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Clopidogrel and omeprazole — GPhC CRA MCQ

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HardDrug InteractionsClopidogrel and omeprazoleGPhC CRA

A 72-year-old man is discharged with omeprazole 20mg daily after a duodenal ulcer bleed. He also takes clopidogrel after a coronary stent. The GP asks whether the PPI choice matters. What is the most important interaction to flag?

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

Omeprazole and esomeprazole can inhibit CYP2C19, which is involved in conversion of clopidogrel to its active metabolite. In a patient needing gastroprotection, a less interacting PPI such as lansoprazole or pantoprazole is commonly considered. The concern is reduced antiplatelet effect rather than increased activation. The other options do not describe the clinically relevant interaction.

Reference: BNF; MHRA Drug Safety Update