I've been on effient for 2 years now. Pretty much the same as Plavix but does not interferre with PPIs such as Nexium, Prilosec etc. I had a problem with it in that it caused skin reactions more than Plavix. So I went back to plavix. By skin reations, I mean bumpy goose bump type reaction on arms. Both Plavix and Effient reall mess up my stomach also. Small price to pay if it keeps us alive.