Which proton pump inhibitor (PPI) can be safely given with clopidogrel?

Rabeprazole is the proton pump inhibitor that can be safely given with clopidogrel due to its mechanism of action and interaction profile. Unlike omeprazole and esomeprazole, which significantly inhibit the CYP2C19 enzyme, thereby potentially reducing the efficacy of clopidogrel (an antiplatelet medication), rabeprazole has a minimal effect on this enzyme. This means that rabeprazole does not interfere with the activation of clopidogrel, allowing it to maintain its antiplatelet effects effectively.

Lansoprazole also poses some risk of interaction with clopidogrel, as it exhibits moderate inhibition of CYP2C19 but not to the extent seen with omeprazole or esomeprazole. This makes rabeprazole the preferable choice among the commonly used PPIs when co-administering with clopidogrel, ensuring that patients maintain adequate platelet inhibition while being treated for gastric acid-related conditions.