The FDA has added a warning to the clopidogrellabel, about the reduction in clinical efficacy of clopidogrel when used in combination with omeprazole. Although the clinical effects of this reduction in efficacy is unclear, the FDA has recommended to avoid the combination when possible (FDA letter). They also warn against the use of esomeprazole, but cites insufficient information to comment about using other PPIs in combination with clopidogrel. For now, omeprazole and esomeprozole should not be concomitantly adminitered with clopidogrel.
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