Clopidogrel + omeprazole — CYP2C19
- Clopidogrel needs CYP2C19 activation
- Omeprazole inhibits CYP2C19
- active-metabolite exposure ↓ ~40–50%
- Platelet inhibition is reduced
- Prefer pantoprazole if a PPI is needed
- Avoid omeprazole/esomeprazole if feasible
Interaction at a glance
- Omeprazole inhibits CYP2C19
- active-metabolite exposure ↓ ~40–50%
- Avoid omeprazole/esomeprazole if feasible
Magnitude / time course
- Clopidogrel needs CYP2C19 activation
- Omeprazole inhibits CYP2C19
- active-metabolite exposure ↓ ~40–50%
Management
- Platelet inhibition is reduced
Management / timing
- Prefer pantoprazole if a PPI is needed
- Avoid omeprazole/esomeprazole if feasible
Self-check
- In Clopidogrel + omeprazole, what is the approximate magnitude of the exposure change?
active-metabolite exposure ↓ ~40–50%
- What is preferred when managing Clopidogrel + omeprazole?
pantoprazole if a PPI is needed.
- What is the preferred management of Clopidogrel + omeprazole?
Avoid omeprazole/esomeprazole if feasible.
Drugs in this interaction (2)
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