Three major medical societies have collaborated to issue recommendations providing guidance on when proton pump inhibitors and clopidogrel can be prescribed.
The American College of Cardiology, the American College of Gastroenterology, and the American Heart Association have issued consensus recommendations on when physicians should prescribe proton pump inhibitors (PPIs) in addition to clopidogrel. According to an article published in the Journal of the American College of Cardiology, the societies recommend the use of both therapies in high-risk patients, defined as those with a history of upper GI bleeding; those who are elderly or have Helicobacter pylori infections; or those on steroids, warfarin or NSAIDs.
In a previous document, use of PPI was recommended in patients with risk factors for upper GI bleeding treated with dual antiplatelet therapy. Since its publication, evidence of a potential adverse drug interaction between PPIs and thienopyridines has emerged. However, “it has been difficult for practitioners to assimilate this flood of information and to develop optimal treatment strategies for managing patients who might benefit from antiplatelet therapy, yet who might suffer from GI bleeding.”
The goal of the new report is to provide provisional guidance for clinical management, and highlight areas of future research necessary to address current knowledge gaps, the authors wrote.
Key findings from the recommendations are as follows:
To read the recommendations, click here.