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A retrospective cohort study reported on 689 pregnant women exposed to either H2-blockers or omeprazole in the first trimester134 exposed to omeprazoleand 1,572 pregnant women unexposed to either during the first trimesterThe overall malformation rate in offspring born to mothers with first trimester exposure to omeprazolean H2-blockeror were unexposed was 3.65.5and 4.1respectively.

Avoid concomitant use of NEXIUM with clopidogrelClopidogrel is a prodrugInhibition of platelet aggregation by clopidogrel is entirely due to an active metaboliteThe metabolism of clopidogrel to its active metabolite can be impaired by use with concomitant medicationssuch as esomeprazolethat inhibit CYP2C19 activityConcomitant use of clopidogrel with 40 mg esomeprazole reduces the pharmacological activity of clopidogrelWhen using NEXIUM consider alternative anti-platelet therapysee DRUG INTERACTIONS and CLINICAL PHARMACOLOGY

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