Comments on: Heartburn Meds May Interefere With Plavix

By: Charles Gross

Charles Gross — Sun, 04 Oct 2009 23:54:06 +0000

Well, too late now. I just returned home from the hospital after a substantial cardiac event. I’d been on Plavix/Nexium for 5 years. In this drug poppin culture, I’m amazed this sort of thing does not occur more often. When it does occur the results can be deadly.

By: etalley

etalley — Fri, 18 Sep 2009 13:09:38 +0000

I took Nexium and Plavix together from October 2001 to August 2009, when I switched primary care physicians (new insurance). My new doc immediately made two changes: First, no more Nexium - Zantac 150mg twice a day instead. Second, take plavix/aspirin at night. I had previously been taking all my meds together in the morning on an empty stomach. Within 3 weeks I noticed the following results: 1) I stopped having frequent bouts of angina that had required nitrogylcerine to resolve. 2) I began bruising easily and without discernable cause. Also, minor cuts began bleeding more heavily and were more difficult to control.
3) I began having intense symptoms of gastritis. The Zantac was almost completely ineffective at relieving those symptoms.

Based on these changes, I am willing to concede that Nexium does indeed inhibit the effects of Plavix. However, I am now very concerned about the risk of GI bleeding. Looking for a solution….

By: joanne young

joanne young — Wed, 04 Mar 2009 15:39:08 +0000

I have been on plavix for 9 months suppose to
go off June 1 09. That is one year after
medicated stent. I take nexium about 1 or 2
time a week. I usually take it in morning
and I take plavix at bed time about 10 pm
my doctor says that would be ok but I think
I will ommit it all together. What else can
I take when I get heartburn?

By: Jack

Jack — Thu, 13 Nov 2008 19:41:25 +0000

I am a 71 year old male and have been on Plavix since 2002 (stent). I began taking Nexium on an as-needed basis in 2003 (for acid reflux). After experiencing frequent bouts of symptoms that were very similar to my original LAD blockage problems, my physician recommended I take Nexium daily. However, I continued to have intermittant occurences of the symptoms and I now was unsure of the cause. Recently after several days of the symptoms, primarily burning and slight pain in the chest area, I went into the local ER. At physicians recommendation, I had cathe-surgery but found no blockage. Subsequently, after some self-imposed trial-and-error testing, I have found that taking Plavix daily and Nexium every-other-day minimizes the previous symptoms. And now these study results (which my doctor was unaware of) come out and I am even more confused - and just a little scared. What to do now?

By: DeAnn

DeAnn — Thu, 13 Nov 2008 00:55:52 +0000

My husband has been taking nexium for years. After he needed a stent placed last oct., he began taking plavix also. Within 8 weeks, he was having chest pain again and required a double by-pass.

By: Nathan

Nathan — Wed, 12 Nov 2008 19:07:02 +0000

laurie,
That may or may not be true. From what I read, Plavix is metabolized to it’s active form by cyp2C19 within 1 h of administration. (the metabolite then has a T1/2 of ~8h) So the key question is: Is 2C19 inhibited at the “trough” levels of the PPI? If not, then you have a time window in which Plavix can be administered successfully.

By: Salmon

Salmon — Wed, 12 Nov 2008 19:07:00 +0000

Think this is good.

The pharmacometric modelers at FDA put a drug interaction in the labeling for one cancer drug to minimize a lethal reaction but their labeling change told physicians to do something that would kill people via a different mechanism.

Just shows you how good all this data modeling is without understanding the underlying physiology, pharmacology, and therapeutics.

By: harpy

harpy — Wed, 12 Nov 2008 18:41:07 +0000

I feel safer now.

By: Matt

Matt — Wed, 12 Nov 2008 18:31:06 +0000

Drug interactions are not new with Plavix. They are an albatross for this drug and that’s why there are a number of efforts to do one better. It’s amazing to me that this drug has been effective given all its issues.

By: laurie

laurie — Wed, 12 Nov 2008 17:06:01 +0000

“Solution: stagger administration of the PPI and Plavix and adjust the D&A section of the label accordingly”

Staggering dosing times will not prevent the inhibition of the cytochrome P450 2C19 liver pathway, which is the problem with using these two drug in combination. We’re not talking about drug to drug reaction, we’re talking about liver metabolism conflicts.