Pneumology - Reviews
6 October 2025

Inhalation beyond respiratory: the surprising applications of dry powder inhalers

Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
66
Views
51
Downloads

Authors

Dry powder inhalers (DPIs) are the newer devices whereby medicine is dispensed as a fine powder inhaled deeply into the lungs, which is more simplified and stable compared to the pressurized metered dose inhalers. DPIs were developed primarily for respiratory disorders such as asthma and chronic obstructive pulmonary disease but are being investigated for other uses. This review explicates the features of DPIs and how they are made, looking at their effectiveness in respiratory therapy, noting features such as usability, stability of the drugs, and flexibility. It also discusses the potential of systemic drug delivery using other routes, such as insulin for diabetes, calcitonin for osteoporosis, antibacterial agents, vaccines, dermal treatments, and ocular treatments, considering issues like stability and patients’ compliance. Issues related to jet milling, spray drying, and supercritical fluid technology are also covered with regard to improving DPI performance. Hindrances, including formulation stability and regulatory issues, have been discussed as a way of demonstrating how innovation is needed to go beyond respiratory therapy.

Altmetrics

Downloads

Download data is not yet available.

Citations

Islam N, Gladki E. Dry powder inhalers (DPIs)—a review of device reliability and innovation. Int J Pharmaceutics 2008;360:1. DOI: https://doi.org/10.1016/j.ijpharm.2008.04.044
Lee HG, Kim DW, Park CW. Dry powder inhaler for pulmonary drug delivery: human respiratory system, approved products and therapeutic equivalence guideline. J Pharm Investig 2018;48:603-16. DOI: https://doi.org/10.1007/s40005-017-0359-z
Shinde TP, Mahajan NM. A study on dry powder with prescription drugs. Available from: https://ijarst.in/public/uploads/paper/367081703158395.pdf.
Wang B, Xiang J, He B, et al. Enhancing bioavailability of natural extracts for nutritional applications through dry powder inhalers (DPI) spray drying: technological advancements and future directions. Front Nutr 2023;10:1190912. DOI: https://doi.org/10.3389/fnut.2023.1190912
Weers JG, Miller DP. Formulation design of dry powders for inhalation. J Pharm Sci 2015;104:3259-88. DOI: https://doi.org/10.1002/jps.24574
Shur J, Saluja B, Lee S, et al. Effect of device design and formulation on the in vitro comparability for multi-unit dose dry powder inhalers. AAPS J 2015;17:1105-16. DOI: https://doi.org/10.1208/s12248-015-9775-z
Morais-Almeida M, Pité H, Cardoso J, et al. Asthma management with breath-triggered inhalers: innovation through design. Asthma Res Pract 2020;6:4. DOI: https://doi.org/10.1186/s40733-020-00057-7
Eedara BB, Alabsi W, Encinas-Basurto D,et al. Spray-dried inhalable powder formulations of therapeutic proteins and peptides. AAPS PharmSciTech 2021;22:185. DOI: https://doi.org/10.1208/s12249-021-02043-5
Berkenfeld K, Lamprecht A, McConville JT. Devices for dry powder drug delivery to the lung. AAPS PharmSciTech 2015;16:479-90. DOI: https://doi.org/10.1208/s12249-015-0317-x
Dal Negro RW. Dry powder inhalers and the right things to remember: a concept review. Multidiscip Respir Med 2015;10:13. DOI: https://doi.org/10.4081/mrm.2015.288
Price D, Chrystyn H. Concept review of dry powder inhalers: correct interpretation of published data. Multidiscip Respir Med 2015;10:36. DOI: https://doi.org/10.4081/mrm.2015.338
Medication administration: dry powder inhaler (respiratory theraphy). 2024. Available from: https://elsevier.health/en-US/preview/medication-administration-dry-powder-inhaler-respiratory-therapy.
Ortega VE, Izquierdo M. Drugs for preventing and treating asthma. 2025. Available from: https://www.merckmanuals.com/home/lung-and-airway-disorders/asthma/drugs-for-preventing-and-treating-asthma.
