Warning about mixing cardiac drugs

Last update: May 8, 2009 - 1:43 PM

A prominent Minneapolis cardiac center has sent a letter to doctors throughout the state warning that patients who have been treated with a cardiac stent and who take a blood thinner called Plavix should "be careful" when also taking popular heartburn medications.

The Heart Institute, located at Abbott Northwestern Hospital, said heartburn drugs called proton pump inhibitors (PPIs) could negate the blood-thinning effects of Plavix (or clopidogrel), reducing its ability to ward off potentially fatal blood clots.

Cardiac stents are tiny mesh struts that prop open clogged arteries. Often the device is coated with a drug to keep vessels from reclogging. The Food and Drug Administration (FDA) recommends patients take Plavix for at least a year after their stent procedure.

A recently released three-year study of 8,200 patients at Veterans Affairs hospitals across the country found that about 25 percent of stent patients taking Plavix and some types of heartburn medication had an increased risk of dying or other heart-related complications when compared with patients who took Plavix alone.

The FDA issued its own warning about a year ago advising doctors to reassess the use of heartburn medication in these patients, and encouraging patients with concerns to contact their doctor.

Because Plavix can cause internal bleeding, patients are often prescribed PPIs, such as Prilosec, Nexium, Prevacid, Aciphex and Protonix.

In its letter, the Heart Institute cited the over-the-counter heartburn drug Prilosec, as well as prescription drugs such as Nexium, as potentially problematic. Another drug called Protonix and H2 blockers, such as Pepcid, do not interfere with Plavix.

JANET MOORE

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