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Nexium, Other Heart Burn Drugs Interfere with Plavix

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Stent patients who take Plavix along with heartburn drugs known as proton pump inhibitors may have a higher risk of heart attack and stroke, according to a new study.

According to The Wall Street Journal, a article published  in the journal Circulation in 2003 showed that nearly 30 percent of Plavix patients don’t process the drug effectively.  This new study could be an important clue as to why.  People on Plavix are often prescribed proton pump  inhibitors, such as Nexium, Protonix and Prevacid, because Plavix has been linked to a higher risk of ulcers.

For Plavix to work, it must first be converted to its active form by a liver enzyme.  Proton pump inhibitors interfere with the liver enzyme, thereby reducing the amount of Plavix that is converted to an active form.

This new study followed more than 16,000 patients in a database kept by pharmacy benefits manager Medco Health Solutions Inc. from 2005 to 2006.  Of the patients in the study, 9,862 patients were taking Plavix alone;and 6,828 patients were taking Plavix and a proton pump inhibitor.

All patients in the  Medco study  had been implanted with a  stent  to prop open arteries after they have been cleared of plaque. The study tracked whether they had been hospitalized for  heart and circulatory problems within a year of the stent being implanted.

Of those who did have a previous heart attack, 39.2 percent were hospitalized for a serious heart or circulatory event.  For those taking only Plavix, only 26.2 percent did.

Of those who had not had a previous heart attack, only 21.2 percent of patients experienced a serious event within a year of their stent surgery.  That number rose to 32.5 percent among those who took Plavix and a proton pump inhibitor.

The database did not include patients who took over-the-counter proton pump inhibitors.  Medco’s chief medical officer and lead researcher on the study, Robert Epstein, told the Associated Press that the percentage of those who experienced a serious event  would likely be even higher if such drugs were included in the study.

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