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Both omeprazole and esomeprazole inhibit CYP2C19, leading to: Reduced formation of active clopidogrel metabolite Decreased antiplatelet efficacy Increased risk of thrombotic events (MI, stroke, stent thrombosis) Clinical takeaway: When gastric protection is required in patients on clopidogrel, consider safer alternatives such as: Pantoprazole Rabeprazole This simple switch can significantly improve therapeutic outcomes and patient safety

A balanced diet should provide most individuals with adequate vitamin B12 levels, and supplementation in the form of oral supplements or patches may be sufficient for those with specific dietary limitations or absorption issues

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The nitric oxide system plays a significant role in BPC-157s effects