Harvard Heart Letter

Stomach-protecting drug could block Plavix

An acid blocker or antacid may be a better choice for Plavix users.

Some drugs work together, complementing or backing up each other. Others compete or get in each other's way. Aspirin and clopidogrel (Plavix) make a good tag team, combining to prevent heart attacks and strokes. Add a proton-pump inhibitor (PPI) to the mix, though, and it may limit, or even knock out, the prevention provided by Plavix. That's a problem because millions of people take aspirin and Plavix, and many of them are urged to take a PPI to limit the stomach upset or gastrointestinal bleeding that aspirin and Plavix can cause. PPIs include omeprazole (Prilosec, Zegerid), lansoprazole (Prevacid), pantoprazole (Protonix), rabeprazole (Aciphex), and esomeprazole (Nexium), which are all available by prescription. A different version of omeprazole (Prilosec OTC) is sold without a prescription.

Plavix and aspirin are antiplatelet drugs. They make it difficult for the blood-cell fragments known as platelets to stick to each other, an early step in the formation of blood clots. Aspirin and Plavix are considered to be a must for anyone who has had an artery-opening stent implanted, and are also recommended for heart attack survivors.

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