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NSAIDs + fish oil refers to the concurrent use of non-steroidal anti-inflammatory drugs (NSAIDs) and fish oil supplements, typically rich in omega-3 polyunsaturated fatty acids such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). NSAIDs act primarily by inhibiting cyclooxygenase enzymes (COX-1 and COX-2), thereby reducing the synthesis of pro-inflammatory prostaglandins. Fish oil exerts anti-inflammatory effects by providing EPA and DHA, which compete with arachidonic acid for COX binding sites, leading to the production of less inflammatory eicosanoids. The combination is explored mainly in chronic inflammatory conditions like rheumatoid arthritis, where evidence suggests that fish oil can reduce reliance on NSAIDs for symptom control. However, both agents may increase bleeding risk due to their effects on platelet aggregation and coagulation pathways[1][3][6][8].
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