Clopidogrel-drug interactions not clinically relevant

DESPITE many studies questioning clopidogrel safety, there is no consistent evidence interactions between clopidogrel and other drugs have any clinical significance, experts say.

US researchers summarised the literature on clopidogrel-drug interactions, focusing particularly on those with statins and proton pump inhibitors (PPIs), which have been shown to competitively inhibit hepatic cytochrome P450 activation of clopidogrel.

“Statins and PPIs have been shown to decrease adverse clinical event rates and should not be withheld from patients with appropriate indications… because of concern about potential clopidogrel-drug interactions,” they concluded.

Professor Ric Day, professor of clinical pharmacology at the University of NSW, said the variable results led to uncertainty about the clinical importance of the drug interactions, which “strengthens the case to just get on with using the right drug therapy for these people

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