Interazioni tra farmaci
Clopidogrel + Esomeprazole
Gravità: Maggiore
Clopidogrel and Esomeprazole: major interaction.
Ultimo aggiornamento Fonti: US FDA label
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Sintesi
Esomeprazole reduces formation of clopidogrel's active metabolite and lowers its antiplatelet effect. This may increase the risk of thrombotic events, particularly in patients after stent placement or acute coronary syndrome. Labeling advises avoiding the combination.
Cosa significa questa interazione in parole semplici
Clopidogrel and Esomeprazole can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Clopidogrel belongs to Cardiovascular; Esomeprazole belongs to Gastrointestinal Tract.
Perché avviene
Esomeprazole inhibits CYP2C19, the enzyme needed to convert clopidogrel to its active thiol metabolite, reducing platelet P2Y12 inhibition.
Cosa fare
Avoid esomeprazole and omeprazole in patients taking clopidogrel. If gastroprotection is needed, use pantoprazole, which has weaker CYP2C19 inhibition, or an H2 antagonist other than cimetidine.
Cosa chiedere al farmacista
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Riferimenti
Altre interazioni di Clopidogrel
- Clopidogrel + Ombitasvir / paritaprevir / ritonavir and dasabuvir Controindicata
- Abrocitinib + Clopidogrel Maggiore
- Acetylsalicylic acid + Clopidogrel Maggiore
- Apixaban + Clopidogrel Maggiore
- Aspirin + Clopidogrel Maggiore
- Betrixaban + Clopidogrel Maggiore
Altre interazioni di Esomeprazole
- Esomeprazole + Mavacamten Controindicata
- Esomeprazole + Rilpivirine Controindicata
- Acalabrutinib + Esomeprazole Maggiore
- Atazanavir + Esomeprazole Maggiore
- Citalopram + Esomeprazole Maggiore
- Dacomitinib + Esomeprazole Maggiore
Domande frequenti
Can I take Clopidogrel with Esomeprazole?
MediHelp rates the interaction as major. Clopidogrel and Esomeprazole can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Esomeprazole reduces formation of clopidogrel's active metabolite and lowers its antiplatelet effect. This may increase the risk of thrombotic events, particularly in patients after stent placement or acute coronary syndrome. Labeling advises avoiding the combination.
How serious is the interaction between Clopidogrel and Esomeprazole?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid esomeprazole and omeprazole in patients taking clopidogrel. If gastroprotection is needed, use pantoprazole, which has weaker CYP2C19 inhibition, or an H2 antagonist other than cimetidine.
What other medicines interact with Clopidogrel?
MediHelp also lists interactions of Clopidogrel with, for example, Ombitasvir / paritaprevir / ritonavir and dasabuvir, Abrocitinib, Acetylsalicylic acid. The full list is on the Clopidogrel page.
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