Plavix, Heartburn Drugs May Be Risky Combination

May 7 -- WEDNESDAY, May 6 (HealthDay News) -- Anyone who takes the clot-preventing drug Plavix after receiving a stent in a coronary artery-opening procedure should avoid popular heartburn medications called proton pump inhibitors (PPIs), if possible, a group of heart experts now say.

PPIs include blockbuster acid reflux medications such as Nexium, Prevacid and Prilosec.

The problem, according to experts at the Society for Cardiovascular Angiography and Interventions (SCAI), is that the combination of Plavix and a PPI increases the user's risk of heart attack, stroke and other cardiovascular problems.

One study showed that this combination is associated with a 70 percent increased risk of heart attack, a 48 percent increased risk of stroke and a 35 percent increased risk for the need for repeat coronary procedures, according to the SCAI.

While more research on the issue is needed, "given the thousands of patients who receive stents each year, coupled with significant risks demonstrated in this study, SCAI recommends the use of alternative medications for gastrointestinal symptoms in patients with stents when appropriate," said a statement issued at the society's annual meeting in Las Vegas.

The recommendation applies to older proton pump inhibitors such as Protonix, Nexium, Prilosec and Prevacid, but not to newer PPI drugs such as Aciphex and Kapidex, it said.

The study results were reported at a Wednesday press conference, held as part of the SCAI annual meeting.

Eric J. Stanek, senior director of research at Medco Health Solutions, a drug distributing company, said his team analyzed data on almost 17,000 people who took Plavix (clopidogrel) for more than a full year after coronary stenting.

The overall incidence of major adverse cardiovascular events was 51 percent higher in those taking Plavix and a PPI than in those taking Plavix alone, Stanek said.

"Considering all the available evidence, PPI use should be limited in patients taking clopidogrel, based on the physician's judgment," Stanek said.