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This is a combination of three selective cyclooxygenase-2 (COX-2) inhibitors: parecoxib, valdecoxib, and etoricoxib. All three are nonsteroidal anti-inflammatory drugs (NSAIDs) that act by selectively inhibiting the COX-2 enzyme, thereby reducing the synthesis of prostaglandins involved in pain and inflammation. Parecoxib is a water-soluble injectable prodrug rapidly converted to valdecoxib after administration; both are used for short-term management of perioperative pain. Etoricoxib is an oral COX-2 inhibitor with high selectivity for COX-2 over COX-1 and is used primarily for chronic conditions such as osteoarthritis and rheumatoid arthritis. The combination would theoretically provide potent anti-inflammatory and analgesic effects but may increase the risk of adverse events, particularly cardiovascular complications[1][2][3][6].
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