Letters Clopidogrel

Authors’ reply

BMJ 2009; 338 doi: http://dx.doi.org/10.1136/bmj.b2006 (Published 20 May 2009) Cite this as: BMJ 2009;338:b2006
  1. Doson Chua, clinical pharmacotherapeutic specialist, cardiology1,
  2. Andrew Ignaszewski, head, division of cardiology1
  1. 1St Paul’s Hospital, Vancouver, BC, Canada V6Z 1Y6
  1. dchua{at}providencehealth.bc.ca

    In response to our correspondents,1 administration of a proton pump inhibitor with clopidogrel increases the risk of recurrent myocardial infarction and adverse cardiovascular outcomes, probably owing to inhibition of the cytochrome P450 2C19 pathway. Pantoprazole may be devoid of this interaction with clopidogrel on the basis of its lack of cytochrome P450 …

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