Double the dose of clopidogrel or switch to prasugrel to antagonize proton pump inhibitor interaction

Background: The potential negative metabolic interaction between proton pump inhibitors (PPI) and clopidogrel is of particular concern. We have hypothesized that doubling the maintenance dose (MD) of clopidogrel (150mg, double) was less effective than switching to prasugrel 10mg MD (switch) to attenuate this potential negative interaction. Methods: In a prospective randomized placebo-controlled double blind study, we assigned 82 stable coronary artery disease patients treated with 75 mg clopidogrel MD dose and aspirin to receive lanzoprazole (30mg/day) or placebo in addition to either clopidogrel double MD (150 mg/jour) or standard prasugrel MD (10 mg/jour). The primary endpoint was the relative change in residual platelet reactivity (RPA, assessed by light transmission aggregometry, 20

Epistemonikos ID: 50046063ec017c015ce14d3f8deb4d4e8a6332e3
First added on: Feb 05, 2025