In 166 elderly patients with the presence of primary gonoarthritis 2—3 stages according to Kellgren—Lawrence, with the severity of articular pain according to the WOMAC index of more than 200 mm, the effect of nonsteroidal anti-inflammatory drugs was studied: Nimesulide (Nimesil, «Berlin-Chemi/Menarini Pharma», Germany, granules for the preparation of suspensions for oral administration, at a dose of 200 mg/day); meloxicam (Movalis, «Boehringer Ingelheim», Germany, at a dose of 15 mg/day in the tablets) on the state of the kidneys (glomerular filtration and indicators of renal tubular epithelium membrane destruction — determination of hydrogen peroxide in the urine). Monotherapy of non-steroidal anti-inflammatory drugs had anti-inflammatory effect (reduction of pain index and morning stiffness by WOMAC index and CRP level). However, with the use of these doses of drugs for a month, a decrease in glomerular filtration and an increase in the excretion of hydrogen peroxide in the urine were noted. Decrease in the daily dose of nimesulide and meloxicam by 50 percent, but the addition of melatonin (Melaksen, «Unifarm», USA at a dose of 3 mg tablets at night) to the treatment made it possible to achieve a reduction in joint pain, morning stiffness in patients and reduce inflammation activity. Nephrotoxic effect on the background of complex therapy on the 30th and 60th days of treatment was not noted. Reduction in the nephrotoxicity of nonsteroidal anti-inflammatory drugs is achieved by reducing the daily dose of drugs, and the enhancement of the anti-inflammatory and analgesic effect by adding melatonin.