Non-steroidal anti-inflammatory drugs (NSAIDs) are a large and extremely heterogeneous group of drugs that have a single mechanism of action and therapeutic activity. The article lists their main subgroups by chemical structure and selectivity of action, describes the most typical side effects due to the pharmacodynamic characteristics of drugs, explains the reasons for their formation, and describes the cardiovascular complications they cause. Taking into account the lack of the desired safety of classical NSAIDs for cardiological practice, the possibility of optimizing their tolerance with the help of modern generations of cyclooxygenase inhibitors, namely the dextrorotatory S-enantiomer of ketoprofen – dexketoprofen trometamol (Dexketoprofen-SZ, «Severnaya Zvezda», Russia) was considered. The drug is distinguished by high efficiency and low risk of cardiovascular toxicity, which makes it widely used in symptomatic therapy of cardiac patients.