Using Famotidine as an alternative for Omeprazole to prevent drug-drug interaction between Clopidogrel and Omeprazole in CVS Patients: A Systematic Literature Review

Abstract

Background: Omeprazole is a proton pump inhibitor that is the most widely prescribed agent for the treatment of gastrointestinal diseases such as GERD, esophagitis, and peptic ulcer disease. Patients having CVS diseases (MI, stroke, and stent thrombosis) also receive omeprazole for the treatment of gastrointestinal bleeding due to frequent consumption of clopidogrel. In the last few years, there are certain case reports that the use of omeprazole with clopidogrel is associated with severe CVS adverse effects such as increased risks of MI, ischemic stroke, and thrombosis, due to drug-drug interactions between them.
Objective: This study aimed to review the use of famotidine, a Histamine H2 receptor blocker, as a potential alternative to omeprazole to prevent CVS adverse effects in patients on dual antiplatelet therapy (DAPT).

Methodology: A systematic literature review was conducted following the PRISMA guidelines. So, for this purpose, a systematic literature review was performed according to PRISMA guidelines to gain insight about the drug-drug interaction between omeprazole and clopidogrel and about the safety of famotidine in cardiovascular patients. PubMed, NCBI, Medline, and Google Scholar were searched to identify relevant articles with a focus on drug-drug interaction between omeprazole and clopidogrel and the safety of famotidine in CVS patients. Studies published between 2010 and 2024 were included for data collection and analysis.

Results: Randomized controlled trials and observational studies comparing CVS patients treated with clopidogrel and omeprazole to those treated with clopidogrel and famotidine were analyzed, it was found that the use of famotidine prevents mucosal injury without having interaction with clopidogrel and thus can be safer for CVS patients on DAPT.

Conclusion: Although this study provides basic precautions and guidelines for healthcare professionals and clinicians when prescribing this therapy, further experimental studies are recommended to evaluate the safety and drug-drug interactions between omeprazole and clopidogrel as well as for famotidine and clopidogrel in CVS patients on DAPT therapy