Your Heart or Your Stomach?

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It must be disappointing to know that a label change on another drug -- one that isn't even your competition -- is going to hurt  sales, but that's the position that Procter & Gamble (NYSE: PG) and AstraZeneca (NYSE: AZN) find themselves in.

Yesterday, the Food and Drug Administration said that Bristol-Myers Squibb (NYSE: BMY) and sanofi-aventis' Plavix shouldn't be taken with two heartburn medications -- Procter & Gamble's Prilosec and AstraZeneca's Nexium. The drugs interfere with the effectiveness of Plavix.

Plavix, which helps prevent blood clots, is the world's second-best-selling drug, so we're talking a lot of patients. Plus, the drug often causes upset stomachs, so patients are more likely to be taking heartburn medications.

There may be some repercussions from the label change for Bristol-Myers and Sanofi -- maybe some patients will switch to Eli Lilly's (NYSE: LLY) Effient -- but it seems more likely that patients will pick their heart over their stomach and drop Prilosec or Nexium.

The big winners? Antacids like Johnson & Johnson (NYSE: JNJ) and Merck's (NYSE: MRK) Mylanta or Novartis' Maalox, and other acid reducers like Boehringer, Ingelheim's Zantac or J&J and Merck's Pepcid. The FDA says that they don't interfere with Plavix's effectiveness. 

What's interesting is that the first indication that there was a connection between the efficacy of Plavix and Nexium was picked up by pharmacy benefits manager Medco Health Solutions (NYSE: MHS). Its large database of patients allowed Medco to spot the correlation between taking the pair of drugs and increased hospitalizations for heart issues.

As the data mining progresses, I suspect we'll see more drug interaction connections that will require patients to choose between taking drugs for different ailments.

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