相互作用
Clopidogrel + Esomeprazole
重症度: 重大
Clopidogrel and Esomeprazole: major interaction.
最終更新日 出典: US FDA label
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概要
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.
この相互作用をわかりやすく説明すると
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.
なぜ起こるのか
Esomeprazole inhibits CYP2C19, the enzyme needed to convert clopidogrel to its active thiol metabolite, reducing platelet P2Y12 inhibition.
対処法
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.
薬剤師に尋ねること
- 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?
Pro+会員向け
ページ全体を見る
アカウントを作成してPro+トライアルを始めると、ClopidogrelとEsomeprazoleの臨床対応の詳細なアドバイス、追加の注記、エビデンスの詳細、処方全体を対象とした相互作用チェッカーを利用できます。
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
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参考文献
Clopidogrelのその他の相互作用
Esomeprazoleのその他の相互作用
よくある質問
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.
完全なモノグラフ、用量、相互作用チェッカーはMediHelpアプリで
MediHelpアプリで、完全なリファレンスを開き、複数薬剤の相互作用をチェックし、用量ツールを利用できます。
