From: OTC analgesics and drug interactions: clinical implications
 | No or low NSAID gastrointestinal risk | NSAID gastrointestinal risk |
---|---|---|
No cardiovascular risk (without aspirin) | Nonselective NSAID (cost consideration) | COX-2 selective inhibitor or nonselective NSAID and proton-pump inhibitor |
 |  | COX-2 selective inhibitor and proton-pump inhibitor for those with prior GI bleeding |
Cardiovascular risk (with aspirin) | Naproxena | Proton-pump inhibitor irrespective of NSAID |
 | Addition of proton-pump inhibitor if gastrointestinal risk of aspirin/NSAID combination warrants gastroprotection | Naproxen if CV risk outweighs GI risk |
 |  | COX-2 selective inhibitor and proton-pump inhibitor for those with previous GI bleeding |