Drug interactions
clopidogrel + omeprazole
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Overview
Omeprazole inhibits CYP2C19, reducing clopidogrel’s bioactivation and antiplatelet effect, which may increase risk of thrombotic/cardiovascular events.
Mechanism of action
CYP2C19 inhibition by omeprazole decreases formation of clopidogrel’s active metabolite → reduced platelet inhibition.
Clinical management
Avoid coadministration. Use an alternative acid suppressant (e.g., pantoprazole) or consider a non–CYP2C19-dependent P2Y12 inhibitor when appropriate. Do not rely on dose separation. Monitor for ischemic events.
Drug reference
References
Frequently asked questions
Can I take clopidogrel with omeprazole?
The interaction is rated: Major. Omeprazole inhibits CYP2C19, reducing clopidogrel’s bioactivation and antiplatelet effect, which may increase risk of thrombotic/cardiovascular events.
How serious is the interaction between clopidogrel and omeprazole?
The interaction is rated: Major. Evidence level: High.
How is the interaction between clopidogrel and omeprazole managed?
Avoid coadministration. Use an alternative acid suppressant (e.g., pantoprazole) or consider a non–CYP2C19-dependent P2Y12 inhibitor when appropriate. Do not rely on dose separation. Monitor for ischemic events.
Why do clopidogrel and omeprazole interact?
CYP2C19 inhibition by omeprazole decreases formation of clopidogrel’s active metabolite → reduced platelet inhibition.
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