Heart patients who took a stomach acid-suppressing proton-pump inhibitor along with clopidogrel - a drug that prevents blood clots - were only half as likely to be hospitalized for upper digestive tract bleeding than those who used clopidogrel alone, according to a new study supported by HHS' Agency for Healthcare Research and Quality and the National Heart, Lung, and Blood Institute at the National Institutes of Health.
The study also suggested that combining the drugs did not increase the risk of serious heart problems. Clopidogrel (sold as Plavix, Clopilet, and Ceruvin) is usually prescribed for heart patients to reduce the risk of a heart attack or stroke and can also cause bleeding stomach ulcers. Proton-pump inhibitors, which include pantoprazole (Protonix), omeprazole (Prilosec), lansoprazole (Prevacid), esomeprazole (Nexium) and rabeprazole (Aciphex), are used to prevent or treat ulcers, acid reflux disease and other stomach acid-related problems.
Although proton-pump inhibitors are commonly prescribed with clopidogrel to reduce the risk of upper digestive tract bleeding, clinicians worry that this practice may decrease the antiplatelet drug's ability to prevent blood clots. Until now, there has been limited research on the impact of proton-pump inhibitors on either the effectiveness of clopidogrel or on the ability of the proton-pump inhibitors to reduce digestive tract bleeding and which populations of patients may benefit the most from taking the drugs in combination.
"We need to make sure that the medicines we give patients help and don't harm" said AHRQ Director Carolyn M. Clancy, M.D. "This evidence on benefits and risks helps inform the combined use of these two drugs."