FDA warns on Plavix + Prilosec

[NTB]

http://www.fda.gov/Drugs/DrugSafety/PublicHealthAdvisories/ucm190825.htm

"The U.S. Food and Drug Administration (FDA) has new data showing that omeprazole (Prilosec/Prilosec OTC)—a medicine used to reduce stomach acid—reduces the anti-blood clotting effect of clopidogrel (Plavix) by almost half when these two medicines are taken by the same patient."

"...Patients using clopidogrel should consult with their healthcare provider if they are currently taking or considering taking omeprazole, including Prilosec OTC"

but then, there's also this:
http://www.theheart.org/article/1025121.do
"Cardiologists shocked by new FDA alert on clopidogrel-PPI interaction"

[NTB]

hi, Madge, That website doesn't have the best technical web staff in the world. It might work if you try again, though.

Here's a sample of the commentary, where a cardio says: "I was shocked by the strengthened warning. Proper subgroup analyses from randomized trials, including CREDO, TRITON, PRINCIPLE, and preliminarily from PLATO and CURRENT, all indicate that no interaction exists... And then a preliminary analysis of data from the COGENT trial, a trial dedicated to specifically examining clopidogrel with a PPI vs placebo, fails to suggest even the slightest signal of a negative interaction. For the FDA to then strengthen the warning of a interaction is baffling, to say the least."

Also, IIRC the AHA and ACC haven't advised against the combination.

[Madge270]

I tried to copy and paste the second article you referred ot "Cardiologists shocked by a new FDA alert on clopidogral-ppi interaction," but was unable to access it.  Could you tell us what it says? (Thanks.)