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Stent patients face risk when mixing Plavix, heartburn drugs

November 12, 2008
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NEW YORK - Stent patients who take the blood thinner Plavix along with certain heartburn drugs may face a greater risk of heart attack, stroke, and other dangerous events, according to a study released yesterday.

Researchers found that patients who were taking Plavix with popular prescription heartburn drugs, including Nexium from AstraZeneca PLC, were significantly more likely to be hospitalized for a heart attack, stroke, chest pain, or a coronary artery bypass operation than those who took Plavix alone.

The study followed more than 14,000 patients from 2005 to 2006 in a database kept by pharmacy benefits manager Medco Health Solutions Inc.

Nexium and other proton pump inhibitors, like Wyeth's Protonix, are used to treat chronic heartburn, in which stomach acids come back up the esophagus, causing inflammation. Doctors frequently prescribe these drugs to patients on Plavix because the blood thinner has been linked to a higher risk of ulcers.

Medco said 40 percent of patients in its study were taking the prescription heartburn medications. The company's chief medical officer, Robert Epstein, said that if over-the-counter medications like AstraZeneca's Prilosec were included, the percentage would probably be even higher. Epstein said heartburn drugs could interfere with a liver enzyme needed to process Plavix, neutralizing its effects.

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