OBJECTIVES: To evaluate the use of ‘antacid, antihemetic and adjuvant analgesic opiates and non-opiates’ (AAA) after using intravenous ketoprophene (100mg/day), ketorolac (90mg/day), parecoxib (40mg/day) or tenoxicam (40mg/day) in post-operative orthopedic surgery at five Brazilian private hospitals. METHODS: Medical charts were accessed and selected based on the use of ketoprophene, ketorolac, parecoxib or tenoxicam at the immediate post-operative period and based on the existence of hospital’s billing information. 400 medical charts from November 2010 were evaluated and 121 cases were recruited. Data regarding the regular use of AAA was gathered and grouped by age, sex, length of stay (LOS) at nursing ward and intensive care unit, and number of hours at the immediate post-operative observation room. Ketoprophene, ketorolac, parecoxib and tenoxicam groups were compared using unpaired t-tests with 95% confidence interval. RESULTS: Average age was 51.1 (±13.1)yrs and 60% were female. Average LOS at nursing ward, ICU and immediate post-operative rooms were 3.7 (±2.8) days, 0.8 (±1.1)days, and 95 (±36)min, respectively. Ketoprophene, ketorolac, parecoxib and tenoxicam for overall users represented 39.7%, 28.9%, 19.0% and 12.4% respectively. Ketorolac group exhibited to use more adjuvant non-opiate analgesics than parecoxib and tenoxicam groups(p<0,05). Only parecoxib was found to have significantly less use of antacid and antihemetic medications when compared to others treatments(p<0,004). Other parameters didn’t present meaningful differences. Total mean treatment daily costs considering drug equipment resulted in US$28.2; US$ 34.3; US$27.1 and US$32.9 USD corresponding to ketoprophene, ketorolac, parecoxib and tenoxicam, respectively. Mean AAA daily estimates costs were US$9.0 (±4.8); US$11.0 (±5.7); US$5.3 (±4.1) and US$7.5 (±4.9) USD, respectively. Potential cost savings per patient regarding the reduction of AAA by replacing all alternatives with parecoxib was estimated in US$37.2. CONCLUSIONS: Parecoxib users undergoing orthopedic surgeries showed the least use of antacid and antihemetic medications generating savings in the Brazilian private setting.