Inhalationnas Eng
Inhalationnas Eng
Inhalationnas Eng
NOTICE
Our file number: 06-106624-547
Health Canada is pleased to announce the release of the final version of the Guidance for Industry
Pharmaceutical Quality of Inhalation and Nasal Products. This has been developed as a joint
guidance document by representatives from Health Canada's Therapeutic Products Directorate
(TPD) and the European Medicines Agency's Quality Working Party (QWP).
A draft guidance document, of the same title, was released for Stakeholder consultation in January
2005. The comments received during the consultation process of the January 2005 version, together
with discussions and changes to the guidance document, have been collated in a separate Questions
and Answers (Q&A) Document, which is available upon request. Requests for this Q&A Document
should be directed to the mailing address or e-mail address given below.
The main body of the joint guidance document made available in the two regions is identical.
Recommendations for information that is specific for filing in either Canada or in the European Union
are included as Region-specific Appendices in the documents published in the respective region.
Should you have any comments regarding the content of the guidance document, please contact:
Également disponible en français sous le titre : Qualité des produits pharmaceutiques administrés
par inhalation et par voie nasale
Health Canada Pharmaceutical Quality of Inhalation and Nasal Products
Guidance for Industry
FOREWORD
Guidance documents are meant to provide assistance to industry and health care professionals on how
to comply with the policies and governing statutes and regulations. They also serve to provide review
and compliance guidance to staff, thereby ensuring that mandates are implemented in a fair, consistent
and effective manner.
Guidance documents are administrative instruments not having force of law and, as such, allow for
flexibility in approach. Alternate approaches to the principles and practices described in this document
may be acceptable provided they are supported by adequate scientific justification. Alternate
approaches should be discussed in advance with the relevant program area to avoid the possible finding
that applicable statutory or regulatory requirements have not been met.
As a corollary to the above, it is equally important to note that Health Canada reserves the right to
request information or material, or define conditions not specifically described in this guidance, in order
to allow the Department to adequately assess the safety, efficacy or quality of a therapeutic product.
Health Canada is committed to ensuring that such requests are justifiable and that decisions are clearly
documented.
This document should be read in conjunction with the accompanying notice and the relevant sections of
other applicable guidances.
TABLE OF CONTENTS
1. INTRODUCTION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
5. EXCIPIENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
5.1 Pharmacopoeial Excipients . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
5.2 Non-Pharmacopoeial Excipients . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
9. GLOSSARY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
REGIONAL INFORMATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
Appendix I: Generic Products (Subsequent Market Entry Products) . . . . . . . . . . . . . . . . . . 25
Appendix II: Information for Consumers and Health Care Professionals (Product Monograph
and Labels) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
1. INTRODUCTION
This guidance document applies to human medicinal products intended for delivery of the drug
substance into the lungs, or to the nasal mucosa, with the purpose of evoking a local or systemic effect.
The document outlines expected quality aspects of drug products to be marketed, but the general
principles described here should also be considered for products used in clinical trials. It is not
expected that all described testing would be conducted on all clinical trial batches. However, extensive
characterisation of the drug substance and drug product batches used in pivotal clinical trials is
necessary to qualify the product proposed for marketing.
The document addresses new marketing authorisation applications (including for generic products) and
does not outline expected quality aspects related to changes in existing inhalation and nasal products.
However, the general principles described here should also be considered when making changes to
existing products.
This guidance document has been developed for products containing drug substances of synthetic or
semi-synthetic origin. However, the general principles described here should also be considered for
other inhalation and nasal products.
This document includes products for administration of the drug substance to the lungs, such as
pressurised metered dose inhalers, dry powder inhalers, products for nebulisation, and non-pressurised
metered dose inhalers, as well as pressurised metered dose nasal sprays, nasal powders, and nasal
liquids. Liquid inhalation anaesthetics and nasal ointments, creams and gels are excluded.
Only quality aspects specific to inhalation and nasal products are discussed, although the need for safety
testing (e.g., for excipients and leachables) is also addressed. Additional quality aspects (e.g.,
impurities, process validation, stability testing, specifications) as well as safety and efficacy aspects, are
described in other guidance documents, including ICH guidelines.
Detailed guidance on pharmaceutical development study designs (e.g., priming studies) and the
analytical procedures used primarily for inhalation and nasal products (e.g., cascade impactor analysis)
has not been provided. Some of this information may be found in other publications (e.g., United States
Pharmacopeia, European Pharmacopoeia, ISO standards). It is also recognised that the wide diversity
of inhalation and nasal products with respect to formulation and delivery device characteristics
necessitates some flexibility in testing methodology.
For all inhalation and nasal products containing a drug substance that is not in solution at any time during
drug product manufacture, storage or use, the drug substance specification should include a particle size
test and limits. A validated particle sizing method (e.g., laser diffraction), with acceptance criteria set at
multiple points across the size distribution, should be employed.
Acceptance criteria should assure a consistent particle size distribution in terms of the percentage of
total particles in given size ranges. The median, upper, and/or lower particle size limits should be well-
defined. Acceptance criteria should be set based on the observed range of variation, and should take
into account the particle size distribution of batches that showed acceptable performance in vivo, as
well as the intended use of the product. Process capability and stability data may also be considered,
provided the proposed acceptance criteria have been suitably qualified.
