Which of the following combination has too be avoided
|A||Aspirin + PPI|
|B||Clopidogrel + PPI|
- Clopidogrel is a prodrug that is activated by the cytochrome P450 CYP2C19 enzyme.
- All proton pump inhibitors inhibit CYP2C19 to varying degrees, with omeprazole having the highest and pantoprazole the least level of inhibition. In vitro and in vivo platelet aggregation studies demonstrate that proton pump inhibitors (especially omeprazole) may attenuate the antiplatelet effects of clopidogrel, although the clinical importance of this interaction is uncertain.