Why You Should Never Take Plavix and Nexium Together

While medicines are tested for their efficacy and safety before being released in the open market, certain medicines may react with each other that cause serious and sometimes fatal reactions. Therefore, the FDA releases medical advisories that caution patients against using certain combinations of medicines. One such combination is Plavix and Nexium.

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Plavix is the brand name of a thienopyridine class inhibitor and is manufactured by Sanofi Aventis and Bristol Myers Squibb. It is mainly used for preventing the formation of blood clots after a stroke or a heart attack. It is also used for treating various blood vessel and heart conditions. It is currently one of the most highly prescribed drugs in the world. Plavix is chemically known as Clopidogrel.

However, Plavix should be used very carefully since its property of inhibiting the formation of blood clots may also lead to excessive bleeding. If not vetted carefully, such bleeding can lead to a serious loss of blood and even death in some cases. It is due to this reason that any person suffering from a blood clotting disorder or bleeding disorder should make sure that their doctor knows about their medical condition.


Nexium is a proton pump inhibitor and its chemical name is Esomeprazole. It helps in controlling stomach acid and aids in treating symptoms of various ailments, including Gastroesophageal Reflux Disease (GERD) and Zollinger-Ellison syndrome.

Nexium can cause dizziness, nausea and diarrhea in certain patients. In other cases, it can lead to hives, swelling of the throat and breathing difficulties. Any abnormal muscle movement or cramps following the use of this medicine should be brought to the doctor’s attention. It can also cause abdominal pain in certain patients while others may complain of headache pain.

Why Not Take Plavix with Nexium

While both medicines provide life saving treatment, taking them together can cause harm rather than a benefit. The FDA issued a warning for patients to not mix Plavix with Nexium. The main reason behind the advisory is that the use of Nexium can compromise the efficacy of Plavix. Nexium works by blocking certain enzymes including CYP 2C19 in the body and this enzyme is required by Plavix to effectively treat the condition.

According to a study carried out by Plavix manufacturers Sanofi Aventis and Bristol Myers Squibb, combining Plavix with Nexium can lead to up to a 45% reduction in active metabolite levels. The efficacy of Plavix on blood platelets is also shown to be reduced by 47% with the simultaneous use of Plavix and Nexium. The study has yet to be fully reviewed by the FDA. Further studies need to be conducted to fully understand the implications of the concurrent use of these medicines.

It is highly advisable that patients using Plavix and Nexium together consult their doctor immediately for a future course of action. Despite the FDA advisory, it is not recommended to stop taking a drug without consulting a doctor first. In certain cases, doctors advise to use these drugs with a considerable time gap between their intake. However, this strategy is not considered to be foolproof.

The interaction between Plavix and Nexium is rated as a major cause of concern and therefore should be given notice by patients as well as doctors. It is also noted that the interaction between these medicines can take place irrespective of their time of consumption. Therefore, patients run the risk of an adverse reaction even if these drugs are taken at different times. Various medical authorities such as the American Heart Association and American College of Gastroenterology have also expressed their concern over the possible negative outcomes associated with the interaction of these medicines.

Doctors can resort to the use of alternative Proton Pump Inhibitors which do not inhibit the CYP2C19 enzyme. Apart from Nexium, other drugs which can interfere with the CYP2C19 enzyme should also be avoided while Plavix is being taken by the patient. The FDA has not issued any such advisory about the use of other Proton Pump Inhibitors in conjunction with Plavix. Other medicines such as H2 blockers ranitidine which are used for treating GERD have not been shown to interfere with CYP2C19 and may be used simultaneously with Plavix. However, it is advisable to consult with a doctor first.

Nexium and other drugs, which may interfere with CYP2C19, now come with a proper label warning. The FDA took the step to reduce the instances of complications which can arise from the concurrent use of these drugs with Plavix. Doctors should also take note of the other OTC drugs taken by patients since these drugs can have a negative interaction as well.

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