If alternative sources of drug substance are proposed, evidence of equivalence should include
appropriate physical characterisation and in vitro performance studies (see also Drug Product
Pharmaceutical Development).
Pharmaceutical development studies are conducted to establish that the dosage form, formulation,
manufacturing process, container closure system, microbiological attributes and instructions for use are
appropriate and result in acceptable product performance.
It is generally expected that the development tests be conducted on more than one batch, so that batch
variability is taken into account. For a single strength and a single container closure system, testing two
batches should be sufficient. For products packaged in container closure systems that also serve as the
delivery device, tests that involve delivery of the formulation should also be conducted on more than
one batch of the container closure system. In the case of multiple strengths and multiple package sizes,
a bracketing and/or matrixing design may be used to limit the number of test samples necessary.
Justification should be provided.
Sufficient data should be provided to support the specifications proposed or to give adequate assurance
that those performance characteristics which may not be routinely tested (e.g., priming and testing to
exhaustion) have been adequately investigated. It is not necessary to test all batches used in clinical
studies, but batches used in pivotal clinical studies should be sufficiently characterised to support the
specifications for the drug product.
If the tests described are not conducted due to the particular nature of the product or because
assurance of the parameter has been established by another means, a justification for the omission
should be provided.
The tests indicated in Table 3.1 are normally conducted to characterise inhalation products.
Not all tests are necessary for all types of inhalation products, as noted in Table 3.1. However,
any of the development tests may be applicable to any product, depending on the labelled
instructions for use (e.g., shaking tests for certain dry powder inhalers).
Non-
Pressurised Dry Powder Products for
Pharmaceutical Pressurised
Metered Inhalers Nebulisation
Development Metered
Dose
Study Dose
Inhalers
Device- Pre- Single Multi- Inhalers
Metered Metered Dose Dose
(a) Physical
Yes* Yes Yes Yes* Yes* Yes*
characterisation
(b) Minimum fill
Yes Yes Yes Yes Yes Yes
justification
(c) Extractables /
Yes No No Yes Yes Yes
Leachables
(d) Delivered dose
uniformity & fine
particle mass Yes Yes Yes No No Yes
through container
life
(e) Delivered dose
uniformity & fine
particle mass over No Yes Yes No No No
patient flow rate
range
(f) Fine particle
Yes No No No No No
mass with spacer
use
(g) Single dose fine
Yes Yes Yes No No Yes
particle mass
(h) Particle /
droplet size Yes Yes Yes Yes Yes Yes
distribution
(i) Actuator /
mouthpiece Yes Yes Yes No No Yes
deposition
Non-
Pressurised Dry Powder Products for
Pharmaceutical Pressurised
Metered Inhalers Nebulisation
Development Metered
Dose
Study Dose
Inhalers
Device- Pre- Single Multi- Inhalers
Metered Metered Dose Dose
(j) Drug delivery
rate and total drug No No No Yes Yes No
delivered
(k) Shaking
Yes* No No Yes* Yes* Yes*
requirements
(l,m) Initial & re-
priming Yes No No No No Yes
requirements
(n) Cleaning
Yes Yes Yes No No Yes
requirements
(o) Low
temperature Yes No No No No No
performance
(p) Performance
after temperature Yes No No No No Yes
cycling
(q) Effect of
environmental Yes Yes Yes No No No
moisture
(r) Robustness Yes Yes Yes No No Yes
(s) Delivery device
Yes Yes Yes Yes Yes Yes
development
(t) Preservative
effectiveness / No No No Yes** Yes** Yes**
efficacy
(u) Compatibility No No No Yes Yes No
* For suspensions.
** If a preservative is present.
Physical characteristics such as solubility, size, shape, density, rugosity, charge, and crystallinity
of the drug substance and/or excipients may influence the homogeneity and reproducibility of
the finished product. Development studies should include physical characterisation of drug
substance and excipients, relevant to their effect on the functionality of the product.
If applicable, the effect of pre-processing the material (e.g. micronisation) on the physical
characteristics should be evaluated.
For metered dose inhalers and device-metered dry powder inhalers, a study should be
conducted to demonstrate that the individual container minimum fill, as defined by the drug
product manufacturing process, is sufficient to provide the labelled number of actuations. The
final doses (as defined by the label claim) should meet the drug product specification limits for
delivered dose uniformity and fine particle mass.
For pre-metered dry powder inhalers and products for nebulisation, the acceptance criteria for
the fill volume and/or weight should be justified in relation to delivered dose uniformity and fine
particle mass.
For non-compendial plastic and for rubber container closure components that are in contact
with the formulation during storage (e.g., valves), a study should be conducted to determine the
extractables profile. Details and justification of the study design (e.g., solvents used,
temperature, storage time) and the results should be provided. It should be determined whether
any of the extractables are also leachables present in the formulation at the end of the shelf life
of the product or to the point equilibrium is reached, if sooner. The leachables profile should
also be determined for compendial plastics and rubber container closure components.
For compounds that appear as leachables, identification should be attempted and safety
assessments should be conducted in accordance with adequately established safety thresholds.
A cross-reference to the data presented in Module 4 (Safety) should be included.
Depending on the levels and types of compounds detected, consideration should be given to
including a test and limits for leachables in the drug product specification. If a correlation
between extractable and leachable profiles can be established, control of leachables could be
accomplished via testing and limits on extractables, either on the components or on the raw
materials if a correlation has been shown between the levels in the raw materials and
components. If there are no safety concerns with the type and level of leachables detected,
routine monitoring of leachables would not be necessary.
