASE3)
- A Phase 3, Multicenter, Randomized, Double-blind,Active-controlled, Parallel-group Trial With an Open-labelExtension Phase to Evaluate the Efficacy and Safety of OralE5501 Versus Eltrombopag, in Adults With Chronic ImmuneThrombocytopenia (Idiopathic Thrombocytopenic Purpura) (PHASE3)
- Efficacy and Safety of Oral E5501 Plus Standard of Care for the Treatment of Thrombocytopenia in Adults With Chronic Immune Thrombocytopenia (Amendment 02) (PHASE3)
- Efficacy of Proton Pump Inhibitor in Prevention of Clopidogrel-related Peptic Ulcer (PHASE2)
- Cohort Study of Clopidogrel and Proton Pump Inhibitors
- Influence of the Proton Pump Inhibitor Omeprazole on the Anti-Platelet of P2Y12 Antagonists in Subjects With Coronary and Peripheral Artery Disease
Primary sources
Every claim on this page is sourced from regulatory or scientific primary sources. See our editorial policy for full methodology.
| Source | Used for |
|---|---|
| ClinicalTrials.gov | Trial enrolment, design, endpoints, results |
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