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Clopidogrel-omeprazole interaction — GPhC CRA MCQ

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ModerateDrug InteractionsClopidogrel-omeprazole interactionGPhC CRA

A 67-year-old man is collecting his repeat prescription for clopidogrel 75 mg daily. He mentions he has started buying omeprazole 20 mg capsules over the counter for heartburn. What is the most appropriate advice?

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Correct answer: A — Advise him to see his GP to discuss an alternative to omeprazole, as it may reduce the effect of clopidogrel

Omeprazole inhibits CYP2C19, which is involved in the bioactivation of clopidogrel. This interaction can reduce the antiplatelet effect of clopidogrel. The MHRA advises that omeprazole and esomeprazole should be avoided in patients taking clopidogrel. Alternative PPIs with less CYP2C19 inhibition, such as lansoprazole or pantoprazole, may be considered, but this should be discussed with the GP to ensure appropriate management.

Reference: BNF Drug Interactions; MHRA Drug Safety Update