Description

Omeprazole reduces the antiplatelet efficacy of clopidogrel by inhibiting its bioactivation via CYP2C19, potentially increasing thrombotic risk.

Mécanisme

Clopidogrel requires CYP2C19-mediated hepatic activation to form its active thiol metabolite; omeprazole inhibits CYP2C19, reducing active metabolite formation and platelet inhibition.

Signification clinique

Platelet inhibition decreases by ~30–47%; clinical outcomes data are mixed, but the FDA and EMA have issued communications warning about this interaction.

Prise en charge

Prefer pantoprazole (weaker CYP2C19 inhibition) over omeprazole when a PPI is needed with clopidogrel. Avoid omeprazole or esomeprazole if possible.

Avertissement médical

This content is for educational and informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider before making medication decisions.

Data sources: ChEMBL, PubChem, DailyMed.