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[Proton pump inhibitors when using clopidogrel: balance between necessity and disadvantages].
- Source :
-
Nederlands tijdschrift voor geneeskunde [Ned Tijdschr Geneeskd] 2019 May 24; Vol. 163. Date of Electronic Publication: 2019 May 24. - Publication Year :
- 2019
-
Abstract
- Rationale When patients are using carbasalate calcium or acetylsalicylic acid (ASA), it is recommended to prescribe a proton pump inhibitor (PPI) in order to prevent gastrointestinal (GI) bleeding. Should this recommendation also be followed for patients who are using clopidogrel in monotherapy, which is increasingly the case in practice? Method In a systematic literature review of the occurrence of GI bleeding when using clopidogrel versus ASA, we included 9 studies that compared the risk of GI bleeding when using ASA with clopidogrel monotherapy. Results These 9 studies on clopidogrel and ASA show that the risk of GI bleeding is also elevated when using clopidogrel monotherapy and that it is comparable with the risk of GI bleeding when using ASA. Conclusion Based on the current literature, we recommend prescribing pantoprazole to patients who are using clopidogrel monotherapy and have additional risk factors for GI bleeding, in accordance with the procedure for low-dose ASA. The risk of GI bleeding must be weighed against the disadvantages of using PPIs.
- Subjects :
- Aspirin adverse effects
Clopidogrel administration & dosage
Drug Interactions
Female
Gastrointestinal Diseases
Gastrointestinal Hemorrhage chemically induced
Humans
Male
Peptic Ulcer chemically induced
Platelet Aggregation Inhibitors adverse effects
Proton Pump Inhibitors administration & dosage
Risk Factors
Clopidogrel adverse effects
Gastrointestinal Hemorrhage prevention & control
Peptic Ulcer prevention & control
Proton Pump Inhibitors adverse effects
Subjects
Details
- Language :
- Dutch; Flemish
- ISSN :
- 1876-8784
- Volume :
- 163
- Database :
- MEDLINE
- Journal :
- Nederlands tijdschrift voor geneeskunde
- Publication Type :
- Academic Journal
- Accession number :
- 31166094