Plavix And Heartburn Meds Present Deadly Combination
Posted on: Wednesday, 12 November 2008, 07:55 CST
According to a new study, stent patients who take the blood thinner Plavix combined with heartburn drugs may face a greater risk of heart attack.Researchers concluded patients who took Plavix with popular prescription heartburn drugs, including AstraZeneca’s Nexium, were more likely to be hospitalized for a heart attack, stroke, chest pain or a coronary artery bypass operation than those who took Plavix alone.
A stent is a wire-mesh tube used to prop open arteries after they have been cleared of plaque.
The study followed 14,000 patients from 2005 to 2006 and recorded in a database kept by pharmacy benefits manager Medco Health Solutions Inc.
Nexium and other proton pump inhibitors, like Wyeth's Protonix, try to alleviate chronic heartburn; doctors commonly prescribe these drugs to patients on Plavix because the blood thinner has been linked to a higher risk of ulcers.
Medco’s chief medical officer, Robert Epstein, said 40 percent of patients in the study were taking heartburn medicine, which could interfere with a liver enzyme needed to process Plavix, neutralizing its effects.
However, he stressed patients should not stop taking Plavix or heartburn drugs.
"But if you're a person who's otherwise healthy taking Plavix, you might want to consider calling your doctor and asking, 'Do I need really need this' or 'Do I need it every day?'" Epstein said . "There are ways to look at this question now that we wouldn't have thought about previously."
A Bristol-Myers spokesperson urged patients to talk with their doctor before taking action and questioned Medco's approach.
"While we are still reviewing the data, in general, retrospective analyses - in contrast to randomized clinical trials - are more subject to confounding factors," said spokesman Ken Dominski.
During an American Heart Association's annual meeting in New Orleans, academics shared the concerns.
Dr. Robert Harrington of Duke University said that without an intense study comparing patients with similar health profiles "you cannot assume that the groups are balanced."
For example, he said, people taking proton pump inhibitors may also have other health problems that skew their risk for heart disease.
"I would not change practice based on these data," said Harrington, who led an American College of Cardiology panel that last month said it was reasonable for doctors to prescribe these two drugs together.
In patients who had not suffered a previous heart attack, 32.5 percent patients who took Plavix and a heartburn drug experienced one of the severe events within a year of their stent surgery.
According to IMS health, heartburn drugs were the fourth best-selling class of drugs last year, with sales of $25.6 billion.
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Plavix
American College of Cardiology
Nexium
Source: redOrbit Staff & Wire Reports
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