AMichael Loes MD, MD(H) responds: This is an interesting and not so easy to answer question because just as there are many kinds of butterflies, so are there many birds in flight that call themselves NSAIDs and few that prefer to call themselves "coxibs"—the new buzz word for the selective COX-2 inhibitors, Celebrex, Vioxx and Bextra. NSAIDs are non steroidal anti-inflammatory drugs.
From a safety perspective, it is probably okay to take oral systemic enzymes with traditional NSAIDs or coxibs—but only for a short time when there is acute inflammation. NSAIDs will work a little faster than enzymes—a few days faster, but NSAIDs, in my opinion, should never be taken long term in that they do not increase the healing response whereas enzymes do. A word about aspirin. Small amounts of aspirin have been shown to be cardioprotective in high risk individuals. If your doctor recommends long term low dose aspirin therapy, do it. In my opinion, the addition of oral systemic enzymes are safe and beneficial when there is chronic inflammation also present.
Dr. Michael Loes is on the Board of Directors for the National Pain Foundation; he's an Assistant Professor at the University of Arizona; and he's the Director of the Arizona Pain Institute. Dr. Loes has co-authored numerous books exploring the alternative methods of healing naturally.