Ranitidine, brand name Zantac, is a drug commonly used to treat gastroesophageal reflux disease, or GERD. Plavix, also known as clopidogrel, is a platelet aggregator inhibitor that stops platelets from binding together to form clots in the bloodstream. There's some controversy in the medical community regarding interactions between these two drugs, and the concern that ranitidine and other GERD drugs can decrease Plavix's efficacy.
Enzyme Conversion Disturbance
Plavix works by blocking a special enzyme that initiates platelet aggregation, or clumping. This medicine is absorbed in the small intestine and cleared through the liver. Ranitidine, also a systemic medication, is unlike some GERD medications that act only within and on the stomach wall lining. Zantac is also absorbed into the bloodstream and processed through the liver, where it has been documented to impact the effects of Plavix, notes a 2009 article published in "Heartbeat," a South Jersey Heart Group publication.
Acute Coronary Syndrome
The inhibitory effects of ranitidine on Plavix stop the blood from thinning, allowing clots to form and possibly block the arteries Plavix was intended to protect. Complications -- including acute coronary syndrome, or ACS -- have been related to using Plavix while on GERD medications, notes "Heartbeat," which adds that the use of both drugs simultaneously have caused a 25 percent increase of adverse effects. These adverse effects can include incidents of stroke, called cerebral vascular accidents, or CVA, heart attack and peripheral vascular disease.
Ulcer Formation
The presence of an ulcer, or gastrointestinal bleeding, is a contraindication to the use of Plavix. Plavix, by stopping blood's ability to clot, can actually promote bleeding within the body. Plavix can aggravate ulcers and cause excessive gastrointestinal bleeding even in someone who was previously ulcer-free, notes "Heartbeat." Therefore, guidelines were set by the American Heart Association and the American College of Gastroenterology for safe usage of these GERD medications during antiplatelet therapy with Plavix. The risk that ranitidine and associated GERD drugs can decrease platelet inhibition in 5 to 15 percent of patients, has altered the use of these drugs together, according to the website Med Page Today.
