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Clopidogrel and PPI selection — GPhC CRA MCQ

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ModerateGI TherapeuticsClopidogrel and PPI selectionGPhC CRA

A 63-year-old man taking clopidogrel after a TIA asks to buy omeprazole for frequent reflux. He has no alarm symptoms and also takes atorvastatin. What is the most appropriate alternative?

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

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Correct answer: E — Use lansoprazole or another suitable option rather than omeprazole

Omeprazole and esomeprazole can reduce activation of clopidogrel through CYP2C19 inhibition. If a PPI is needed, another PPI such as lansoprazole is commonly preferred. Stopping antiplatelet therapy for reflux would expose the patient to avoidable vascular risk.

Reference: BNF; SPS