The researchers concluded that the increased risk of a heart attack, stroke or death is associated with PPIs, and not the combination of Plavix and a PPI.
"We are confident that the feared interaction between the two drugs does not happen," Charlot said. "We believe that patients who have an indication for PPI treatment should definitely be treated with PPIs to avoid the risk of gastrointestinal bleeding," she added.
Dr. James Brophy, a professor of medicine and epidemiology at the Royal Victoria Hospital in Montreal, Canada, said this new research carries more weight than the earlier studies.
This study "appears to be of superior quality to several previous reports," said Brophy, author of an accompanying journal editorial. "There is not high quality evidence supporting a meaningful drug interaction between clopidogrel and PPIs," he said.
"While unnecessary drug prescribing is always to be avoided, the current evidence suggests that patients taking clopidogrel can take a PPI," Brophy said.
Additional studies would be helpful, Brophy added, "but in the interim, the dangers of bleeding from avoiding PPIs may well be greater than any cardiac risks from inhibiting clopidogrel."
For more information on the Plavix-PPI combo, visit the U.S. Food and Drug Administration.
SOURCES: Mette Charlot, M.D., department of cardiology, Copenhagen University Hospital Gentofte, Hellerup, Denmark; James Brophy, M.D., Ph.D., professor, medicine and epidemiology, Royal Victoria Hospital, Montreal; Sept. 21, 2010, Annals of Internal Medicine
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