藥物交互作用
Clopidogrel + Omeprazole
嚴重程度: 嚴重
Clopidogrel and Omeprazole: major interaction.
最後更新 來源: SPS (NHS), EMA SmPC, NCBI (US National Library of Medicine)
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摘要
Omeprazole inhibits CYP2C19, reducing clopidogrel’s bioactivation and antiplatelet effect, which may increase risk of thrombotic/cardiovascular events.
用白話說明這項交互作用的意義
Clopidogrel and Omeprazole 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; Omeprazole belongs to Gastrointestinal Tract.
為什麼會發生
CYP2C19 inhibition by omeprazole decreases formation of clopidogrel’s active metabolite → reduced platelet inhibition.
處置方式
Avoid coadministration. Use an alternative acid suppressant (e.g., pantoprazole) or consider a non–CYP2C19-dependent P2Y12 inhibitor when appropriate.
可向藥師詢問的問題
- 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?
參考資料
Omeprazole 的其他交互作用
Clopidogrel 的其他交互作用
常見問題
Can I take Clopidogrel with Omeprazole?
MediHelp rates the interaction as major. Clopidogrel and Omeprazole 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. 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?
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 coadministration. Use an alternative acid suppressant (e.g., pantoprazole) or consider a non–CYP2C19-dependent P2Y12 inhibitor when appropriate.
What other medicines interact with Omeprazole?
MediHelp also lists interactions of Omeprazole with, for example, Mavacamten, Rilpivirine, Acalabrutinib. The full list is on the Omeprazole page.
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