Experts discuss PPI use for GI protection in patients on antithrombotics, highlighting risk factors, dosing, drug interactions, and side effects.
2025 held in Paris, France, Gilles Macaigne, MD, from the Intercommunal Hospital Group Le Raincy Montfermeil, France, reviewed updated strategies for prescribing PPI s, emphasizing risk stratification, side effects, drug interactions, andWhile 50%-80% of PPI prescriptions are unjustified, particularly for unnecessary nonsteroidal anti-inflammatory drug -related ulcer prophylaxis, PPI s remain underprescribed for patients at risk for bleeding on antithrombotics, particularly direct oral...
“Patients over 65 years of age on DOACs must receive prophylactic PPI treatment,” as do patients treated with a combination of antithrombotics, Macaigne noted.Among DOACs, rivaroxaban is associated with the highest risk for GI bleeding, with a fivefold increased risk in placebo-controlled studies, while apixaban has a lower risk than other DOACs .“A single dose of PPI allows a reduction in gastric acidity of approximately 60% for almost 24 hours,” Macaigne noted.
Cardiovascular Risk CV Risk Factors Cardiovascular Risk Factors Cardiovascular Risk Management Gastric Ulcer Ulcer Of The Stomach Stomach Ulcer Gastrointestinal Hemorrhage Gastrointestinal Bleeding Gi Hemorrhage Gi Bleeding Abdominal Infection Proton Pump Inhibitor Proton-Pump Inhibitor Acid Suppressive Therapy PPI Thromboembolism Antithrombotics Anti-Thrombotics
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