Interaksi Obat Antara Klopidogrel dan Proton Pump Inhibitor (PPI)
Authors
Ni Made Amelia Ratnata DewiDOI:
10.29303/sjp.v1i1.12Published:
2020-04-30Issue:
Vol. 1 No. 1 (2020): AprilKeywords:
Keywords, Interaksi obat, klopidogrel, proton pump inhibitorArticles
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Abstract
Abstrak: Pemberian Proton Pump Inhibitor (PPI) dapat menurunkan terjadinya kejadian perdarahan gastrointestinal berulang pada pasien yang mendapatkan dual therapy antiplatelet yaitu klopidogrel dan aspirin. Klopidogrel diaktivasi melalui proses metabolisme oleh enzim CYP2C19 sedangkan obat golongan PPI dimetabolisme dan menghambat enzim CYP2C19. Studi farmakodinamik menunjukkan adanya efek PPI terutama omeprazole terhadap metabolisme klopidogrel yang dapat mengakibatkan penurunan efek dari inhibisi platelet. Beberapa studi klinik mendapatkan bahwa tidak terdapat kejadian yang dapat menyebabkan permasalahan pada jantung (cardiovascular event) jika kedua obat diberikan secara bersamaan. Kemaknaan klinis dari interaksi obat dari klopidogrel dan PPI belum diketahui secara jelas sehingga untuk keamanan direkomendasikan untuk membatasi penggunaan PPI terutama omeprazole. Pilihan lain adalah dengan mengganti PPI dengan H2 blocker ataupun menggunakan golongan PPI yang tidak banyak dimetabolisme oleh enzim CYP2C19 seperti pantoprazole.References
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