Since I shouldn't mix Nexium and Plavix, what can I use instead of Nexium?

It appears that Nexium (esomeprazole) decreases the effectiveness of Plavix (clopidogrel).

Let's start with why you need the Plavix. After a stent is placed in a coronary artery, you need to take medicine to prevent blood clots from forming inside the stent. The standard combination is aspirin and Plavix.

People who have drug coated stents (also called drug eluting stents) need to take Plavix for at least one year. Many doctors tell these patients to take Plavix with aspirin forever.

However, if you had bare metal stents (no drug in the stents), Plavix does not need to be used as long. One year is usually enough. Always check with your doctor first. If your doctor tells you that you may stop the Plavix, keep taking your daily aspirin.

I suspect that you have drug coated stents because your heart doctor wants you to stay on Plavix, even if it means having to stop the Nexium. But you might be able to do both -– stay on the Plavix and treat symptoms related to your hernia.

Nexium (esomeprazole) is one type of proton pump inhibitor (PPI). Proton pump inhibitors are the strongest stomach acid inhibitors. So far, it seems as though Nexium, omeprazole (Prilosec), lansoprazole (Prevacid) and rabeprazole (Aciphex) have more interaction with Plavix compared to pantoprazole (Protonix).

You can't buy pantoprazole over-the-counter, but it is available as a prescription. There is even a generic version.

The importance of the PPI and Plavix interaction is still being sorted out.

If your heart doctor feels that it is too risky to take pantoprazole, you could try a higher dose of ranitidine (Zantac). This is an H2 blocker. Sometimes, a different H2 blocker might help you more. Other H2 blockers include famotidine (Pepcid) and nizatidine (Axid).