Inhaled corticosteroids (ICSs) are commonly prescribed for asthma and COPD but need careful management to minimize the risk of side effects.

NHS data for 2013–2014 suggests that, in England, of the 242 million ICS-containing inhalers dispensed at a cost of almost £355m ($548M), 39% were for high-dose inhalers.

A high dose of ICS is defined as ?1000mcg beclometasone dipropionate (BDP) equivalent per day. Fluticasone propionate, mometasone and the newer ultrafine particle BDP hydrofluoroalkane (HFA) inhalers (ie QVAR and Fostair) are considered twice as potent as standard BDP inhalers. However, dose equivalents are approximate, and the dose delivered will depend on other factors such as inhaler technique.