What considerations must be taken into account when deciding on the best approach to long-term use ...

The following is a list of things to consider when using anti-inflammatory agents:

When administering NSAIDs it is important to monitor for gastrointestinal side effects such as bleeding, vomiting, and diarrhea. Clients should call the clinic if any of these side effects occur. To avoid gastrointestinal side effects, NSAIDs may be given with food, be enteric coated, or be given in lower doses.

If another drug can be used with fewer side effects, its use should be considered. This is especially true with steroidal anti-inflammatory drugs.

Use the smallest possible dose that provides the clinical response.

Reduce the dose of drug, if possible, as the clinical condition improves.

Avoid using long-acting forms of the drug (especially glucocorticoids). Long-acting glucocorticoid use over long periods of time may lead to iatrogenic Cushing's disease, due to the suppression and atrophy of the adrenal cortex.

Periodic recheck examinations and blood work may be indicated with some NSAIDs and steroidal anti-inflammatory drugs.