Cardiologists warn on Plavix plus PPI

A cardiology society is raising the red flag on drug-mixing: The clot-busting Plavix and heartburn meds like Nexium shouldn't be taken together. The Society for Cardiovascular Angiography and Interventions has sent out a warning to doctors, advising that they limit the use of heartburn pills known as proton-pump inhibitors in patients who are also using Plavix. The warning comes on the heels of a study that showed the PPI meds boosted the risk of heart attack and stroke by 50 percent among cardiac patients taking the Bristol-Myers Squibb blood thinner.

Plavix is often prescribed for patients who've had stents implanted into their arteries, as well as to patients who have had heart attacks or strokes. But Plavix can cause stomach bleeding and acid reflux, so about half of patients using the drug are also prescribed a PPI to deal with those side effects, the Wall Street Journal reports. The class includes Nexium, Takeda Pharmaceutical's Prevacid, Wyeth's Protonix, and Procter & Gamble-marketed Prilosec OTC.

AstraZeneca, which makes Nexium, says the jury's still out on whether nixing use of the drug with Plavix is warranted. "There is a lot of conflicting data on this," a spokesman told the WSJ, saying that the new study and others that reached similar conclusions were data-crunching studies rather than clinical trials. Some cardiologists agreed, saying that the heartburn itself may be causing the extra risk, not the PPI meds. But others said that they'd moved patients to other non-PPI heartburn meds--such as Zantac and Tagamet--because they figured they'd been overprescribing the PPIs to Plavix patients.

- read the WSJ piece

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