Plavix Users Should Avoid Heartburn DrugsMay 7, 2009 | Parker Waichman LLP
Plavix (clopidogrel) users are being warned by a group of heart experts to avoid some common heartburn drugs. HealthDay News is saying that patients taking the clot-preventing Plavix following stent implantation should stay away from PPIs, or proton pump inhibitors. Stents are implanted in artery-opening cardiac surgeries and PPIs, said HealthDay News, include drugs such as Nexium, Prevacid, and Prilosec.
According to the experts at the Society for Cardiovascular Angiography and Interventions (SCAI), the PPI-Plavix combination increases a patient’s risk for heart attack, stroke, and other cardiovascular problems, reported HealthDay News. The SCAI cited one study in which the PPI-Plavix combination was linked to significant increases: 70 percent for heart attack, 48 percent for stroke, and 35 percent for repeat heart procedures, said HealthDay News.
The SCAI said in a statement released at its annual meeting, "given the thousands of patients who receive stents each year, coupled with significant risks demonstrated in this study, SCAI recommends the use of alternative medications for gastrointestinal symptoms in patients with stents when appropriate," quoted HealthDay News. The group noted that additional research is called for and also pointed out that this recommendation refers to the older PPIs—Protonix, Nexium, Prilosec, and Prevacid—not the newer PPIs—Aciphex and Kapidex, said HealthDay News.
Data on nearly 17,000 Plavix users—who took the drug for over one year following stent implantation—were analyzed, said HealthDay News, citing Eric J. Stanek, senior director of research at drug distributor Medco Health Solutions. The team found that the incidence of cardiovascular events was 51 percent greater in patients taking the Plavix-PPI combination over those on Plavix alone, said Stanek, according to HealthDay News. "Considering all the available evidence, PPI use should be limited in patients taking clopidogrel, based on the physician's judgment," Stanek said.
PPIs are often prescribed to Plavix patients to minimize gastric effects such as nausea and heartburn. Since Plavix and PPIs are metabolized by the same liver enzyme, a PPI can reduce Plavix’s benefits, explained HealthDay News. Also, early studies linked the PPI-Plavix combination to increased cardiac risk and the U.S. Food and Drug Administration (FDA) issued an alert on this recently, said HealthDay News.
In past reports, we have discussed PPIs such as Prilosec and Nexium and that the FDA had investigated a suspected link between cardiac trouble and PPIs. Also, because such drugs may be overly effective at stopping stomach acid production, they have also been know to raise pneumonia, bone loss, and fracture risk; this, by over 40 percent in patients on long-term use.
A Canadian study of PPIs such as Aciphex, Nexium, Prevacid, Prilosec, and Protonix and osteoporosis-related fractures revealed a link between long-term PPI use and the increased risk for such fractures of the hip, wrist, or spine. It remains unclear how PPIs might increase fracture risk, but some experts believe it may be related to the medications’ stomach acid inhibiting qualities.