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New lower-carbon asthma inhalers have been approved by the Medicines and Healthcare products Regulatory Agency (MHRA), in what the regulator has described as a “world first”.
On 21 July 2026, the MHRA said that new versions of the Clenil Modulite 100mcg and 200mcg pressurised metered dose (pMDI) inhalers, manufactured by Chiesi, use HFA-152a as a propellant, which has a lower carbon footprint compared with older propellants.
The use of HFA-152a in the asthma inhalers can reduce the carbon footprint of pMDI inhalers by up to 90%, Chiesi said.
The MHRA also noted that the Clenil Modulite inhalers contain beclometasone dipropionate as the active ingredient, which are used for the maintenance treatment of asthma in adults and children. It added that no changes are being made to the active ingredient or the dosing of the medication.
The new versions of the inhalers will be available in the UK later in 2026, the MHRA said.
Julian Beach, executive director of healthcare quality and access at the MHRA, commented: “This approval marks the world’s first authorisation of an inhaler using the next-generation propellant HFA-152a. It demonstrates how innovation can support both patient care and environmental sustainability while maintaining the high standards of quality, safety and effectiveness patients expect.
“As with all medicines, we will continue to monitor its safety and effectiveness closely.”
Toby Capstick, consultant pharmacist in respiratory medicine at Leeds Teaching Hospitals NHS Trust, said the approval is “an important milestone for asthma management”.
“Current HFA propellants (HFA-134 and HFA-227) have a global warming potential that is 1,300 to 3,300 times greater than carbon dioxide and consequently contribute to 3% of the NHS total carbon footprint,” he said.
“Whilst the NHS has endeavoured to prescribe more low-carbon inhalers over the past few years, such as dry powder inhalers and soft mist inhalers, pMDI devices remain an integral component of asthma management for many people. In England, approximately two-thirds of all inhalers prescribed in primary care are pMDIs.”
Capstick added that the approval will be important for patients who may not be able to use dry powder inhalers, such as young children.
“[Pharmacists] should be alert to reassure patients that the only change to their inhaler is the propellant. Studies have demonstrated bioequivalence of the two versions of these inhalers, so no change in effectiveness and asthma control would be anticipated,” he continued.
Capstick also noted that from October 2026, two other strengths of Clenil Modulite inhalers (50mcg and 250mcg), as well as the Atimos Modulite 12mcg pMDI (formoterol), will be discontinued. Pharmacists should now “proactively identify patients on these products, review their asthma management and offer alternatives in line with national guidelines”, he said.
The MHRA’s approval of lower-carbon asthma inhalers follows its May 2025 approval of a low-carbon version of Trixeo Aerosphere (AstraZeneca), which is a triple combination inhaler for adults with moderate-to-severe chronic obstructive pulmonary disease.