Duarte AG, Tung L, Zhang W, et al. Spirometry measurement of peak inspiratory flow identifies suboptimal use of dry powder inhalers in ambulatory patients with COPD. Chronic Obstr Pulm Dis 2019;6:246-55. DOI: https://doi.org/10.15326/jcopdf.6.3.2018.0163
Leving MT, Bosnic-Anticevich S, van Cooten J, et al. Clinical recommendations for dry powder inhaler use in the management of COPD in primary care. NPJ Prim Care Respir Med 2022;32:59. DOI: https://doi.org/10.1038/s41533-022-00318-3
What do rescue inhalers do? 2023. Available from: www.medicalnewstoday.com/articles/321068.
Chogale MM, Dhoble SB, Patravale VB. A triple combination'nano'dry powder inhaler for tuberculosis: in vitro and in vivo pulmonary characterization. Drug Deliv Transl Res 2021;11:1520-31. DOI: https://doi.org/10.1007/s13346-021-01005-5
Rehman AU. Inhaled medications for asthma management: DPIs vs. MDIs - a comprehensive comparison. Available from: https://medium.com/@Dr.AtiqUrRehman/inhaled-medications-for-asthma-management-dpis-vs-mdis-a-comprehensive-comparison-da569216d309
Lexmond AJ, Kruizinga TJ, Hagedoorn P, et al. Effect of inhaler design variables on paediatric use of dry powder inhalers. PLoS One 2014;9:e99304. DOI: https://doi.org/10.1371/journal.pone.0099304
Ramadan WH, Sarkis AT. Patterns of use of dry powder inhalers versus pressurized metered-dose inhalers devices in adult patients with chronic obstructive pulmonary disease or asthma: an observational comparative study. Chron Respir Dis 2017;14:309-20. DOI: https://doi.org/10.1177/1479972316687209
Breathe Free. Inhalers A-Z. Available from: www.breathefree.com/blogs/advantages-limitations-dry-powder-inhalers.
Moon C, Smyth HD, Watts AB, Williams III RO. Delivery technologies for orally inhaled products: an update. AAPS PharmSciTech 2019;20:117. DOI: https://doi.org/10.1208/s12249-019-1314-2
Shetty N, Cipolla D, Park H, Zhou QT. Physical stability of dry powder inhaler formulations. Expert Opin Drug Deliv 2020;17:77-96. DOI: https://doi.org/10.1080/17425247.2020.1702643
Laube BL, Janssens HM, de Jongh FH, et al. What the pulmonary specialist should know about the new inhalation therapies. Eur Respir J 2011;37:1308-31. DOI: https://doi.org/10.1183/09031936.00166410
Crompton GK. Dry powder inhalers: advantages and limitations. J Aerosol Med 1991;4:151-6. DOI: https://doi.org/10.1089/jam.1991.4.151
Pernigotti D, Stonham C, Panigone S, et al. Reducing carbon footprint of inhalers: analysis of climate and clinical implications of different scenarios in five European countries. BMJ Open Respir Res 2021;8:e001071 DOI: https://doi.org/10.1136/bmjresp-2021-001071
Wilkinson AJ, Braggins R, Steinbach I, Smith J. Costs of switching to low global warming potential inhalers. An economic and carbon footprint analysis of NHS prescription data in England. BMJ Open 2019;9:e028763. DOI: https://doi.org/10.1136/bmjopen-2018-028763
Yang MS, Kang JH, Kim DW, Park CW. Recent developments in dry powder inhalation (DPI) formulations for lung-targeted drug delivery. J Pharm Investig 2024;54:113-30. DOI: https://doi.org/10.1007/s40005-023-00635-w
Encinas-Basurto D, Eedara BB, Mansour HM. Biocompatible biodegradable polymeric nanocarriers in dry powder inhalers (DPIs) for pulmonary inhalation delivery. J Pharm Investig 2024;54:1-6. DOI: https://doi.org/10.1007/s40005-024-00671-0
Sato H. Design strategies of dry powders for pulmonary delivery of pharmaceutical peptides. In: Lam J, Kwok PCL, eds. Respiratory delivery of biologics, nucleic acids, and vaccines. Cham: Springer International Publishing; 2023. pp. 1-20. DOI: https://doi.org/10.1007/978-3-031-47567-2_1
Ara N, Hafeez A. Nanocarrier-mediated drug delivery via inhalational route for lung cancer therapy: a systematic and updated review. AAPS PharmSciTech 2024;25:47. DOI: https://doi.org/10.1208/s12249-024-02758-1
