Clopidogrel and Naproxen and esomeprazole interaction
Clopidogrel and Naproxen and esomeprazole: both prescribing labels flag this combination with the strongest language, such as a contraindication, a boxed warning, or an instruction to avoid it.
Do not combine without a prescriber's guidance. The label language below is the strongest FDA uses.
What the FDA labels say
From the Clopidogrel (Plavix) label · effective 2025-05-30
Avoid concomitant use of Plavix with omeprazole or esomeprazole because both significantly reduce the antiplatelet activity of Plavix [see Drug Interactions (7.1) ] .
Omeprazole or Esomeprazole Avoid concomitant use of Plavix with omeprazole or esomeprazole.
CYP2C19 inhibitors: Avoid concomitant use of omeprazole or esomeprazole.
A similar reduction in antiplatelet activity was observed with esomeprazole when given concomitantly with Plavix.
Dexlansoprazole, lansoprazole, and pantoprazole had less effect on the antiplatelet activity of Plavix than did omeprazole or esomeprazole [see Warnings and Precautions (5.1) and Clinical Pharmacology (12.3) ] .
From the Naproxen and esomeprazole (Naproxen and esomeprazole magnesium) label · effective 2026-05-27
Interaction with Clopidogrel : Avoid concomitant use.
5.22Interaction with Clopidogrel Avoid concomitant use of esomeprazole with clopidogrel.
Clopidogrel : Avoid concomitant use of clopidogrel with naproxen and esomeprazole magnesium delayed-release tablets.
Concomitant use of clopidogrel with 40 mg esomeprazole reduces the pharmacological activity of clopidogrel.
•Concomitant use of esomeprazole 40 mg resulted in reduced plasma concentrations of the active metabolite of clopidogrel and a reduction in platelet inhibition [see Clinical Pharmacology (12.3) ].
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Open in the checkerNot medical advice. Interaction Checker quotes FDA label text and NIH fact sheets. Whether an interaction matters for you depends on doses, timing, kidney and liver function, and other conditions. Confirm with a pharmacist or prescriber.