3.1(d) Delivered dose uniformity and fine particle mass through container life (CTD
3.2.P.2.4)
A study should be conducted to demonstrate the consistency of the minimum delivered dose
(e.g., one or more actuations) and the fine particle mass through the life of the container from
the first dose (post-priming dose for products with priming instructions) until the last labelled
dose. The containers should be used and tested according to the information for the patient with
respect to storage orientation and cleaning requirements, as well as minimum dosing interval. It
is generally expected that at least ten doses from the combination of the beginning, middle, and
end of the container be tested.
The doses obtained should meet the drug product specification limits for delivered dose
uniformity and fine particle mass. Non-conforming results should be explained.
The doses between the last labelled dose and the last container exhaustion dose should also be
tested for delivered dose uniformity and fine particle mass, and information on the tail-off profile
should be provided where applicable. At least three containers from each of two different
batches should be investigated. This testing may be waived if the container contains a lockout
mechanism that prevents dosing beyond the labelled number of doses.
3.1(e) Delivered dose uniformity and fine particle mass over patient flow rate range
(CTD 3.2.P.2.4)
A study should be conducted to demonstrate the consistency of the minimum delivered dose
and the fine particle mass over the range of flow rates (through the delivery device) achievable
by the intended patient population, at constant volume. The range of flow rates should be
justified in relation to clinical studies or published data for the same delivery device. The
minimum (e.g., 10th percentile), median, and maximum (e.g., 90th percentile) achievable rate
should be investigated.
Depending on the results of this study (e.g., if the minimum flow rate does not produce an
acceptable dose), consideration should be given to providing information on the effect of flow
rate on the performance of the product to health care professionals.
3.1(f) Fine particle mass with spacer/holding chamber use (CTD 3.2.P.2.4)
For inhalation products that may be administered with a spacer or holding chamber, a study
should be conducted to determine whether the use of the spacer or holding chamber changes
the fine particle mass. If the instructions accompanying the spacer or holding chamber include
an in-use cleaning schedule (e.g., weekly cleaning), the fine particle mass should be tested
before and after cleaning the spacer or holding chamber according to the instructions provided
with the device. The fine particle mass test used for routine testing of the product may be
altered to mimic patient performance with the spacer or holding chamber (e.g., a 2 second
delay, tidal breathing).
Any differences in fine particle mass should be assessed for their clinical relevance, with support
from any clinical data obtained with the spacer or holding chamber. See also Regional
Information Appendix III: Devices, Spacers and Holding Chambers (European Union only).
The fine particle mass should be routinely determined using the minimum recommended dose, if
technically possible. If the fine particle mass test included in the drug product specification uses
a sample size greater than the minimum recommended dose, a study should be conducted to
demonstrate that the sample size used routinely provides results equivalent to those obtained
using the minimum recommended dose. Justification for not conducting this test (e.g., for low
dosed products) and for non-equivalent results should be provided.
The fine particle mass of one dose should be determined according to the drug product
specification fine particle mass method, modified only as necessary to accommodate the
reduced sample size. Stage pooling prior to analysis is acceptable. The selection of the pooled
stages should be justified. If this study is not feasible due to the sensitivity of the analytical
method, data supporting this claim should be provided.
The results obtained should be compared to fine particle mass results obtained according to the
unmodified fine particle mass method for the same batches. Any differences should be assessed
for their significance.
To allow an assessment of the complete profile of the product used in in vivo (pivotal clinical
and/or comparative) studies, individual stage particle size distribution data should be provided
for the batches used in these studies, as well as data on batches representative of the
commercial process.
Using a multistage impactor or impinger, the drug mass on each stage and the cumulative mass
undersize a given stage should be determined rather than the percentage of emitted dose (or
other derived parameter) as these can hide variations in delivered dose. A plot of cumulative
percentage less than a stated cut-off diameter versus cut-off diameter should usually be
provided. From this, the Mass Median Aerodynamic Diameter (MMAD) and Geometric
Standard Deviation (GSD) may be determined, if appropriate (in the case of uni-modal log-
normal distribution). Mass balance reconciliation should also be considered.
When a range of different strengths is proposed, proportionality in fine particle mass and other
size ranges (e.g., mass deposited in the impactor throat) should be considered.
For solutions for nebulisation, droplet size distribution may be tested by other methods (e.g.,
laser diffraction).
The amount of drug deposited on the actuator or mouthpiece should be determined and, where
applicable, demonstrated to be consistent with any correction factor used to support ex-valve
(or ex-delivery device) label claims.
3.1(j) Drug delivery rate and total drug delivered (CTD 3.2.P.2.4)
To allow an assessment of the complete delivery profile of the product used in in vivo (pivotal
clinical and/or comparative) studies, the drug delivery rate and total drug delivered (i.e. total
dose delivered to the patient) results should be provided for the batches used in these studies.
A validated method (e.g., breath simulator), should be employed. The aerosol should be
generated with the nebuliser system(s) and settings used in the in vivo studies.
For products requiring shaking before use (according to the instructions for use), a study should
be conducted to demonstrate that the shaking instructions provided to the consumer are
adequate. The possibility of excessive shaking leading to foaming and inaccurate dosing should
be examined by testing the delivered dose uniformity.
A study should be conducted to support the number of actuations recommended in the labelling
that should be fired to waste (priming actuations) prior to the consumer using the product for
the first time. Containers should be stored in various orientations prior to the initiation of the
study in order to determine the effect of orientation. The length of storage prior to conducting
the study should be indicated and justified.
The number of priming actuations required until the subsequent doses meet the drug product
specification limits for delivered dose uniformity should be determined.
Priming instructions should be provided to the health care professional and the consumer.
A study should be conducted to support the length of time that the product may be stored
without use (after initial priming) before re-priming as recommended in the labelling, as well as
the number of re-priming actuations required. Containers should be stored in various
orientations prior to and during the study in order to determine the effect of orientation. The
need to test products at different stages through container life should also be considered.
Multiple time points should be used. The number of re-priming actuations required until the
subsequent doses meet the drug product specification limits for delivered dose uniformity should
be determined.
Re-priming instructions, including any necessary instructions with respect to storage orientation,
should be provided to the health care professional and the consumer.
Delivered dose uniformity and fine particle mass or droplet size distribution data to support the
recommended cleaning instructions provided to the health care professional and the consumer
(including method and frequency) should be provided. The study should be conducted under
conditions of normal patient usage, in accordance with recommendations for priming, dosing
intervals, and typical dosing regimen.
A study should be conducted to determine the effect of low temperature storage on the
performance of the product. Containers should be stored in various orientations for at least 3
hours at a temperature below freezing (0°C), and then immediately tested.
The number of actuations required until the subsequent doses meet the drug product
specification limits for delivered dose uniformity and fine particle mass should be determined. If
the product does not perform satisfactorily (e.g., re-priming actuations required exceed the
number required according to the instructions for use), an additional study should be conducted
to determine the method and length of time needed to adequately warm the containers so that
satisfactory performance is achieved.
Instructions regarding cold temperature use should be provided to the health care professional
and the consumer. If this study is not conducted, information on how and how long to warm the
container should be provided to the health care professional and the consumer. Alternative
approaches for inhalation products which do not tolerate low temperatures should be fully
justified.
A study should be conducted to determine the effect of temperature cycling on the performance
of the product. Containers should be stored in various orientations and cycled between
recommended storage conditions and a temperature below freezing (0°C). For suspensions,
cycling between the recommended storage conditions and a high temperature (e.g., 40°C)
should be considered, and may be combined with the low temperature cycling study. Storage
time should be at least 24 hours under each condition, and containers should be stored under
each condition at least five times.
The containers should be examined visually for any obvious defects, and tests such as leak rate,
weight loss, delivered dose uniformity, fine particle mass, related substances and moisture
content should be performed. Any changes from initial results should be assessed for their
significance.
The product performance should be investigated under conditions to simulate use by patients.
This includes activating the delivery device at the frequency indicated in the instructions for use.
Carrying the delivery device between use and simulation of dropping the delivery device, etc.,
and the robustness of any lockout mechanism should be considered.
The development of the delivery device should be described. Any changes implemented in the
design (e.g., change of component materials) and/or manufacturing process of the delivery
device (e.g., scale up from single cavity to multiple cavity tooling) during the development of the
product should be discussed in terms of the impact on the product performance characteristics
(e.g., delivered dose, fine particle mass, etc.) If prototype delivery devices were used in clinical
studies, appropriate data should be provided to demonstrate the equivalence of the
prototype(s) with the product intended for marketing.
For device-metered dry powder inhalers, safeguards to prevent inadvertent multiple dose
metering (and subsequent inhalation by the patient) should be demonstrated.
For breath-activated delivery devices, data should be provided to demonstrate that all target
patient groups are capable of triggering the delivery device. This could be evaluated as part of
the clinical programme during patient handling studies. The triggering mechanism should be well
characterised as part of the delivery device development programme.
For device-metered dry powder inhalers each unit should have a counter or other fill indicator
to give the patient some indication of when the number of actuations stated on the label has
been delivered. Inclusion of dose counters is also encouraged for other multiple dose products.
Parameters such as precipitation, pH, droplet size distribution, output rate and total drug output
should be tested, and differences from the original product should be assessed for their
significance.
The tests indicated in Table 3.2 are normally conducted to characterise nasal products. Not all
tests are necessary for all types of nasal products, as noted in Table 3.2.
The pharmaceutical development studies should be performed as discussed in Section 3.1, with
the exception of tests for fine particle mass.
With regard to particle / droplet size distribution, full characterisation of the product should be
provided. It should be demonstrated that deposition of the product is localised in the nasal
cavity (i.e., by demonstrating that the vast majority of the particles / droplets are larger than 10
microns).
Nasal Liquids
Pressurised Nasal
Pharmaceutical
Metered Dose Powders
Development Non-
Nasal Sprays (Device-
Study Single Multiple Single Pressurised
Metered)
Use Use Use Multiple Use
Drops Drops Sprays Metered
Dose Sprays
(a) Physical
Yes* Yes Yes* Yes* Yes* Yes*
characterisation
(b) Minimum fill
Yes Yes Yes Yes Yes Yes
justification
(c) Extractables /
Yes No Yes Yes Yes Yes
Leachables
Nasal Liquids
Pressurised Nasal
Pharmaceutical
Metered Dose Powders
Development Non-
Nasal Sprays (Device-
Study Single Multiple Single Pressurised
Metered)
Use Use Use Multiple Use
Drops Drops Sprays Metered
Dose Sprays
(d) Delivered dose
uniformity through Yes Yes No No No Yes
container life
(h) Particle /
droplet size Yes Yes No No Yes Yes
distribution
(i) Actuator /
mouthpiece Yes Yes No No Yes Yes
deposition
(k) Shaking
Yes* No Yes* Yes* Yes* Yes*
requirements
(l, m) Initial &
re-priming Yes No No No Yes Yes
requirements
(n) Cleaning
Yes Yes No Yes No Yes
requirements
(o) Low
temperature Yes No No No No No
performance
(p) Performance
after temperature Yes No No No Yes Yes
cycling
(q) Effect of
environmental Yes Yes No No No No
moisture
(r) Robustness Yes Yes Yes Yes Yes Yes
(s) Delivery device
Yes Yes Yes Yes Yes Yes
development
(t) Preservative
effectiveness / No No Yes** Yes** Yes** Yes**
efficacy
* For suspensions.
** If a preservative is present.
For clarity, the formulation of the product should include the concentration of the drug substance in the
formulation, the fill amount, and the target delivery amount.
The manufacturing process of the drug product, including all filling and packaging operations, should be
described for each strength and each container closure system (e.g., number of actuations).
The manufacturing process for all products should be validated to ensure the homogeneity of the
formulation throughout the filling process during routine production and include controls assuring that all
containers are within an appropriate fill volume or fill weight range, and that the closure system is
applied correctly (e.g., crimp dimensions and leak testing for pressurised products, blister sealing for
dry powder inhalers, torque measurement for screw thread pumps). All products should also have a
process control for performance testing of the actuation release mechanism (e.g., shot weight) of each
unit where appropriate.
Any equilibration time allowed for pressurised products before release testing should be specified and
justified along with other aspects of the manufacturing process.
5. EXCIPIENTS
Besides the usual pharmacopoeial requirements, additional tests to characterise the material used should
be included in the specifications as appropriate.
For dry powder inhalers for example, a test and suitable multi-point particle size test should be included
for the excipient(s) (e.g., lactose) or where appropriate, for granules of excipients and/or drug
substance. The limits for this test should be qualified by the results of batches used to produce drug
product for in vivo (pivotal clinical and/or comparative) studies, although in vitro data (from multistage
impaction / impinger) may suffice to demonstrate the suitability of the extremes of the limits.
Control of other physical parameters may be achieved by specification of the grade of each material
used. For excipients which have physical properties that cannot be easily controlled (but are relevant
for the drug product performance), it may be necessary to limit the source to a single, validated
supplier. Alternatively, the suitability of different suppliers may be demonstrated with in vitro data for
finished product manufactured with different batches from each source. If these conditions are met, no
specification for physical characteristics, other than particle size distribution (if relevant), is necessary.
In addition, control of microbiological quality should be considered, and where applicable, justification
provided for not conducting routine microbiological quality control tests.
Excipients that have a well-established history of use in inhalation and nasal products, and are
tested according to a monograph of an accepted pharmacopoeia, may be used without
providing safety data on the excipient alone, provided that the amounts used are common for
the route of administration. Any excipient without a well-established history of use in inhalation
and nasal products must be demonstrated to be safe when administered by the new route of
administration. The type of safety data needed may be discussed with the authority prior to
filing.
Excipients that are not tested according to an accepted pharmacopoeial monograph must be
demonstrated to be safe when administered by the inhalation or nasal route of administration, as
appropriate. The excipient specification tests and limits, particularly with respect to purity,
should be established based on results for batches used in safety studies. The type of safety
data needed may be discussed with the authority prior to filing.
In addition to the specification, information on the manufacture of the excipient may also be
necessary. The extent of manufacturing information needed may be discussed with the authority
prior to filing.
This section describes specification tests specific to inhalation and nasal products. Standard drug
product specification tests (e.g., identification, degradation products, pH) have not been included here,
but it is expected that these tests be included in the specifications. Other guidance documents (e.g.,
ICH) should be consulted in this regard.
Acceptance criteria should be set based on the observed ranges of variation in batches that showed
acceptable performance in vivo, as well as the intended use of the product. Process capability and
stability data may also be considered. In addition, different tests and limits may apply at release versus
shelf life; differences should be clearly described and justified. Other guidance documents that apply to
all types of dosage forms should be consulted regarding specification-setting, release versus shelf-life
testing, periodic testing, etc.
The following list includes the tests normally included in the drug product specifications for
inhalation products. Not all tests are necessary for all types of inhalation products, as noted in
Table 6.1.
* For suspensions.
** If the product is sterile.
*** If a preservative is present.
6.1(a) Description
A description of both the formulation and the full delivery device (e.g., including actuator)
should be given where applicable. For products for nebulisation, the immediate packaging
should be described (e.g., translucent LDPE nebule).
6.1(b) Assay
For multi-dose products, the amount of drug substance should be determined per weight unit or
per volume unit, as applicable. For single dose products, the assay should be expressed as
mass per dosage unit. The usual assay limits for medicinal products apply.
The limit for moisture content should be established based on results seen in stability studies. If
the results are stable throughout the shelf life of the product, or if any changes in moisture
content do not result in changes to any other parameters, it may be acceptable to omit this test
from the specification; this should be fully explained in the Justification of Specification(s)
section.
The amount of drug substance in one actuation should also be determined by calculating the
mean of the delivered dose uniformity test results, with corrections as necessary to convert from
“per dose” amounts to “per actuation” amounts. Limits of ± 15% of the label claim apply.
The use of uniformity of weight per actuation in lieu of the uniformity of the content of the
delivered dose may be acceptable for solution formulations. Justification should be provided.
Content uniformity should be investigated on samples removed from the containers as per the
instructions provided to consumers and health care professionals. Acceptance limits should be
justified, taking into consideration pharmacopoeial requirements.
The use of uniformity of weight per actuation in lieu of content uniformity may be acceptable for
solution formulations. Justification should be provided.
The fine particle mass test should be conducted using a validated multistage impactor or
impinger method, or a suitably validated alternative. It is normally considered acceptable to set
upper and lower limits on the results of pooled stages corresponding to a particle size
distribution of less than 5 :m, although alternative limits may be found acceptable with
adequate justification. The drug mass should be reported rather than the percentage of emitted
dose (or other derived parameter). Additional criteria may be appropriate such as grouped
stages or limits for mass median aerodynamic diameter (MMAD) and / or geometric standard
deviation (GSD) if the fine particle mass alone is insufficient to fully characterise the particle size
distribution of the therapeutic dose. Control of the particle size distribution above 5 :m may be
necessary depending on the relevance of this fraction for the therapeutic index of the product.
In all cases, limits should be qualified by the fine particle mass results for batches used in in
vivo (pivotal clinical and/or comparative) studies and should be reported on a per actuation or
per dose basis.
6.1(j) Sterility
6.1(k) Leachables
The number of actuations per container should be demonstrated to be no less than the labelled
number of actuations.
The following list includes the tests normally included in the drug product specifications for nasal
products. Not all tests are necessary for all types of nasal products, as noted in Table 6.2.
The tests should be performed as discussed in Section 6.1, supplemented by a test for particle /
droplet size distribution, if applicable. See below.
Testing should be conducted using a validated method (e.g., cascade impaction or, for
solutions, laser diffraction). The limits should include an allowed range for the median diameter
and a limit on the sub 10 micron particles / droplets. The limits for the median diameter and the
sub 10 micron particles / droplets should be qualified by results for batches used in in vivo
(pivotal clinical and/or comparative) studies.
Nasal Liquids
Pressurised
Nasal
Drug Product Metered
Powders Non-
Specification Dose Nasal
(Device- Single Multiple Single Pressurised
Test Sprays
Metered) Use Use Use Multiple Use
Drops Drops Sprays Metered Dose
Sprays
(a) Description Yes Yes Yes Yes Yes Yes
(b) Assay Yes Yes Yes Yes Yes Yes
(c) Moisture
Yes Yes No No No No
content
(d) Mean
Yes Yes No Yes No Yes
delivered dose
(e) Delivered
Yes Yes No Yes No Yes
dose uniformity
(f) Content
uniformity /
No No Yes No Yes No
Uniformity of
dosage units
(h) Leak rate Yes No No No No No
(i) Microbial /
Microbiological Yes Yes Yes** Yes Yes** Yes
limits
(j) Sterility No No Yes* Yes* Yes* Yes*
(l) Preservative
No No Yes** Yes** Yes** Yes**
content
(m) Number of
actuations per Yes Yes No No No Yes
container
(n) Particle /
droplet size Yes Yes No No Yes Yes
distribution
In addition to standard container closure system specification tests (e.g., identification, dimensions), the
specifications should include further tests to confirm reproducible drug delivery by the delivery device,
where applicable. For example, for pressurised metered dose products for inhalation or nasal use,
specifications should include tests such as shot weight of individual sprays and actuator orifice length
and diameter.
The composition of all container closure system components should be provided and should comply
with relevant standards (e.g., pharmacopoeial) in relation to their intended use.
For coated canisters and / or valves, the complete composition of the coating and the procedure
(including process controls) used in the coating process should be provided.
For non-compendial components, in addition to the resin used, any additives included should also be
described.
All inhalation and nasal products should be tested on stability against the stability-indicating tests
included in the drug product specification, according to applicable guidance documents. Weight loss
should also be monitored where appropriate.
If product performance is considered to be influenced by the storage orientation (e.g., for pressurised
metered dose inhalers), containers should be stored in various orientations during the study in order to
determine the effect of orientation. Data should be presented separately for each orientation.
If the product includes secondary packaging in order to protect it from light and/or humidity (e.g., dry
powder inhaler inside a foil overwrap), the length of time that the product may be used after the
protective packaging has been removed should be supported by stability results. The studies should
involve removing the product from the protective packaging close to the end of its shelf life and testing
the exposed product against the drug product specifications. For example, if a product should be used
within three months after removal of the protective packaging (according to the instructions for use), the
product should be removed from the protective packaging three months before the end of the shelf life,
and tested at the end of the shelf life.
Information on the use of the product once the protective packaging has been removed should be
provided to the consumer.
