The role of clopidogrel after percutaneous coronary intervention (PCI) or acute coronary syndrome (ACS) is well supported by strong clinical evidence, which has led to a dramatic increase in its use.
The use of a combination of proton-pump inhibitors (PPIs) and clopidogrel has recently been questioned due to pharmacological interaction, with possible implications and effects on clinical outcome in patients using this combination. This has brought uncertainty and confusion into clinical practice.
There is a definite interaction between the two drugs, at a pharmacodynamic level; however, the clinical relevance remains uncertain.
In this article I will review the subject and suggest a management strategy, which I hope will be of help to clinicians dealing with these patients on a daily basis.