Prilosec Side Effects Interfere with Effectiveness of Plavix: FDA Warns

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The FDA has issued a public health advisory warning that side effects of Prilosec, a stomach acid reducer, may interfere with the effectiveness of Plavix, an anti-blood clotting medication, increasing the risk of a heart attack, death or other injuries for patients.

The advisory was released on November 17 after an FDA review of the effects of combining Prilosec and Plavix found that use of the drugs together reduces the effects of Plavix by about 50%. Therefore, the regulatory agency is requiring new warnings on the label for Plavix, Prilosec and other heartburn drugs that work the same way by inhibiting the CYP2C19 enzyme, which could interact with Plavix.

The announcement comes on the heels of a study presented at an annual meeting of the American Heart Association that found heart patients given medications known as proton pump inhibitors (PPIs), like Prilosec and Protonix, were more likely to die after heart surgery. The study, conducted by researchers at Mount Sinai Medical Center in New York, found that the risk of death for heart surgery patients on Prilosec was 30% higher than for other patients.

Plavix (clopidogrel) is a blood thinner that prevents blood platelets from sticking together to form clots. It is prescribed to prevent heart attacks, strokes and blood clotting when drug coated stents are used in patients with arteriosclerosis and in other at-risk patients. It is a blockbuster medication, generating annual sales of over $6 billion for Bristol Myers Squibb Co. and Sanofi-Aventis.

Prilosec (omeprazole) is a proton pump inhibitor used to reduce stomach acid, which is manufactured by AstraZeneca and available as a generic.

Prilosec and other stomach acid drugs are often prescribed along with Plavix, to combat upset stomachs caused by gastrointestinal bleeding, a common Plavix side effect. The FDA indicates that Prilosec may actually inhibit the drug metabolizing enzyme in the body that normally would convert Plavix into its active form, which reduces its effectiveness, putting patients at risk of heart attack and stroke.

The FDA began its review of the drug interactions in January. In March, a study published in the Journal of the American Medical Association found that patients were 25% more likely to be readmitted to the hospital or die if they were also taking a proton pump inhibitor with Plavix.

The FDA is warning health care professionals not to prescribe Plavix and Prilosec together, and is also warning patients not to take the over-the-counter version of Prilosec or similar drugs to fight upset stomachs that occur while on Plavix. The FDA also suspects that Nexium, also manufactured by AstraZeneca, will have the same reduction of Plavix effectiveness. Other drugs which may inhibit Plavix include Tagamet and Tagamet HB, Diflucan, Nizoral, VFEND, Intelence, Felbatol, Prozac, Serafem, Symbyax, Luvox and Ticlid.

The FDA recommends that patients who are taking Plavix can use antacids and acid-reducers known as H2 blockers to combat Plavix side effects. The agency believes that taking Zantac, Pepcid, Axid, Mylanta and Maalox are safe alternatives.

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  1. A. T. Reply

    My mother is 69 yrs old, suffer a heart attack in 2000, and she’s been plavix since. Dr. said she’s not to stop taking it every.? In 2003 she had suffer a mild stroke. over the years the Dr. saying her bloods low, aneamic. Put her on iron pills, make to digestive track stubborn & constipated. SHe has acid reflux attacks often. She occasionally passes out, with no warning. And my dad has to shake her to bring her around. she’s always cold. This plavix has thinned her blood so much, that she cold all the time.
    Her last ekg was 3 yrs ago, then dr. said heart was healthy. She justed stopped taking the iron presc on 1/26/10, because dr. says no more blood in her gastro trac. (hhmm?)
    I want to see her off the plavix, period! and she scared she’s goig to have another heart attack if she does. I don’t know…any thoughts.

  2. LAURIE Reply

    April 2009 I had a heart attack and had 2 stints put in. They started me on Plavix. For the past year I have had heartburn and took Prilosec OTC. July 2010 I had another heart attack and 2 additional stints put in and one of those was put in between the first two. I was told to quit taking Prilosec OTC, I had quit taking it about end of April 2010 after seeng the commercials regarding this problem with the two products interaction. To late

  3. Al Reply

    I had a heart attack in June 2007 that required the implanting of two stents. I was on Mobic for pain after 6 knee surgies due to an injury and staff infection, but was not removed from it by the cardiologist that implanted the stents. The results was anemia and ulcers and more surgery in October 2007. I was put on Prilosec OTC then along with the Plavix. I had another heart situation in February 2008 which required the implanting of 2 more stents. All of my stents are drug eluting stents. However in July 2010 I had to have one of the newer stents replaced due to restenosis. I was never removed from the Prilosec OTC until this past week when my doctor realized that it may have caused the restenosis. Still having problems, and stuck with a $50,000.00 hospital bill.

  4. overthemountain2 Reply

    My husband had two stints put in a couple of yrs ago
    and was put on plavix. When he started having stomach
    problems and acid reflux they added prilosec.
    It has been almost 1 year now and he is having
    problems with his memory, coordination, getting
    numbers backwards. It is like he does’nt have prope
    clarity. Has any one else experienced anything like this?

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