Which PPI is known to cause CP450 inhibition?

Omeprazole is a proton pump inhibitor (PPI) that is particularly known for its ability to inhibit the cytochrome P450 enzyme system, specifically the 2C19 isoenzyme. This inhibition can lead to increased levels of certain medications that are metabolized by this pathway, which may enhance their effects or increase the potential for adverse reactions.

One of the significant implications of this interaction is its impact on medications like clopidogrel, an antiplatelet agent. Since clopidogrel’s activation depends on the CYP2C19-mediated pathway, the inhibition caused by omeprazole can reduce its effectiveness, potentially leading to a failure to prevent thrombotic events in patients who require dual antiplatelet therapy.

While the other PPIs listed have different metabolic pathways and varying degrees of interaction with CP450 enzymes, omeprazole stands out for its well-documented inhibitory effects on CYP2C19, which is crucial in clinical decision-making when prescribing concurrent therapies. Understanding the implications of this interaction is essential for optimizing pharmacotherapy and ensuring patient safety.