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PPI and clopidogrel — GPhC CRA MCQ

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ModerateGastro-intestinal TherapeuticsPPI and clopidogrelGPhC CRA

A 66-year-old man taking clopidogrel after a TIA asks to buy omeprazole for reflux. He has no alarm symptoms and no prescription for gastroprotection. What is the most appropriate alternative?

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Correct answer: D — Consider a PPI with less CYP2C19 inhibition after assessing need

Omeprazole can inhibit CYP2C19, which is involved in clopidogrel activation. If acid suppression is needed, a PPI with less effect on CYP2C19 may be preferred depending on local guidance and the patient's risk factors. Clopidogrel should not be stopped without prescriber direction. Aspirin and NSAIDs are not reflux treatments and may increase bleeding risk.

Reference: BNF