clopidogrel + omeprazole + aspirin

This is a combination therapy involving three drugs: clopidogrel, omeprazole, and aspirin. Clopidogrel is an antiplatelet agent that inhibits the P2Y12 component of ADP receptors on platelet surfaces, preventing platelet aggregation and reducing the risk of cardiovascular events. Aspirin is also an antiplatelet agent that irreversibly inhibits cyclooxygenase 1 (COX1), thereby inhibiting thromboxane A2 formation and further reducing platelet aggregation[6][8]. Omeprazole is a proton pump inhibitor that decreases gastric acid secretion by inhibiting the H+/K+ ATPase in gastric parietal cells, used to reduce gastrointestinal side effects associated with antiplatelet therapy[8]. This triple combination may be considered in patients at high risk for both cardiovascular events and gastrointestinal bleeding; however, there are clinically significant drug-drug interactions between clopidogrel and omeprazole due to CYP2C19 inhibition by omeprazole, which can reduce the activation and efficacy of clopidogrel[3][4][5]. The use of all three together should be carefully evaluated due to increased risks for bleeding as well as potential reduction in antiplatelet effect.

Brand names

Duoplavin (for clopidogrel + aspirin)Yosprala (for aspirin + omeprazole)

Other names

Plavix (clopidogrel)Aspirin/omeprazoleClopidogrel/aspirinClopidogrel/omeprazole