Proton pump inhibitor co-therapy in patients receiving non-vitamin K antagonist oral anticoagulants: current evidence, gastrointestinal bleeding prevention, and clinical considerations - Takeaways - MDSpire

Proton pump inhibitor co-therapy in patients receiving non-vitamin K antagonist oral anticoagulants: current evidence, gastrointestinal bleeding prevention, and clinical considerations

  • By

  • Dong-Hyeok Kim

  • Yeji Kim

  • Moon-Hyun Kim

  • Jeongmin Kang

  • Junbeom Park

  • June 16, 2026

  • 0 min

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  • 1

    Non-vitamin K antagonist oral anticoagulants (NOACs) are effective for stroke prevention but carry a risk of gastrointestinal bleeding, particularly upper gastrointestinal bleeding.

  • 2

    Proton pump inhibitors (PPIs) are often co-prescribed with NOACs to reduce the risk of gastrointestinal bleeding, with observational studies suggesting potential benefits.

  • 3

    A Korean nationwide cohort study indicated that PPI co-therapy significantly lowers hospitalization and transfusion-requiring bleeding risks in NOAC-treated patients.

  • 4

    Meta-analyses of nearly 2 million oral anticoagulant users showed reduced odds of total and major gastrointestinal bleeding with PPI use.

  • 5

    Despite promising findings, most evidence is observational and subject to confounding, highlighting the need for dedicated randomized trials in high-risk populations.

Original Source(s)

Proton pump inhibitor co-therapy in patients receiving non-vitamin K antagonist oral anticoagulants: current evidence, gastrointestinal bleeding prevention, and clinical considerations

  • by Dong-Hyeok Kim, Yeji Kim, Moon-Hyun Kim, Jeongmin Kang, Junbeom Park

  • June 16, 2026

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