Early pressurized metered-dose inhalers (pMDIs) used chlorofluorocarbons (CFCs) as propellants, which harmed the ozone layer, leading to their phase-out under the 1987 Montreal Protocol.
Current pMDIs now use hydrofluoroalkanes (HFAs), like HFA-134a, which do not deplete ozone but contribute to global warming, prompting a gradual reduction in their use.
Instead of switching to dry powder inhalers (DPIs), which may not be suitable for all patients, an alternative is to reformulate pMDIs to use low-global warming potential propellants like HFA-152a, addressing environmental impact while considering patient