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January
28,
2009 -- 10:25am EST
Plavix Safety Update
Monday's
post about the FDA
statement on the safety of Plavix (clopidogrel) when used in conjunction
with proton
pump
inhibitors (PPI) such as Prilosec, Prevacid, Protonix, Nexium,
etc., made reference to a joint statement by the American College
of Cardiology Foundation, American Heart Association and the American
College of Gastroenterology.
So here is a link to the paper, titled: "ACCF/ACG/AHA
2008 Expert Consensus Document on Reducing the Gastrointestinal
Risks of Antiplatelet Therapy and NSAID Use".
The summary states:
In appropriate patients oral antiplatelet
therapy decreases ischemic risks, but this therapy may increase
bleeding complications. Of the major bleeding that occurs,
the largest proportion is due to GI hemorrhage. Concomitant
use of NSAIDs further raises the risk of GI bleeding. Gastroprotection
strategies consist of use of PPIs in patients at high risk
of GI bleeding and eradication of H. pylori in patients with
a history of ulcers. Communication between cardiologists, gastroenterologists,
and primary care physicians is critical to weigh the ischemic
and bleeding risks in an individual patient who needs antiplatelet
therapy but who is at risk for or develops significant GI bleeding.
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