A lot of my customers are on Omeprazole (commonly used for heartburn) and Clopidogrel (for stroke and heart attack prevention), this combination gives me heartburn every time I see it (no pun intended). Clopidogrel is often prescribed without respect to Omeprazole because “the patient has been on Omeprazole for ages” and providers often leave staple drugs on.
I’m sure you’re thinking “one stops the blood from clotting while the other treats heartburn, what’s the connection here?” Well, Clopidogrel is used for heart attack and stroke prevention. It is also a prodrug that is mainly metabolized by CYP2C19 into an active metabolite that allows the drug to stop blood from clotting together. Omeprazole stops this enzyme from working and can greatly reduce well Clopidogrel can do its job. 1This means that it may be unable to prevent another stroke or heart attack from occurring when used with Omeprazole!2
So What Do you Do with this Informaiton?
Speak to your doctor about alternative heart burn drugs for safe use in clopidogrel. Make sure they substitute Omeprazole with an alternative therapy right away. Just removing Omeprazole with no other alternative can result in rebound GERD, which often comes with worse symptoms than before.
Share your story in the comments below or reach out to your local healthcare advocate.
- Howden CW. Clinical pharmacology of omeprazole. Clin Pharmacokinet. 1991 Jan;20(1):38-49. doi: 10.2165/00003088-199120010-00003. PMID: 2029801 ↩︎
- McTavish, D., Buckley, M. M., & Heel, R. C. (1991). Omeprazole. An updated review of its pharmacology and therapeutic use in acid-related disorders. Drugs, 42(1), 138–170. https://doi.org/10.2165/00003495-199142010-00008 ↩︎
As Told By a Pharmacist 
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