Clopidogrel and Lansoprazole / Omeprazole -interaction.

[Pollyone]

HI

Just wanted to let anyone who is on a blood thinner to check they are on appropriate PPI medication. My GP, Consultant and Pharmacist all happy to prescribe the two mentioned at separate times for over 10 months.. I was having various reactions and changed from one to the other and looked into this only to discover that both negate Clopidogrel and are officially listed as having Major interaction. Having had a TIA and not wanting to experience another or a stroke the fact taking these PPI s negated the Clopidogrel (blood thinner) I found shocking that it took myself to raise the issue. I was immediately changed by a new pro active Pharmacist who I discussed it with. She immediately phoned my GP. If this helps one more person it’s worth posting. Some of these drugs may go by other names, especially for those overseas. In this day and age we have to be so vigilant re our health. I was initially put on double the steroid dose for PMR (30 mg) I should have been on 10 months ago. Unfortunately I didn’t know enough at the time to challenge this. Feel I am looking after my own condition alone most of the time so this website invaluable.

[PMRpro Ambassador]

Clopidogel is a particular type of blood thinner - called a platelet inhibitor.

However - if it is any consolation, you were probably fine!

mmrjournal.biomedcentral.co....

says

"In conclusion, the study results suggest that combination therapy with omeprazole or pantoprazole and clopidogrel does not restrict ADP-induced platelet aggregation. There was no apparent association between clinical events and clopidogrel-omeprazole or clopidogrel-pantoprazole combination in NSTE-ACS patients. "

And it is only omeprazole - other PPIs hadn't been implicated.

[Pollyone in reply to PMRpro]

Hi there

Probably jumped the gun naming Lanzaprole but the chemist did say the family of those drugs including particularly Omerprazole to be avoided. The data I found was on a formal medical site.. Didn’t want to be alarmist to others but I myself was ‘alarmed’ but luckily fine.

Part of the info synopsis - MANAGEMENT: Until further data are available, empiric use of proton pump inhibitors should preferably be avoided in patients treated with clopidogrel. PPIs should only be considered in high-risk patients such as those receiving dual antiplatelet therapy, those with a history of gastrointestinal bleeding or ulcers, and those receiving concomitant anticoagulant therapy, and then only after thorough assessment of risks versus benefits. If a PPI is required, dexlansoprazole, lansoprazole, or pantoprazole may be safer alternatives. Otherwise, H2-receptor antagonists or antacids should be prescribed whenever possible.

References

[PMRpro Ambassador in reply to Pollyone]

Now there I agree wholeheartedly - they are used far too much, though I suspect it is a UK thing. No-one makes a fuss about stomach protection here,

[Badger1966 in reply to PMRpro]

30mg Lansoprazole , been on this for 4 months, yea sorted out acid reflux, feels heavy on my feet lately, does this drug break down your muscles over time, more prone to bone fractures over time, because of being ex semi alcoholic, could this affect nerve system in body , muscles, and as on aspirin bone fractures,

Regards Badger

[PMRpro Ambassador in reply to Badger1966]

Don't think it affects muscles but the suppression of acid production can affect calcium absorption and if that is affected enough wouldn't help bones. Also it may impair vit B12 absorption so if that becomes a factor it could affect nerves so if you have a history your GP should check at intervals. Don't understand your mention of aspirin and bones?

[Badger1966 in reply to PMRpro]

You bruise easy on aspirin, so that why asked if could affect your bones , And no disrespect to GPs when have they got time this day and age , bring back the old fashion doctor who would look at your medical records, 👍

[PMRpro Ambassador in reply to Badger1966]

Just tell them you need a blood test to include B12 and bone panel.

Not much of a link between bruising and bones really.

[Badger1966 in reply to PMRpro]

👍

[WilfDog]

Hi Pollyone

So well done on doing your research. This is why I am so proactive in my own health. Omaprozole was prescribed to my mum for many years and she was on clopidogrel. I am convinced that omaprozole had huge long term negative effects on her digestive system.

I an fortunate that I have efficient consultants that look out for my welfare. That said I continue to be vigilant on self care. Not everyone is as lucky. Thanks for highlighting this important piece of information xx

[Freya32]

Hi Pollyone,I was given lansoprazole but don.t take it.

I have the preds after a yoghurt breakfast. So stomach nicely coated before the preds go down.

Thank you to member on here who advised Yoghurt.

I take clopidogrel, bisoprolol and ramipril in evening and amytryptyline before 8 pm.

Very little sleep for months.

Then a period of wonderful sleep. All night and half the day.

Now back to very little. Heart banging wakes me as does the cold.

Preds... been on them for two years next month which I have reduced to 5 mg.

Tried 4 mg but arthritic pain came back in full force.

BP always high at night and low in morning.

I need to drink more water.

But what is more water.

I do think one needs to go with what feels right for you.

I have little Tia s....too.

Lost balance, taste numeracy and writing....all came back eventually.

Weight balloned to 77k

Now 58...just another 8k to lose now.

Diet. No carbs. The hunger has gone but....

Oh the longing for hot buttered toast and damson jam...

Gut says please . Daughter says no.

I read Brazil nuts were good for you so I thought choc covered brazils would be twice as good.

Fatal . They are too more ish.

Cannot walk without support or alone. So exercise limited.

Get well soon.

Little by little does it.