OTTAWA – New evidence shows that a class of drugs used to treat heartburn and stomach ulcers can interact with Plavix, but not all of these drugs reduce the blood thinner’s effectiveness to the same degree, Health Canada said Thursday.
As a result, Health Canada has updated its recommendations for the use of Plavix combined with proton pump inhibitors.
Plavix, the brand name for clopidogrel, is a prescription blood thinner used to prevent blood clots that could lead to heart attack or stroke and is given to patients with a history of heart-related problems to prevent future events. PPIs are prescription antacids used to treat heartburn and stomach ulcers. Since heartburn and stomach ulcers can be side-effects of Plavix, patients taking Plavix may also be given a PPI to prevent or ease their symptoms.
In 2009, the labelling for Plavix was updated to indicate that the use of any PPI in patients taking Plavix should be discouraged, as emerging data suggested that PPIs potentially reduced the ability of Plavix to protect against blood clots.
But Health Canada reports new studies have shown that while PPIs do interact with Plavix, not all PPIs interact to the same degree. Some have a strong effect on Plavix, while others do not.
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Here are the new recommendations on the labelling for Plavix for use with PPIs:
– PPIs known to strongly or moderately reduce Plavix effectiveness should be avoided. Omeprazole is one of these.
– If a PPI must be used in a patient taking Plavix, consider a PPI that does not interact as strongly. Pantoprazole is one of these.
Patients taking Plavix should continue taking it as directed. If you are considering or are already taking a PPI, talk to your health professional regarding any questions or concerns about your treatment. There are alternatives to PPIs for the treatment of stomach ulcers and heartburn.
The following proton pump inhibitors are available in Canada: Dexlansoprazole (sold under the brand name Dexilant); Esomeprazole (sold under the brand name Nexium and its generic equivalent); Omeprazole (sold under the brand name Losec and its generic equivalents); Lansoprazole (sold under the brand name Prevacid and its generic equivalents); Pantoprazole (sold under the brand names Pantoloc and Panto IV, and their generic equivalents); Pantoprazole/magnesium (sold under the brand name Tecta); Rabeprazole (sold under the brand name Pariet and its generic equivalents).
PPIs are also available in combination with other drugs, for example: Vimovo (contains esomeprazole).
Side-effects to these or other health products can be reported to Health Canada’s Canada Vigilance Program by calling toll-free 1-866-234-2345 or via the Internet at http://www.healthcanada.gc.ca/medeffect.
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