Find Information About:

Drugs & Supplements

Get information and reviews on prescription drugs, over-the-counter medications, vitamins, and supplements. Search by name or medical condition.

Pill Identifier

Pill Identifier

Having trouble identifying your pills?

Enter the shape, color, or imprint of your prescription or OTC drug. Our pill identification tool will display pictures that you can compare to your pill.

Get Started

My Medicine

Save your medicine, check interactions, sign up for FDA alerts, create family profiles and more.

Get Started

WebMD Health Experts and Community

Talk to health experts and other people like you in WebMD's Communities. It's a safe forum where you can create or participate in support groups and discussions about health topics that interest you.

  • Second Opinion

    Second Opinion

    Read expert perspectives on popular health topics.

  • Community


    Connect with people like you, and get expert guidance on living a healthy life.

Got a health question? Get answers provided by leading organizations, doctors, and experts.

Get Answers

Sign up to receive WebMD's award-winning content delivered to your inbox.

Sign Up

Heart Disease Health Center

Font Size

Plavix, PPI Combo: Risky for Heart Patients?

Study Shows Risks of Combining Plavix and Proton Pump Inhibitors

PPIs Routinely Given With Plavix continued...

Taking Plavix with a PPI at any time during the follow-up was associated with a 25% increase in risk for death or hospitalization.

American Heart Association president Timothy Gardner, MD, tells WebMD that it is now clear that PPIs should be prescribed cautiously to heart patients taking Plavix.

"If a patient has a history of GI bleeding, we know that [Plavix] can increase the risk of recurrence," he says. "It may be that we need to limit the use of PPIs to these patients and other patients who have a clear need for protection."

Are All PPIs Equal?

Findings from a large Canadian trial, reported in late January, suggest that all PPIs are not equal when it comes to inhibiting the antiplatelet activity of Plavix.

The study included more than 13,000 heart attack patients treated with Plavix with or without a PPI.

Study researcher David N. Juurlink, MD, PhD, tells WebMD that although most PPIs did appear to interact with Plavix, one -- Protonix (pantoprazole, Wyeth Pharmaceuticals) -- showed no evidence of reducing the effectiveness of the antiplatelet drug.

Juurlink says he received no funding from Wyeth or any other drug company to conduct his research.

"Literally millions of people who are taking Plavix and aspirin are also taking a PPI," he says. "If a patient on Plavix requires a PPI, it would seem to make sense to preferentially give them pantoprazole."

In late January, the FDA announced that Plavix manufacturers Bristol-Myers Squibb and Sanofi-Aventis had agreed to conduct studies to clarify the impact of PPIs and other drugs on the effectiveness of Plavix in heart patients.

"Patients taking clopidogrel should consult with their healthcare provider if they are currently taking or considering taking a PPI, including Prilosec OTC," the statement noted.

Wyeth Pharmaceutical spokeswoman Gwen Fisher tells WebMD that the company is awaiting the results from these trials.

A spokesman for AstraZeneca, which makes Prilosec and Nexium, tells WebMD that rigorously designed, prospective studies are needed to determine if PPIs interact with Plavix.

"To date, there have been contradictory conclusions and scientific limitations in studies about the potential interaction between clopidogrel and PPIs," AstraZeneca spokesman Blair Hains says. "AstraZeneca believes that before definitive conclusions are drawn, more evidence involving thorough, well-designed, prospective clinical trials is needed."

Calls to Plavix manufacturer Bristol Myers Squibb were not returned by publishing time.

1 | 2

Today on WebMD

x-ray of human heart
A visual guide.
atrial fibrillation
Symptoms and causes.
heart rate graph
10 things to never do.
heart rate
Get the facts.
empty football helmet
red wine
eating blueberries
Simple Steps to Lower Cholesterol
Inside A Heart Attack
Omega 3 Sources
Salt Shockers
lowering blood pressure