parecoxib + valdecoxib + dexamethasone

This is a combination of three drugs: parecoxib, valdecoxib, and dexamethasone. Parecoxib is an injectable prodrug that is rapidly converted in vivo to valdecoxib, a selective cyclooxygenase-2 (COX-2) inhibitor used primarily for the short-term management of perioperative pain. Valdecoxib itself is also a COX-2 selective nonsteroidal anti-inflammatory drug (NSAID) with anti-inflammatory, analgesic, and antipyretic properties. Dexamethasone is a synthetic glucocorticoid corticosteroid with potent anti-inflammatory and immunosuppressant effects. The rationale for combining these agents would be to provide multimodal analgesia by targeting different inflammatory pathways—COX-2 inhibition via parecoxib/valdecoxib and glucocorticoid receptor agonism via dexamethasone—to reduce postoperative pain and inflammation more effectively than monotherapy.