skip to main content

Clopidogrel and PPI selection — GPhC CRA MCQ

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

HardCardiovascular TherapeuticsClopidogrel and PPI selectionGPhC CRA

A 70-year-old man takes clopidogrel 75mg once daily after a TIA and needs gastroprotection because of previous peptic ulcer bleeding. A new prescription requests omeprazole 20mg daily. He has tolerated PPIs before and has no liver impairment. What is the most appropriate alternative?

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

Reveal the answer and explanation

Correct answer: B — Pantoprazole 20mg once daily

Omeprazole and esomeprazole can reduce activation of clopidogrel through CYP2C19 inhibition. Pantoprazole is generally preferred where a PPI is needed with clopidogrel. Cimetidine has its own interaction burden and ranitidine is not a suitable routine option. The need for gastroprotection remains valid because of the previous bleeding history.

Reference: https://www.pharmacyregulation.org/students-and-trainees/pharmacist-education-and-training/registration-assessment