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Clopidogrel and omeprazole — GPhC CRA MCQ

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ModerateCardiovascular TherapeuticsClopidogrel and omeprazoleGPhC CRA

A 68-year-old woman is prescribed clopidogrel 75mg daily after a transient ischaemic attack. Her repeat prescription also includes omeprazole 20mg daily for reflux. She has ongoing dyspepsia needing acid suppression. What is the most important interaction to flag?

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Correct answer: D — Omeprazole may reduce clopidogrel activation and an alternative PPI should be considered

Omeprazole and esomeprazole can inhibit CYP2C19 and may reduce conversion of clopidogrel to its active metabolite. If gastroprotection is needed, another PPI such as lansoprazole is often preferred depending on local guidance. The issue is metabolic activation rather than simple gut binding.

Reference: https://www.pharmacyregulation.org/students-and-trainees/pharmacist-education-and-training/registration-assessment