Antiplatelet drug interactions with proton pump inhibitors

Antiplatelet agents and proton pump inhibitors – personalizing treatment

INTRODUCTION Antiplatelet therapy remains one of the cornerstones in the management of non-cardioembolic ischemic stroke. However, a significant percentage of patients have concomitant gastroesophageal reflux or peptic ulcer disease that requires acid-reducing medications, the most powerful and effective being the proton pump inhibitors (PPIs). Antiplatelet efficacy, at least in vivo, and parti...

Interaction of proton pump inhibitors with cytochromes P450: consequences for drug interactions.

Omeprazole, lansoprazole and pantoprazole are metabolized by several human cytochromes P450, most prominently by CYP2C19 and CYP3A4. Only pantoprazole is also metabolized by a sulfotransferase. Differences in the quantitative contribution of these enzymes and in the relative affinities of the substrates explain some of the observed interactions with carbamazepin, diazepam, phenytoin and theophy...

Proton Pump Inhibitors: Omeprazole

Oral Proton Pump Inhibitors

There is currently a lack of evidence to suggest superior clinical efficacy of one oral proton pump inhibitor over any other. Proton pump inhibitors display similar doseresponse relationships with similar potencies and efficacies at the equivalent dose. The decision to select one proton pump inhibitor over another is likely to be based on the agents’ licensed indication, patient tolerability an...

Intravenous proton pump inhibitors.

Intravenous (IV) administration of a proton pump inhibitor (PPI) is a faster way to achieve gastric acid suppression than oral administration of the same agent. Peak suppression after IV administration occurs within hours, compared with several days later after oral administration. Thus the IV route of administration offers a faster onset of gastric suppression, achievement of intragastric pH c...