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Aspirin plus PPI safer than clopidogrel if there is history of GI bleeding
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For patients with a history of bleeding peptic ulcer, the combination of aspirin and a proton pump inhibitor (PPI) twice a day was safer than clopidogrel in terms of bleeding side effects. Although esomeprazole (Nexium) was used in this study, generic omeprazole 20 mg give twice a day provides nearly the same degree of acid suppression at a much lower cost. This study calls into question the overall safety of clopidogrel (Plavix), which has been claimed to not significantly increase the risk of bleeding. (LOE=1b)

 
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Chan FK, Ching JY, Hung LC, et al. Clopidogrel versus aspirin and esomeprazole to prevent recurrent ulcer bleeding. N Engl J Med 2005; 352:238–244.

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The Journal of Family Practice - 54(4)
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303-309
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Author and Disclosure Information

Chan FK, Ching JY, Hung LC, et al. Clopidogrel versus aspirin and esomeprazole to prevent recurrent ulcer bleeding. N Engl J Med 2005; 352:238–244.

Author and Disclosure Information

Chan FK, Ching JY, Hung LC, et al. Clopidogrel versus aspirin and esomeprazole to prevent recurrent ulcer bleeding. N Engl J Med 2005; 352:238–244.

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Bottom Line

For patients with a history of bleeding peptic ulcer, the combination of aspirin and a proton pump inhibitor (PPI) twice a day was safer than clopidogrel in terms of bleeding side effects. Although esomeprazole (Nexium) was used in this study, generic omeprazole 20 mg give twice a day provides nearly the same degree of acid suppression at a much lower cost. This study calls into question the overall safety of clopidogrel (Plavix), which has been claimed to not significantly increase the risk of bleeding. (LOE=1b)

 
Bottom Line

For patients with a history of bleeding peptic ulcer, the combination of aspirin and a proton pump inhibitor (PPI) twice a day was safer than clopidogrel in terms of bleeding side effects. Although esomeprazole (Nexium) was used in this study, generic omeprazole 20 mg give twice a day provides nearly the same degree of acid suppression at a much lower cost. This study calls into question the overall safety of clopidogrel (Plavix), which has been claimed to not significantly increase the risk of bleeding. (LOE=1b)

 
Issue
The Journal of Family Practice - 54(4)
Issue
The Journal of Family Practice - 54(4)
Page Number
303-309
Page Number
303-309
Publications
Publications
Topics
Article Type
Display Headline
Aspirin plus PPI safer than clopidogrel if there is history of GI bleeding
Display Headline
Aspirin plus PPI safer than clopidogrel if there is history of GI bleeding
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