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Clopidogrel and omeprazole — GPhC CRA MCQ

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HardCardiovascular TherapeuticsClopidogrel and omeprazoleGPhC CRA

A 55-year-old woman takes omeprazole 20mg daily and clopidogrel 75mg daily after a recent NSTEMI. Her GP asks whether continuing omeprazole is acceptable because she has recurrent dyspepsia. She has no history of GI bleeding. What is the most important interaction to flag?

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Correct answer: EOmeprazole may reduce activation and antiplatelet effect of clopidogrel

Omeprazole can inhibit CYP2C19 and may reduce conversion of clopidogrel to its active metabolite. If gastroprotection is needed, an alternative PPI with lower interaction concern is usually preferred. The recent ACS history makes antiplatelet effectiveness clinically important.

Reference: BNF; NICE CKS