Interações medicamentosas
Clopidogrel + Esomeprazole
Gravidade: Grave
Clopidogrel and Esomeprazole: major interaction.
Última atualização Fontes: US FDA label
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Resumo
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.
O que esta interação significa em palavras simples
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.
Por que acontece
Esomeprazole inhibits CYP2C19, the enzyme needed to convert clopidogrel to its active thiol metabolite, reducing platelet P2Y12 inhibition.
O que fazer
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.
O que perguntar ao farmacêutico
- 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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Referências
Outras interações de Clopidogrel
Outras interações de Esomeprazole
- Esomeprazole + Mavacamten Contraindicada
- Esomeprazole + Rilpivirine Contraindicada
- Acalabrutinib + Esomeprazole Grave
- Atazanavir + Esomeprazole Grave
- Citalopram + Esomeprazole Grave
- Dacomitinib + Esomeprazole Grave
Perguntas frequentes
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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