GI Topics in the News
Plavix and Proton Pump Inhibitors (PPIs):
A new study published in this week’s Journal of the American Medical Association reports that patients taking the antiplatelet drug Plavix along with a proton pump inhibitor (a type of drug used to block stomach acid such as Aciphex, Nexium, Prevacid) have an increased risk of a subsequent hospitalization for heart trouble.
The lead researcher, Dr. P. Michael Ho, a cardiologist at the Denver VA medical center, said the results suggest that proton pump inhibitors reduce the effectiveness of Plavix, which is designed to prevent blood clots by keeping blood platelets from sticking together. He said that the "study doesn't change the reasons for prescribing Plavix," but he added that "both clinicians and patients should look at why the PPI is being prescribed.”
Patients who are already taking Plavix should discuss the use of PPIs with their healthcare provider who will help determine whether they should be on a PPI or whether there are alternative medications for reflux or stomach problems.
Black Box Warning for Reglan:
The U.S. Food and Drug Administration announced on Thurs., Feb. 26, that manufacturers of metoclopramide (Reglan), a drug used to treat gastrointestinal disorders, must add a boxed warning to their drug labels about the risk of its long-term or high-dose use. Chronic use of metoclopramide has been linked to tardive dyskinesia, which may include involuntary and repetitive movements of the body, even after the drugs are no longer taken. The development of this condition is directly related to the length of time a patient is taking metoclopramide and the number of doses taken. Those at greatest risk include the elderly, especially older women, and people who have been on the drug for a long time.
“The FDA wants patients and health care professionals to know about this risk so they can make informed decisions about treatment,” said Janet Woodcock, M.D., director of the FDA’s Center for Drug Evaluation and Research. “The chronic use of metoclopramide therapy should be avoided in all but rare cases where the benefit is believed to outweigh the risk.” Patients are encouraged to discuss the use of Reglan with their health care provider.