PPI with clopidogrel — GPhC CRA MCQ

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ModerateCardiovascular TherapeuticsPPI with clopidogrelGPhC CRA

A patient taking clopidogrel after a TIA needs a proton pump inhibitor for dyspepsia. The GP asks which PPI is preferred. What is the most appropriate alternative?

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Correct answer: A — Lansoprazole

Omeprazole and esomeprazole can reduce activation of clopidogrel through CYP2C19 inhibition and are generally avoided with clopidogrel. Lansoprazole is commonly used where gastroprotection is needed with clopidogrel. Cimetidine has multiple interaction concerns and ranitidine is not routinely available in UK practice. The choice should also consider symptom severity and patient risk factors.

Reference: https://www.pharmacyregulation.org/registration-assessment#stage-8-order-64