Although nonsteroidal anti-inflammatory drugs (NSAIDs) have definite indications and can offer relief for many conditions, many patients have severe gastrointestinal problems after taking them. Physicians should prescribe these drugs more selectively and advise patients to limit their use of over-the-counter NSAIDs. For patients at high risk who need an NSAID, a prophylactic drug or a cyclooxygenase 2-selective NSAID can decrease the risk.