What kind of reactions can happen when you take Valium, Ultram, and Nexium together?

I would say listen to your body - you are allergic to something in these meds. They don't agree with you. I'd say you need to change one of the three- see if it makes a difference. If not, try one of the other two. It's when we don't listen to our bodies that we get into trouble. I checked for interactions between these three meds and found some moderate and minor ones. You can read the list here: Interactions between your selected drugs

diazepam ↔ tramadol
Applies to: Valium (diazepam), Ultram (tramadol)
MONITOR: Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these effects, especially in elderly or debilitated patients.

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MANAGEMENT: During concomitant use of these drugs, patients should be monitored for potentially excessive or prolonged CNS and respiratory depression. Ambulatory patients should be counseled to avoid hazardous activities requiring mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.

diazepam ↔ esomeprazole
Applies to: Valium (diazepam), Nexium (esomeprazole)
The coadministration of esomeprazole and diazepam may result in elevated plasma concentrations of the latter. The mechanism is decreased clearance of diazepam due to competitive inhibition of CYP450 2C19 activity by esomeprazole. The manufacturer reports a 45% decrease in clearance, although increased plasma levels of diazepam were observed only from 12 hours after dosing and onwards, at which time the plasma levels were below the therapeutic interval. No particular action or caution is required, as this interaction is unlikely to be of clinical significance.

No other interactions were found between your selected drugs.
Note: this does not necessarily mean no interactions exist. ALWAYS consult with your doctor or pharmacist.

Other drugs that your selected drugs interact with

Nexium (esomeprazole) interacts with more than 100 other drugs.
Ultram (tramadol) interacts with more than 300 other drugs.
Valium (diazepam) interacts with more than 300 other drugs.
Interactions between your selected drugs and food

diazepam ↔ food
Applies to: Valium (diazepam)
MONITOR: Grapefruit juice may increase the plasma concentrations of orally administered drugs that are substrates of the CYP450 3A4 isoenzyme. However, the interaction seems to affect primarily those drugs that undergo significant presystemic metabolism by CYP450 3A4 (i.e., drugs with low oral bioavailability), presumably due to the fact that grapefruit juice inhibits intestinal rather than hepatic CYP450 3A4. Because pharmacokinetic interactions involving grapefruit juice are often subject to a high degree of interpatient variability, the extent to which a given patient may be affected is difficult to predict.

MANAGEMENT: Patients who regularly consume grapefruit or grapefruit juice should be monitored for adverse effects and altered plasma concentrations of drugs that undergo significant presystemic metabolism by CYP450 3A4. Grapefruit and grapefruit juice should be avoided if an interaction is suspected. Orange juice is not expected to interact with these drugs.

esomeprazole ↔ food
Applies to: Nexium (esomeprazole)
ADJUST DOSING INTERVAL: Food may interfere with the absorption of esomeprazole. The manufacturer reports that the area under the concentration-time curve for esomeprazole following a single 40 mg dose was 33% to 53% lower when administered after food intake as opposed to during fasting conditions.

MANAGEMENT: Esomeprazole should be taken at least one hour before meals.

See also...

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Drug Interaction Classification

The classifications below are a guideline only. The relevance of a particular drug interaction to a specific patient is difficult to determine using this tool alone given the large number of variables that may apply.

Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Do not stop taking any medications without consulting your healthcare provider.

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