Mixing Bristol-Myers Squibb Co.’s anti-clotting Plavix, also known as clopidrogel, with stomach medicines, known as proton pump inhibitors, may raise heart patients’ risk of dying or being readmitted to a hospital to 25 percent, according to a study published in the Journal of the American Medical Association.

 

Plavix, the world's second-best selling drug, generated revenue of $7.3 billion in 2007. More than 90 million patients around the world have taken the drug to reduce the risk of blood clots that may lead to heart attacks and strokes.

 

Doctors often prescribe proton pump inhibitors with Plavix to reduce intestinal bleeding that can be a side effect of the anti-clotting drug. Proton pump inhibitors include AstraZeneca Plc’s Nexium and Prilosec.

 

“A lot of patients are on Plavix and also a lot of patients are being prescribed PPI medication just prophylactically to prevent a stomach bleed,” Dr. P. Michael Ho, a cardiologist at the Denver VA Medical Center and lead researcher of the study said.

 

The study tracked 8,205 patients discharged from 127 Veterans Affairs hospitals after suffering a heart attack or unstable angina. 63.9 percent of them were given a proton pump inhibitor.

 

The researchers found that almost 30 percent of the patients taking both Plavix and a PPI died or were re-hospitalized, compared with 20.8 percent of the patients who were given only Plavix. This equals with a 25 percent increased risk of dying or being re-hospitalized in the patients who received a combination of Plavix and PPI compared to the ones on Plavix alone.

 

“Our study highlights a potential interaction between clopidrogel and PPI medication. And it suggests that maybe PPI medication should not just be prescribed routinely or prophylactically in patients who are on aspirin and clopidrogel,” Dr. Ho said.