How the MHRA’s Approval of Trixeo Aerosphere Supports Net Zero NHS Goals

One in every five inhalers prescribed in the UK contributes significantly to the NHS’s carbon footprint, making respiratory care a surprising player in the climate conversation. With over 1.2 million people relying on inhalers for chronic obstructive pulmonary disease, the environmental impact of these essential medicines is far from trivial.

Now, the MHRA's approval of Trixeo Aerosphere marks a pivotal moment for patient care and the planet. This innovative inhaler, featuring a near-zero global warming propellant, is more than just a medical advancement—it is a bold step towards the NHS’s ambitious Net Zero goals. 

Discover how this breakthrough is set to transform respiratory treatment and lead the way for sustainable healthcare across the UK.

COPD and the Role of Inhalers

Chronic obstructive pulmonary disease (COPD) is a progressive lung condition that affects around 1.2 million people in the UK. It is the second most common cause of emergency hospital admissions, significantly burdening patients and the NHS. Effectively managing COPD is crucial for improving quality of life, reducing hospital visits, and preventing severe flare-ups.

Inhalers are the cornerstone of COPD management. They deliver medication directly to the lungs, helping to relieve symptoms such as breathlessness, wheezing, and persistent cough. However, not all inhalers are created equal in terms of their environmental impact. Traditional pressurised metered dose inhalers (pMDIs) use propellants that contribute to greenhouse gas emissions, making them a hidden carbon source within the healthcare system.

What’s New: The Low-Carbon Trixeo Aerosphere

A Triple Combination for Modern Care

Trixeo Aerosphere is a triple combination inhaler designed for adults with moderate to severe COPD. It combines three active ingredients to provide comprehensive symptom control and reduce the risk of exacerbations. The innovation lies not in the medication but in the propellant used to deliver it.

The Propellant Revolution

The newly approved version of Trixeo Aerosphere replaces the traditional HFA-134a propellant with HFO-1234ze(E), a fluorinated gas with near-zero global warming potential. This change dramatically reduces each inhaler's carbon footprint without altering the treatment's effectiveness or safety. The propellant is not an active medicine but essential for delivering the correct lung dose.

Key Features of the New Trixeo Aerosphere

• Same active ingredients and dosage as the previous version

• Near-zero global warming potential with HFO-1234ze(E)

• No compromise on safety, quality, or clinical benefit

• Twice-daily use for long-term maintenance

Environmental Impact: Why This Approval Matters

The Carbon Footprint of Inhalers

Inhalers account for a significant portion of the NHS’s carbon emissions, with pMDIs being a major contributor due to their propellants. The NHS has set ambitious Net Zero targets to become the world’s first health service to reach net zero carbon emissions. Every step towards reducing the environmental impact of essential medicines is vital.

Supporting the NHS Net Zero Plan

The approval of the low-carbon Trixeo Aerosphere aligns perfectly with the NHS’s Plan for Change. By switching to a propellant with near-zero global warming potential, the NHS can:

1. Reduce greenhouse gas emissions from inhaler use

2. Maintain high standards of patient care

3. Lead the way in sustainable healthcare innovation

4. Support the UK’s broader climate commitments

A Model for Future Medicines

This move sets a precedent for other pharmaceutical companies and healthcare systems worldwide. It demonstrates that it is possible to innovate without compromising patient health and environmental sustainability.

Safety, Effectiveness, and Clinical Evidence

Rigorous Assessment by the MHRA

The Medicines and Healthcare products Regulatory Agency (MHRA) thoroughly reviewed the new Trixeo Aerosphere. Their assessment included:

• Clinical evidence showing the new propellant delivers the same dose and therapeutic effect as the original

• Product quality and device performance evaluations

• Stability testing to ensure long-term safety and efficacy

No Change for Patients

Patients can be reassured that:

• The active ingredients, recommended dose, and clinical use remain unchanged

• The safety profile is consistent with the previous version

• The Patient Information Leaflet (PIL) and Summary of Product Characteristics (SmPC) will be updated to reflect the new formulation.

Ongoing Monitoring

As with all medicines, the MHRA will continue to monitor Trixeo Aerosphere's safety and effectiveness. The Yellow Card Scheme encourages Patients and healthcare professionals to report any suspected side effects.

Availability and Transition for Patients

When Will the New Inhaler Be Available?

The low-carbon Trixeo Aerosphere will be available in the UK from the second half of 2025. Until then, the current version will remain accessible to patients, ensuring no disruption in care.

What Should Patients Expect?

• No immediate changes to prescriptions until the new version is launched

• Continued access to effective COPD treatment

• Clear communication from healthcare providers when the transition occurs

Tips for a Smooth Transition

• Stay informed by reading updates from your healthcare provider or TMMT

• Ask questions if you are unsure about your inhaler or any changes

• Report any side effects promptly to ensure ongoing safety monitoring

The Role of The Medicines Management Team (TMMT)

Supporting Healthcare Providers and Patients

The Medicines Management Team (TMMT) is committed to guiding healthcare professionals and patients through this critical transition. Our role includes:

• Providing up-to-date information on the new Trixeo Aerosphere

• Offering training and resources for prescribers and pharmacists

• Supporting patient education to ensure understanding and confidence in the new inhaler

• Promoting best practices in sustainable prescribing and medicine use

Our Commitment to Sustainability

TMMT supports the NHS’s Net Zero ambitions by championing greener healthcare solutions. We believe that innovation in medicine should always consider both patient outcomes and environmental impact.

Conclusion

The MHRA’s approval of the low-carbon Trixeo Aerosphere is a landmark achievement for respiratory care and environmental sustainability. The NHS is taking a decisive step towards its Net Zero goals by embracing innovation that benefits patients and the planet.

The Medicines Management Team remains committed to supporting this transition, ensuring every patient receives safe, effective, and sustainable care. 

Stay connected with TMMT for the latest updates and guidance as we move towards a greener future for healthcare in the UK.

FAQs

What is Trixeo Aerosphere used for?

Trixeo Aerosphere is prescribed for adults with moderate to severe chronic obstructive pulmonary disease (COPD). It helps to relieve symptoms such as breathlessness and wheezing, and reduces the risk of COPD flare-ups.

Does the Trixeo inhaler contain steroids?

Yes, Trixeo Aerosphere contains an inhaled corticosteroid (budesonide) as one of its three active ingredients. This helps to reduce inflammation in the airways and improve breathing.

What is the difference between Trixeo and Trimbow?

Both Trixeo Aerosphere and Trimbow are triple combination inhalers for COPD, but they use different inhaler devices and formulations. Trixeo is delivered via a pressurised metered dose inhaler (pMDI), while Trimbow is available as both a pMDI and a dry powder inhaler (DPI).

Is Trixeo the same as Trelegy?

Trixeo Aerosphere and Trelegy Ellipta are both triple therapy inhalers for COPD, but they contain different combinations of active ingredients and are delivered using different inhaler devices. Your healthcare provider will recommend the most suitable option based on your individual needs.