Clopidogrel and Omeprazole and sodium bicarbonate interaction
Clopidogrel and Omeprazole and sodium bicarbonate: both prescribing labels flag this combination with the strongest language, such as a contraindication, a boxed warning, or an instruction to avoid it.
Do not combine without a prescriber's guidance. The label language below is the strongest FDA uses.
What the FDA labels say
From the Clopidogrel (Plavix) label · effective 2025-05-30
Avoid concomitant use of Plavix with omeprazole or esomeprazole because both significantly reduce the antiplatelet activity of Plavix [see Drug Interactions (7.1) ] .
Omeprazole or Esomeprazole Avoid concomitant use of Plavix with omeprazole or esomeprazole.
CYP2C19 inhibitors: Avoid concomitant use of omeprazole or esomeprazole.
In clinical studies, omeprazole was shown to reduce significantly the antiplatelet activity of Plavix when given concomitantly or 12 hours apart.
Dexlansoprazole, lansoprazole, and pantoprazole had less effect on the antiplatelet activity of Plavix than did omeprazole or esomeprazole [see Warnings and Precautions (5.1) and Clinical Pharmacology (12.3) ] .
From the Omeprazole and sodium bicarbonate (Konvomep) label · effective 2025-12-16
Interaction with Clopidogrel : Avoid concomitant use of KONVOMEP.
Interaction with Clopidogrel Avoid concomitant use of KONVOMEP with clopidogrel.
Concomitant use of clopidogrel with 80 mg omeprazole reduces the pharmacological activity of clopidogrel, even when administered 12 hours apart.
CYP2C19 Substrates (e.g., clopidogrel, citalopram, cilostazol, phenytoin, diazepam) Clopidogrel Clinical Impact: Concomitant use of omeprazole 80 mg results in reduced plasma concentrations of the active metabolite of clopidogrel and a reduction in platelet inhibition [see Clinical Pharmacology ( 12.3 )] .
There are no adequate combination studies of a lower dose of omeprazole or a higher dose of clopidogrel in comparison with the approved dose of clopidogrel.
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Open in the checkerNot medical advice. Interaction Checker quotes FDA label text and NIH fact sheets. Whether an interaction matters for you depends on doses, timing, kidney and liver function, and other conditions. Confirm with a pharmacist or prescriber.