3. Duplicative Therapy

The combination of two or more NSAIDs is not recommended except the use of less than 325 mg daily of aspirin plus another NSAID.

Concurrent administration of an NSAID and ketorolac, another NSAID utilized primarily for pain management with limited treatment duration, is contraindicated due to the potential for increased gastrointestinal adverse events.

The combined use of specific COX-2 inhibitors like celecoxib and nonspecific COX-1/COX-2 inhibitors does not provide additional therapeutic benefit and may result in additive adverse effects, including gastrointestinal toxicity. Concurrent therapy with specific COX-2 inhibitors and nonspecific COX-1/COX-2 inhibitors is not recommended and will be reviewed.