On Tuesday, November 18th, the FDA released a warning regarding the use of Prilosec and Prilosec OTC (generic omeprazole) while taking Plavix (generic clopidogrel). The warning came about after new research has shown that people who are taking Prilosec with Plavix do not get the full benefit of the anti-clotting of Plavix. This means that people who are put on Plavix for heart problems are not as protected by the Plavix as they think they are.
Why is this a problem?
In order for Plavix to work it needs to be changed into its active form which it does with the help of a liver enzyme. The necessary liver enzyme is blocked by Prilosec so the Plavix isn’t adequately changed this makes the Plavix less effective.
Can you take other PPIs?
There is a list of other anti-reflux and other medications that also block the necessary liver enzymes: Nexium, Tagamet & Tagamet HB, Diflucan, Nizoral, VFEND, Itelence, Felbatal, Prozac, Serafem, Symbyax, Luvox and Ticlid. This would also include the generic forms of these medications. The FDA does not know at this time if it is also a problem for other PPIs and at this time is recommending the use of other types of acid reducing medications if needed such as Zantac, Pepcid, Axid and anti-acids.
What should you do if you are taking a PPI and Plavix?
Make an appointment to see your doctor to discuss your options. Taking these medications together doesn’t increase your risk of a heart attack over those with similar heart problems who aren’t taking Plavix at all. Someone who is taking both is not getting the full benefit of the Plavix which means he is at a greater risk of a heart attack than someone who is taking Plavix and not taking a PPI or any of the other medicines.
Remember - It’s always important to let every doctor and pharmacist know all of the medications you are taking including your over the counter medications. Now that PPIs are available over the counter, your pharmacist may not know you are taking them when you pick up your Plavix prescription. Try to stick with one pharmacy so they can keep track of all of your medications and if you are on many, make sure to keep a list with you so that it can be reviewed by each doctor you see and by every pharmacist who gives you your medications.
You can read the FDA News Release at: