First published 25 October 2021


  • Lung and brain blood clots common in COVID patients
  • Doctors have been using the drug Edoxaban taken by mouth to prevent blood clots
  • The same drug by inhalation could target the lungs directly, lower dosage and also health costs: study shows

QUT pharmaceutical scientist Dr Nazrul Islam from School of Clinical Sciences said that clots in the lungs were common in patients whose lungs are affected by COVID-19.

“COVID-19 patients also can develop blood clots in the brain along with the lung and so doctors have been prescribing the anticoagulation drug Edoxaban (EDX) orally to reduce the risk of clots,” said Dr Islam, who has studied the delivery of medicines by dry powder inhalers extensively.

“Recent (2021) US research has shown that the initial use of an anticoagulant preventatively has reduced the risk of death and cause no increased risk of serious bleeding cases in patients with COVID-19.

“This prompted us to study in-vitro the ability of dry powder inhalants to deliver anticoagulant drug particles directly to the target site of the lungs.

“This delivery method allows a rapid onset of action that substantially reduces the total administered dose and serious dose-related gastrointestinal bleeding.”

Dr Nazrul said the team tested EDX because, compared with the commonly used anticoagulant warfarin, EDX needs less monitoring and dietary conditions, has a wide therapeutic window and reduced overall medication associated costs.

“EDX has been extended to management of lung clots in some patients with COVID-19 with good effect,” he said.

“We developed an EDX dry powder inhalation formulation which we tested alone and with a variety of excipients along with large carrier particles to help improve the power flow properties because the inhalable micronized drug particles are highly cohesive.

“Once inhaled the drug particles detach from the surface of large carrier lactose particles and get into the lung along with the inhaled air, while the carrier particles deposit in the mouth or upper respiratory tract.

“We then tested the DPI EDX formulation’s anticoagulation action in the laboratory and found a promising in-vitro anticoagulation effect at a very low concentration within 10 to 20 minutes.

“To date, this is the first study to investigate the inhaled EDX DPI formulation for anticoagulation effect.

“It has demonstrated a promising strategy to resolve a pressing health problem and also have a major impact on health research.

“We need further studies to investigate the toxicity and clinical application of the inhaled EDX formulations.”

QUT researchers conducted the study in collaboration with Dr Md Abdur Rashid and Dr Yahya Al Hamhoom from the Department of Pharmaceutics, College of Pharmacy, King Khalid University, Saudi Arabia.

Inhaled Edoxaban dry powder inhaler formulations: Development, characterization and their effects on the coagulopathy associated with COVID-19 infection was published in the International Journal of Pharmaceutics.

QUT Media contact:

Niki Widdowson, 07 3138 2999 or

After hours: Rod Chester, 0407 585 901 or

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