Before nonsteroidal anti-inflammatory drugs (NSAIDs) are indicated, risk factors such as age, the use of other drugs potentially harmful to the gastrointestinal tract, smoking, and concomitant use of aspirin should be evaluated, to select the most appropriate option for each patient and determine the need for gastroprotective therapy. Because of the possibility of cardiovascular risk posed by COX-2 selective NSAIDs, cardiovascular risk factors should also be analyzed in each patient before starting treatment of this type, mainly bearing in mind that the protective effect of COX-2 selective NSAIDs is substantially reduced in patients taking aspirin.