Clopidogrel

Green-G

Brand Name(s):Plavix, Grepid

Indication:Atherosclerotic events (Prevention)

Rationale:

Considered:Apr-07

Review Date:Apr-22

Comments:
MHRA Drug Safety Update -risk of acquired haemophilia, information at:http://www.mhra.gov.uk/Safetyinformation/DrugSafetyUpdate/CON350671
December 2013
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* Concomitant use of clopidogrel and omeprazole or esomeprazole is to be discouraged unless considered essential
* Doctors should check whether patients who are taking clopidogrel are also buying over-the-counter omeprazole and consider whether other gastrointestinal therapies would be more suitable
* Pharmacists should check whether patients buying omeprazole are also taking clopidogrel
* Consider PPIs other than omeprazole or esomeprazole in patients who are taking clopidogrel. Other gastrointestinal therapy such as H2 blockers (except cimetidine) or antacids may be more suitable in some patients
* Discourage concomitant use of other known CYP2C19-inhibiting medicines with clopidogrel because these are expected to have a similar effect to omeprazole and esomeprazole (CYP2C19 inhibitors include fluvoxamine, fluoxetine, moclobemide, voriconazole, fluconazole, ticlopidine, ciprofloxacin, cimetidine, carbamazepine, oxcarbazepine, and chloramphenicol)
MHRA Drug Safety Update Volume 3 Issue 9 April 2010