The FDA has added a warning to the clopidogrellabel, about the reduction in clinical efficacy of clopidogrel when used in combination with omeprazole. Although the clinical effects of this reduction in efficacy is unclear, the FDA has recommended to avoid the combination when possible (FDA letter). They also warn against the use of esomeprazole, but cites insufficient information to comment about using other PPIs in combination with clopidogrel. For now, omeprazole and esomeprozole should not be concomitantly adminitered with clopidogrel.
Dr. Scheurer is a clinical hospitalist and the Medical Director of Quality and Safety at the Medical University of South Carolina in Charleston, South Carolina, and is Assistant Professor of Medicine. She is a graduate of the University of Tennessee College of Medicine, completed her residency at Duke University, and completed her Masters in Clinical Research at the Medical University of South Carolina. She also serves as the Web Editor and Physician Advisor for the Society of Hospital Medicine.