skip to main content

Omeprazole clopidogrel OTC — GPhC CRA MCQ

Instant feedback + full explanation. One question, done properly.

HardGastro-intestinal TherapeuticsOmeprazole clopidogrel OTCGPhC CRA

Omeprazole is added to treatment for a patient taking clopidogrel. Which pharmacokinetic change most directly explains the clinically important interaction?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — Reduced CYP2C19 conversion of clopidogrel to its active metabolite

Clopidogrel is a prodrug that requires CYP2C19-mediated activation. Omeprazole inhibits CYP2C19 and can therefore reduce plasma exposure to activated clopidogrel. This is why SPS advises avoiding omeprazole and esomeprazole with clopidogrel and choosing another PPI when gastroprotection is required. Dose separation does not correct persistent enzyme inhibition.

Reference: NHS SPS, Using clopidogrel with proton pump inhibitors: https://sps.nhs.uk/articles/using-clopidogrel-with-proton-pump-inhibitors-ppis/