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Do Your Patients Overuse Oral Corticosteroids (OCS)?

While OCS can be an important tool in managing asthma in certain cases, use should always be carefully monitored by a qualified asthma specialist, or a primary care provider with asthma expertise. OCS carry serious health risks – just four bursts of steroids or 1-2.5 grams of OCS over a lifetime can increase your patient’s risk for serious side effects. Even short-term low-dose use of OCS (under 30 days) can result in serious health problems, doubling their risk for fracture, tripling it for blood clots, and a fivefold increase in sepsis risk. Other long-term effects include cataracts, high blood sugar (can trigger or worsen diabetes), infections, osteoporosis and thin skin, bruising, and slower wound healing.

OCS use is a signal that a patient may need an updated treatment plan, or support with adherence concerns. Conventional medications often include inhaled corticosteroids (ICS), which result in much lower overall steroid exposure than even one course of OCS.

What can you do to help prevent OCS overuse? Educate your patients and their caregivers about:

  • The risks associated with OCS: even a brief discussion about these risks will help inform them about the possible dangers from short- and long-term use.
  • The importance of adherence to other asthma medicines: emphasizing that they take their ICS daily, even when they aren’t having symptoms, to help prevent severe flare-ups that require OCS. Single Maintenance and Reliever Therapy (SMART) uses a single inhaler that contains both an ICS and a quick-relief medication (formoterol) for both daily maintenance and quick-relief. This can help patients who struggle to understand when to use their different asthma medications.
  • Advanced treatment options: Biologic medications for asthma are precision add-on therapies used for moderate-to-severe asthma that is not well-controlled with standard inhalers. They can reduce asthma symptoms, hospital visits, and the need for oral steroids.

Sometimes these conversations are hard to start, and patients want a “quick fix” for their symptoms. These resources can help:

Last Updated: 01/08/2026