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Table 2 ADP-induced platelet aggregation in four subjects treated with clopidogrel with and without PPI co-therapy

From: Clopidogrel and proton pump inhibitor (PPI) interaction: separate intake and a non-omeprazole PPI the solution?

Medication

Subjects

   
 

#1 (wt/wt)

#2 (wt/wt)

#3 (wt/*2)

#4 (wt/*2)

baseline

normal

normal

normal

normal

(day 0)

85 U

79 U

89 U

101 U

clopidogrel mono-therapy

inhibited

inhibited

normal

inhibited

(day 7)

42 U

16 U

97 U

31 U

clopidogrel and omeprazole

inhibited

inhibited

n.s.*

normal

taken together (day 14)

44 U

10 U

 

74 U

clopidogrel and omeprazole

n.s.*

n.s.*

n.s*

normal

intake separated (day 21)

   

67 U

clopidogrel and rabeprazole

n.s.*

n.s.*

n.s.*

inhibited

taken together (day 28)

   

43 U

  1. The reference range of the test was 53-122 U.
  2. Clopidogrel intake inhibits ADP-induced platelet aggregation in subjects showing the expected clopidogrel effect. Normal platelet function under clopidogrel mono-therapy represents a non-responder status. The normalization of platelet function by co-therapy with clopidogrel and PPI after platelet function is inhibited by clopidogrel mono-therapy indicates a pharmacologically relevant drug interaction.
  3. *n.s., not studied, according to protocol.