9. GLOSSARY
actuation: the release of drug from the drug delivery device by a single activation
(e.g., mechanical or breath).
container closure the sum of packaging components that together contain and
system: protect the dosage form. The container closure system may serve as a
delivery device.
delivered dose: the quantity of drug substance that is available to the user, ex-device,
on a per dose basis.
delivery device: the sum of component(s) of the container closure system responsible
for delivering the drug to the respiratory tract (inhalation product) or the
nasal and/or pharyngeal region (nasal product).
dosing interval: the recommended length of time between doses, as specified in the
information provided to consumers and health care professionals.
ex-actuator: not including the (quantity of drug substance deposited on the) actuator.
extractables: compounds which may be extracted from the container closure system
by using stressful conditions.
fine particle mass: the quantity of drug substance in an inhalation product that is generally
considered to be of a size capable of penetrating the lung during
inhalation (approximately 5 :m and smaller), on a per actuation or per
dose basis.
geometric standard derived from the plot of the cumulative percentage of mass less
deviation (GSD): than the stated cut-off diameter versus the cut-off diameter by the
equation:
(D84.13% / D15.87%)½
inhalation product: a drug product (including the delivery device, where applicable) whose
intended site of deposition is the respiratory tract. The site of action
may be local or systemic.
label claim: the amount of drug (usually on a per actuation basis) declared on the
label of the product.
leachables: compounds which may leach from the container closure system into the
formulation under normal conditions of storage and use.
metered dose: the quantity of drug substance contained in the delivery device metering
chamber
mass median aerodynamic the diameter of a sphere of unit density having the same terminal
diameter (MMAD): settling velocity as the particle at issue; derived from the plot of the
cumulative percentage of mass less than the stated cut-off diameter
versus the cut-off diameter by determination of the diameter at 50.00%.
minimum delivered dose: the smallest recommended dose according to the Information for
Consumers and Health Care Professionals, expressed as delivered
dose.
nasal product: a drug product (including the delivery device, where applicable) whose
intended site of deposition is the nasal and/or pharyngeal region. The
site of action may be local or systemic.
pressurised metered dose product for nasal administration containing one or more
nasal spray: propellants in a pressurised delivery device.
product for nebulisation: a liquid inhalation product administered via a commercially marketed
nebuliser.
target delivered dose: the quantity of drug substance expected to be released from the device
in the number of actuations equivalent to a dose.
target delivery amount: the quantity of drug substance expected to be released from the
delivery device (i.e., ex-actuator or ex-device) in one actuation.
therapeutic index: the ratio of the dose resulting in toxicity to the dose required to achieve
the desired therapeutic effect.
REGIONAL INFORMATION
This appendix only outlines quality related issues specific to subsequent market entry inhalation and
nasal products. Additional information is provided in other guidance documents.
In addition to conducting the development tests as described in Section 3 of this guidance document,
subsequent market entry inhalation and nasal products must be shown to be equivalent to the Canadian
Reference Product in a number of aspects. It is generally expected that the development tests be
conducted on more than one batch, so that batch variability is taken into account. For a single strength
and a single container closure system, testing two batches of each product should be sufficient. For
products packaged in container closure systems that also serve as the delivery device, tests that involve
delivery of the formulation should also be conducted on more than one batch of the container closure
system. In the case of multiple strengths and multiple package sizes, a bracketing and/or matrixing
design may be used to limit the number of test samples necessary. Justification should be provided.
Comparative studies for subsequent market entry inhalation products are outlined in Table I.1. Not all
tests are necessary for all types of inhalation products, as noted in Table I.1.
Table I.1: Comparative Studies for Subsequent Market Entry Inhalation Products
Table I.1: Comparative Studies for Subsequent Market Entry Inhalation Products
* For suspensions
** Over the range of flow rates achievable by the intended patient population (through the delivery
device), at constant volume.
I.1(a) Formulation
The ingredients in the subsequent market entry product should be qualitatively the same and
quantitatively essentially the same as the Canadian Reference Product. For the purposes of this
document, essentially the same would be interpreted as the amount (or concentration) of each
excipient in the subsequent entry product to be within ±10% of the amount (or concentration) of each
excipient in the Canadian Reference Product. A side-by-side comparison of the qualitative and
quantitative formulations for the subsequent market entry product and the Canadian Reference Product
should be provided.
Any difference beyond this criterion should be scientifically justified and the potential impact on the
safety and efficacy of the drug product (e.g., deposition and absorption characteristics) should be
discussed.
To the extent possible, the drug substance particle size and crystal structure of the Canadian Reference
Product and the subsequent market entry product should be compared and the results provided. Some
drug substance information may be gathered by tests on the drug product. Differences should be
scientifically justified and the potential impact on the safety and efficacy of the drug product (e.g.,
deposition and absorption characteristics) should be discussed.
Results of a comparative analysis of the Canadian Reference Product and the subsequent market entry
product should be provided.
Examples of tests for aqueous products include description, osmolality (or osmolarity), surface tension,
viscosity, pH, buffering capacity and specific gravity.
Examples of tests for pressurised metered dose inhalers include surface tension, viscosity, specific
gravity, vapour pressure, freezing point and refractive index.
Examples of tests for dry powder inhalers include particle size distribution of the carrier (if present),
bulk and tapped density, particle morphology (shape, texture and surface properties), melting point,
electrostatic charge, porosity, specific surface area, hygroscopicity and moisture content.
