Greener Inhalers Are Coming — Here's How to Make the Switch Safe for Patients

Millions of people around the world use a small spray device called a pressurised metered-dose inhaler, or pMDI, to treat asthma and other breathing problems. These inhalers work well, but the gas inside them is bad for the climate. Now, drug makers are working on new inhalers that use gases with a much smaller carbon footprint, and health experts want to make sure the switch happens safely for every patient.

The gas used in most inhalers today is called HFA-134a. It is more than 1,500 times more powerful as a greenhouse gas than carbon dioxide. New gases in development have a climate impact that is up to 99 percent lower, which would make inhalers much better for the environment.

Laws in Europe and other regions are already forcing companies to phase out the old high-GWP gases within the next five years. If the change is not handled carefully, some patients could face shortages or confusing device switches. Experts warn that any disruption could make it harder for people to control their breathing conditions.

A group of 28 experts from 13 countries met at a roundtable in September 2025 to talk about how to manage this change. The group included doctors, pharmacists, patient advocates, and representatives from the World Health Organization. After their discussions, they agreed on four key principles to keep patients safe during the transition.

The first principle is that patient safety must come first. Studies show patients could not tell the difference between the old and new inhaler gases, so the switch should feel the same. Simple guidance about inhaler technique should be enough to help most people through the change.

The second principle is that everyone must work together to keep inhalers available. Right now, most of the world's inhaler gas supply comes from just one company in the United Kingdom, which creates a risk. Drug makers, governments, doctors, and patient groups all need to share responsibility for keeping inhalers stocked and affordable everywhere.

The third principle is that rules and laws across different countries need to line up with each other. When governments have different regulations, it creates confusion and can slow down the rollout of new inhalers. Health and environmental regulators need to coordinate so their plans support — rather than block — each other.

The fourth principle is about building trust through honest, clear communication. Health workers should use calm language, such as 'transition' instead of 'switch,' to avoid worrying patients. Messages should focus on safety and health outcomes first, and also explain the environmental benefits of the change.

The experts believe that following these four principles can make the move to greener inhalers a real chance to improve care for people with asthma and other breathing diseases. Patients could get their inhaler technique checked and learn more about managing their condition. At the same time, the planet benefits from a lower carbon footprint.