Article information
Objetivo
realizar una revisión estructurada de la interacción clopidogrel y omeprazol, establecer su relevancia clínica y generar recomendaciones prácticas respecto al tema.
Métodorevisión estructurada en PubMed/MedLine de trabajos publicados en los últimos diez años, utilizando como estrategia clopidogrel AND omeprazole. La información se agrupó y complementó acorde con el método utilizado para la cuantificación del efecto y con la determinación de un posible efecto de clase.
Resultadosla búsqueda generó 35 artículos, de ellos se incluyeron 18 (cinco valoraron la interacción in-vitro, seis la interacción in-vivo y diez la interacción como un efecto de clase). Siete estudios reportaron pérdida del efecto antiagregante, mientras que tres no encontraron una alteración relevante del mismo.
Conclusionesla evidencia de la relevancia clínica de la interacción clopidogrel y omeprazol no es concluyente. Se recomienda seguir las indicaciones de las agencias regulatorias y, en algunos casos, sustituir omeprazol por pantoprazol.
Palabras clave:
antiagregación plaquetaria
clopidogrel
interacción medicamentosa
omeprazol
Objective
to perform a structured review of the clopidogrel and omeprazole interaction, establish its clinical relevance and generate practical recommendations on the subject.
Methoda structured review on PubMedLine of studies published in the last ten years, using clopidogrel AND omeprazole as strategy. The information was grouped and complemented according to the method used to quantify the effect and with the determination of a possible class effect.
Resultsthe search generated 35 articles, of which 18 were included (five assessed the in-vitro interaction, six the in-vivo interaction and ten analyzed the interaction as a class effect). Seven studies reported loss of the platelet anti-aggregation effect, while three found no significant alteration of the effect.
Conclusionsthe evidence of the clinical relevance of clopidogrel and omeprazole interaction is nor conclusive. It is recommended to follow the regulatory agencies indications, and in some cases replace omeprazole for pantoprazole.
Keywords:
platelet anti-aggregation
clopidogrel
drug interaction
omeprazole
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