The Food and Drug Administration last year warned patients who are taking the anti-clotting drug Plavix against taking the acid-reducing medications Prilosec or Nexium with it because either of the proton pump inhibitors could reduce Plavix's efficacy, but a new consensus document issued Monday by three medical groups says that the benefits of the combination sometimes outweigh the potential risks.
Plavix, with more than $9 billion in sales annually, is the second-best-selling drug in the world. It is widely used to prevent clotting in patients who have undergone bypass surgery, angioplasty, stenting and certain other procedures. Because Plavix leaves patients more susceptible to bleeding, physicians frequently prescribe acid-reducing drugs to reduce the risk of stomach irritation that could lead to bleeding. But the FDA warned in November of 2009 that taking Prilosec, Nexium or the generic drug omeprazole could reduce the efficacy of Plavix by 50%. Instead, the FDA suggested that patients take a drug from the family known as H2 inhibitors, such as Zantac. Those drugs, however, are not as effective at reducing acid.