Reflux drugs may inhibit the breakdown of other drugs

Circulation, the journal published by the American Heart Association, suggest that the drug interaction between a class of acid reflux medicines called proton pump inhibitors and the blood thinner Plavix may result in serious adverse outcomes within one year of therapy initiation, and further research support investigations into the effects of cytochrome P450 2C19 genetic polymorphisms. The Food and Drug Administration on Monday said it has ordered the makers of clopidogrel -- also known as Plavix -- to conduct studies into the possible interaction. Until those studies have been assessed by the FDA, federal regulators are advising physicians to reconsider whether to start or continue patients on drug therapy that combines the two drugs.

Proton pump inhibitors, which suppress the production of stomach acid, include the prescription drugs Nexium, Prevacid, Aciphex and Protonix. Prilosec is a proton pump inhibitor largely sold over the counter, and FDA urged patients on Plavix who may take any of these drugs to discuss the combination with their physician.

FDA says it was prompted by published reports that clopidogrel is less effective in reducing cholesterol levels in some patients. Proton pump inhibitors appear to reduce the breakdown of some drugs by the liver. It may also increase the concentration of diazepam (Valium), phenytoin (Dilantin) and warfarin (Coumadin).

Bonnie - this is not a surprise. We knew that PPIs reduced/blocked the absorption of many vitamins and minerals.