Profile of the Respimat soft mist inhaler for chronic obstructive pulmonary disease treatment: overview of its safety and efficacy

Introduction: The Respimat Soft Mist Inhaler (SMI), introduced in the early 2000s, represented a significant, represented a significant advancement in inhaled drug delivery for chronic obstructive pulmonary disease (COPD). It offers improved lung deposition, lower oropharyngeal impaction, and enhanced ease of use compared to traditional pressurized or dry powder inhalers. Area covered: This review provides an up-to-date overview of the Respimat SMI's design, inhaler performance, aerosol and lung deposition characteristics, clinical efficacy, patient-reported outcomes, and environmental impact. Comparative data with pressurized metered-dose inhalers (pMDIs), dry powder inhalers (DPIs), and emerging generic alternatives (e.g. MRX004) are critically discussed. The review also addresses usability, patient preference, and the increasing shift toward reusable, propellant-free inhalation platforms. Expert opinion: Respimat provides an effective, user-friendly alternative to conventional inhalers, especially for patients with suboptimal inspiratory flow or poor coordination Its fine-particle aerosol, high peripheral deposition, and environmentally sustainable design align with evolving clinical, economic, and policy priorities. Although further real-world data are needed, particularly regarding long-term adherence and device mastery, Respimat sets a benchmark for future inhaler innovation in terms of therapeutic performance, sustainability, and patient-centered care.