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Clopidogrel and PPI choice — GPhC CRA MCQ

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ModerateCardiovascular TherapeuticsClopidogrel and PPI choiceGPhC CRA

A patient taking clopidogrel after a coronary stent asks for advice about reflux symptoms. Their GP has issued omeprazole 20 mg daily. The patient has no alarm symptoms. What is the most important interaction to flag?

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Correct answer: C — Query omeprazole and discuss a PPI with lower interaction potential

Omeprazole can reduce clopidogrel activation through CYP2C19 inhibition and should generally be avoided with clopidogrel where possible. An alternative such as lansoprazole or pantoprazole is often preferred depending on local guidance and patient factors. The pharmacist should not alter antiplatelet dosing or stop clopidogrel. NSAIDs may worsen reflux and increase bleeding risk.

Reference: BNF