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TiO2 is also used in oral pharmaceutical formulations, and the Pharmaceutical Excipients handbook considers nano-sized TiO2 a non-irritant and non-toxic excipient. Despite the fact that TiO2 submicron- and nano-sized particles are widely used as food and pharmaceutical additives, information on their toxicity and distribution upon oral exposure is very limited.
A review published in 2022 in the journal NanoImpact evaluated the latest research related to genotoxic effects of titanium dioxide through in vivo studies and in vitro cell tests. Researchers summarized the results by stating TiO2 nanoparticles “could induce genotoxicity prior to cytotoxicity,” and “are likely to be genotoxic to humans.”