Interaction with clopidogrel. Clopidogrel (Plavix) is a drug that discourages the formation of artery-clogging blood clots. But clopidogrel is hard on the lining of the stomach and intestines, so many doctors prescribe a PPI to be taken along with it. Two years ago, the FDA issued a strong warning that said some PPIs may cut clopidogrel’s effectiveness in half. However, two recent studies showed that those taking a PPI with clopidogrel had no increase in heart attack or stroke and did have substantially less risk for gastrointestinal bleeds.
Fracture risk. Some research shows that suppression of stomach acid could reduce the body’s ability to absorb calcium, which could lead to osteoporosis, weaker bones, and a greater chance of breaking a bone. The risk is probably pretty small, but it’s another reason to take PPIs only when necessary.
Pneumonia risk. Several studies have shown that people who take a PPI are more likely to catch pneumonia than those who don't take one.
The Harvard Health Letter notes that the PPI-clopidogrel interaction seems to be less important than once feared, but there are other reasons to be cautious about PPIs. All PPI prescriptions should be reviewed periodically by a doctor to be sure the drug is still needed to treat symptoms. And PPI prescriptions should always be for the lowest dose that’s effective. Read the full-length article: “Proton-pump inhibitors”
Also in this issue:
- The benefits of crying
- Soda and salt guidelines
- Health care cost control
- Creatine for muscle strength?
The Harvard Health Letter is available from Harvard Health Publications, the publishing division of Harvard Medical School, for $29 per year. Subscribe at www.health.harvard.edu/health or by calling 877-649-9457 (toll-free).
