ReviewExpert opinion on drug metabolism & toxicology2014
Antiplatelet drug interactions with proton pump inhibitors.
Review in Expert opinion on drug metabolism & toxicology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
23 citing papers in PubMed, 2 syntheses or guidelines pooled it, 53 citations in OpenAlex.
- Gastroprotection in Heart Failure and Outcomes: A Systematic Review of Proton Pump Inhibitors and Histamine-2 Receptor Antagonists.Cardiovascular drugs and therapy · 2026Pooled it
- A network meta-analysis: evaluating the efficacy and safety of concurrent proton pump inhibitors and clopidogrel therapy in post-PCI patients.Frontiers in cardiovascular medicine · 2024Pooled it
- Variability of platelet response to clopidogrel is not related to adverse cardiovascular events in patients with stable coronary artery disease undergoing percutaneous coronary intervention.European journal of clinical pharmacology · 2017Trial
- Vietnam Association of Gastroenterology (VNAGE) guideline on the management of gastroesophageal reflux disease.Frontiers in medicine · 2026Review
- Endobronchial biopsies in patients receiving clopidogrel and aspirin treatment.BMC pulmonary medicine · 2025Article
- Pharmacodynamics, pharmacokinetics, interactions with other drugs, toxicity and clinical effectiveness of proton pump inhibitors.Frontiers in pharmacology · 2025Review
- Short-term usage of proton pump inhibitors during admission was associated with increased risk of rehospitalization in critically ill patients with myocardial infarction: a cohort study.European journal of clinical pharmacology · 2024Article
- Management of potentially inappropriate medication use among older adult's patients in primary care settings: description of an interventional prospective non-randomized study.BMC primary care · 2024Article
- Impact of CYP2C19 metabolizer status on esophageal mucosal inflammation, acid exposure, and motility among patients on chronic proton-pump inhibitor therapy with refractory symptoms of gastroesophageal reflux disease.Journal of the Canadian Association of Gastroenterology · 2024Article
- Helicobacter pylori Eradication Treatment in Older Patients.Drugs & aging · 2024Review
- Antacid Therapy in Coronary Artery Disease and Heart Failure: Proton Pump Inhibitors vs. HCardiovascular drugs and therapy · 2024Review
- Proton pump inhibitors and gastroprotection in patients treated with antithrombotic drugs: A cardiologic point of view.World journal of cardiology · 2023Review
- Antiplatelet Resistance: A Review of Concepts, Mechanisms, and Implications for Management in Acute Ischemic Stroke and Transient Ischemic Attack.Stroke (Hoboken, N.J.) · 2023Review
- ComprehensiveFrontiers in pharmacology · 2023Article
- 2020 Asian Pacific Society of Cardiology Consensus Recommendations on the Use of P2YEuropean cardiology · 2021Review
- Risk of Adverse Cardiovascular Events Following a Myocardial Infarction in Patients Receiving Combined Clopidogrel and Proton Pump Inhibitor Treatment: A Nested Case-Control Study.Drugs - real world outcomes · 2020Article
- Trends in concomitant clopidogrel and proton pump inhibitor treatment among ACS inpatients, 2000-2016.European journal of clinical pharmacology · 2019Article
- Antiplatelet treatment in acute coronary syndrome patients: Real-world data from the START-Antiplatelet Italian Registry.PloS one · 2019Observational
- The use of proton pump inhibitors among older adults with intellectual disability: A cross sectional observational study.Saudi pharmaceutical journal : SPJ : the official publication of the Saudi Pharmaceutical Society · 2018Article
- Adherence with regulatory resolutions on prevention of NSAIDS-related gastrointestinal injury in Italy.International journal of clinical pharmacy · 2016Observational
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 3 institutions in 2 countries.
Funding
Abstract
introductionNon-aspirin antiplatelet agents (e.g., clopidogrel, prasugrel, ticagrelor) are commonly prescribed for the prevention of recurrent cardiovascular events among patients with acute coronary syndromes (ACS) and/or those undergoing percutaneous coronary intervention (PCI). In addition, combination therapy with proton pump inhibitors (PPIs) is often recommended to attenuate gastrointestinal bleeding risk, particularly during dual antiplatelet therapy (DAPT) with clopidogrel and aspirin. Importantly, a pharmacological interaction between clopidogrel and some PPIs has been proposed based on mutual CYP450-dependent metabolism, but available evidence is inconsistent. AREAS COVERED: This article provides an overview of the currently approved antiplatelet agents and PPIs, including their metabolic pathways. Additionally, the CYP450 isoenzyme at the center of the drug interaction, CYP2C19, is described in detail, and the available evidence on both the potential pharmacological interaction and influence on clinical outcomes are summarized and evaluated. EXPERT OPINION: Although concomitant DAPT and PPI use reduces clopidogrel active metabolite levels and ex vivo-measured platelet inhibition, the influence of the drug interaction on clinical outcomes has been conflicting and largely reported from non-randomized observational studies. Despite this inconsistency, a clinically important interaction cannot be definitively excluded, particularly among patient subgroups with higher overall cardiovascular risk and potentially among CYP2C19 loss-of-function allele carriers.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.