Cazzola M, Cavalli F, Usmani OS, Rogliani P. Advances in pulmonary drug delivery devices for the treatment of chronic obstructive pulmonary disease. Expert Opin Drug Deliv 2020;17:635-46. DOI: https://doi.org/10.1080/17425247.2020.1739021
Kim ES, Plosker GL. AFREZZA®(insulin human) inhalation powder: a review in diabetes mellitus. Drugs 2015;75:1679-86. DOI: https://doi.org/10.1007/s40265-015-0472-0
Muñoz-Torres M, Alonso G, Mezquita Raya P. Calcitonin therapy in osteoporosis. Treat Endocrinol 2004;3:117-32. DOI: https://doi.org/10.2165/00024677-200403020-00006
Ghosh A, Srivastava R. Nanomedicines for the pulmonary delivery of antibiotics. In: Patravale VB, Date AA, Jindal AB, eds. Nanomedicines for the prevention and treatment of infectious diseases. Cham: Springer International Publishing; 2023. pp. 35-75 DOI: https://doi.org/10.1007/978-3-031-39020-3_2
Placha D, Jampilek J. Chronic inflammatory diseases, anti-inflammatory agents and their delivery nanosystems. Pharmaceutics 2021;13:64. DOI: https://doi.org/10.3390/pharmaceutics13010064
Groneberg DA, Witt C, Wagner U, et al. Fundamentals of pulmonary drug delivery. Respir Med 2003;97:382-7. DOI: https://doi.org/10.1053/rmed.2002.1457
Abdulbaqi IM, Assi RA, Yaghmur A, et al. Pulmonary delivery of anticancer drugs via lipid-based nanocarriers for the treatment of lung cancer: an update. Pharmaceuticals 2021;14:725. DOI: https://doi.org/10.3390/ph14080725
Ji D, Zhang Y, Sun J, et al. An engineered influenza virus to deliver antigens for lung cancer vaccination. Nat Biotechnol 2024;42:518-28. DOI: https://doi.org/10.1038/s41587-023-01796-7
Li Q, Humphries F, Girardin RC, et al. Mucosal nanobody IgA as inhalable and affordable prophylactic and therapeutic treatment against SARS-CoV-2 and emerging variants. Front Immunol 2022;13:995412. DOI: https://doi.org/10.3389/fimmu.2022.995412
Qin L, Sun Y, Gao N, et al. Nanotechnology of inhalable vaccines for enhancing mucosal immunity. Drug Deliv Transl Res 2024;14:597-620. DOI: https://doi.org/10.1007/s13346-023-01431-7
Mangla B, Javed S, Sultan MH, et al. Nanocarriers-assisted needle-free vaccine delivery through oral and intranasal transmucosal routes: a novel therapeutic conduit. Front Pharmacol 2022;12:757761. DOI: https://doi.org/10.3389/fphar.2021.757761
Xing Z, Jeyanathan M. A next-generation inhalable dry powder COVID vaccine. Nature 2023;624:532-4. DOI: https://doi.org/10.1038/d41586-023-03557-7
Kateryna K. RSV poses serious risks, but new vaccine options are emerging. Available from: https://www.nature.com/articles/d42473-023-00149-x#:~:text=mRNA%20technology%20shows%20promise%20for,CoV%2D2%20%E2%80%94%20at%20once.
Heida R, Hinrichs WL, Frijlink HW. Inhaled vaccine delivery in the combat against respiratory viruses: a 2021 overview of recent developments and implications for COVID-19. Expert Rev Vaccines 2022;21:957-74. DOI: https://doi.org/10.1080/14760584.2021.1903878
Xia Y, Zhang Y, Du Y, et al. Comprehensive dry eye therapy: overcoming ocular surface barrier and combating inflammation, oxidation, and mitochondrial damage. J Nanobiotechnology 2024;22:233. DOI: https://doi.org/10.1186/s12951-024-02503-7
Liu LC, Chen YH, Lu DW. Overview of recent advances in nano-based ocular drug delivery. Int J Mol Sci 2023;24:15352. DOI: https://doi.org/10.3390/ijms242015352
Sun H, Wang G, Feng Q, Liu S. Polymer-based self-assembled drug delivery systems for glaucoma treatment: design strategies and recent advances. Polymers 2023;15:4466. DOI: https://doi.org/10.3390/polym15224466
Wei J, Mu J, Tang Y, et al. Next-generation nanomaterials: advancing ocular anti-inflammatory drug therapy. J Nanobiotechnology 2023;21:282. DOI: https://doi.org/10.1186/s12951-023-01974-4

How to Cite



“Inhalation Beyond Respiratory: The Surprising Applications of Dry Powder Inhalers”. 2025. Monaldi Archives for Chest Disease, October. https://doi.org/10.4081/monaldi.2025.3172.