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Clopidogrel PPI choice — GPhC CRA MCQ

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EasyCardiovascular TherapeuticsClopidogrel PPI choiceGPhC CRA

A 71-year-old patient on clopidogrel after ischaemic stroke has dyspepsia requiring a PPI. The GP asks which PPI would be preferred because omeprazole is on repeat from a previous prescription. What is the most appropriate alternative?

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Correct answer: B — Lansoprazole

Omeprazole and esomeprazole can reduce clopidogrel activation through CYP2C19 inhibition. Lansoprazole is commonly used when a PPI is needed with clopidogrel. Cimetidine has interaction potential and ranitidine is not routinely available in UK practice.

Reference: BNF; MHRA Drug Safety Update