The results for the subsequent entry product and Canadian Reference Product should be essentially
the same. For the purposes of this document, essentially the same would be interpreted as the results
of the subsequent entry product and the Canadian Reference Product are within ±10%. Any difference
beyond this criterion should be scientifically justified and the potential impact on the safety and efficacy
of the drug product (e.g., deposition and absorption characteristics) should be discussed. A side-by-
side comparison of the results for the test and reference products should be provided.
Results of a qualitative and quantitative analysis of the physical attributes and operating characteristics
of the delivery devices (as related to the functionality of the systems) for the Canadian Reference
Product and the subsequent market entry product (e.g., dimensions, materials used) should be
provided. Differences should be scientifically justified and the potential impact on the safety and efficacy
of the drug product (e.g., deposition and absorption characteristics, effect on patient compliance)
should be discussed. This will be taken into consideration when determining whether the products are
considered to be comparable dosage forms.
Results of a comparative analysis of the delivered dose uniformity of the Canadian Reference Product
and the subsequent market entry product should be provided.
A statistical comparison is encouraged. Differences should be scientifically justified and the potential
impact on the safety and efficacy of the drug product (e.g., underdosing or overdosing of the
subsequent market entry product in comparison to the Canadian Reference Product) should be
discussed.
Results of a comparative analysis of the content uniformity of the Canadian Reference Product and the
subsequent market entry product should be provided. Samples should be removed from the containers
as per the instructions provided to consumers and health care professionals. A statistical comparison is
encouraged. Differences should be scientifically justified and the potential impact on the safety and
efficacy of the drug product (e.g., underdosing or overdosing of the subsequent market entry product in
comparison to the Canadian Reference Product) should be discussed.
Results of a comparative analysis of the individual stage particle size distribution (or, for solutions for
nebulisation, droplet size distribution) of the Canadian Reference Product and the subsequent market
entry product should be provided. A statistical comparison is encouraged. Differences should be
scientifically justified and the potential impact on the safety and efficacy of the drug product (e.g.,
deposition and absorption characteristics) should be discussed.
Results of a comparative analysis of the drug delivery rate and total drug delivered of the Canadian
Reference Product and the subsequent market entry product should be provided. A statistical
comparison is encouraged. Differences should be scientifically justified and the potential impact on the
safety and efficacy of the product (e.g., underdosing or overdosing of the subsequent market entry
product in comparison to the Canadian Reference Product) should be discussed.
Comparative studies for subsequent market entry nasal products are outlined in Table I.2. The
comparative tests are the same as those described for subsequent market entry inhalation products in
Section I.1. Not all tests are necessary for all types of nasal products, as noted in Table I.2.
Table I.2: Comparative Studies for Subsequent Market Entry Nasal Products
Nasal Liquids
Pressurised Nasal
Comparative Metered Powders
Study Dose Nasal (Device- Non-
Sprays Metered) Single Multiple Single Pressurised
Use Use Use Multiple Use
Drops Drops Sprays Metered
Dose Sprays
(a) Formulation Yes Yes Yes Yes Yes Yes
(b) Physicochemical
properties of the Yes* Yes Yes* Yes* Yes* Yes*
drug substance
(c) Physicochemical
properties of the Yes Yes Yes Yes Yes Yes
drug product
(d) Delivery system Yes Yes No No Yes Yes
(e) Delivered dose
Yes Yes No Yes No Yes
uniformity
(f) Content
uniformity /
No No Yes No Yes No
Uniformity of
dosage units
(g) Particle / droplet
Yes Yes No No Yes Yes
size distribution
* For suspensions
Appendix II: Information for Consumers and Health Care Professionals (Product Monograph
and Labels)
This appendix only outlines quality related issues specific to the product monograph and labels of
inhalation and nasal products. Additional information is provided in other guidance documents.
Pressurised metered dose inhalers and non-pressurised metered dose inhalers may be labelled with the
target ex-actuator drug substance amount per actuation (e.g., 40 µg/spray, ex-actuator). However, if
the product is a change of an authorised product (e.g., a new combination) that is labelled with the ex-
valve amount, the labeling for the two products should be consistent in order to avoid confusion (e.g.,
50µg/spray, ex-valve).
Pre-metered and device-metered dry powder inhalers may be labelled with the target delivery amount
of drug substance per actuation (e.g., 40 µg/actuation). However, if the product is a change of an
authorised product (e.g., a new combination) that is labelled with the fill target per actuation or metering
chamber amount, the labelling for the two products should be consistent in order to avoid confusion
(e.g., 50 µg/capsule or metered actuation).
Products for nebulisation should be labelled with the target delivery amount of drug substance from the
container (e.g., 2.5 mg/nebule). Additional information (e.g., 0.1% solution) may also be included.
In all cases, the target should be consistent with the results for batches used in vivo (pivotal clinical
and/or comparative) studies and, if available, recent production batches. In addition, the use of the term
"per dose" should be avoided since a dose may, for example, consist of two sprays.
The declaration of strength for a subsequent market entry product should, in all cases, be consistent
with the Canadian Reference Product in order to avoid confusion.
Pressurised metered dose nasal sprays should be labelled as indicated for pressurised metered dose
inhalers in Section II.1.1.
Nasal powders should be labelled as indicated for dry powder inhalers in Section II.1.1.
Nasal drops and sprays should be labelled with the target delivery amount of drug substance from the
container (e.g., 40 µg/drop or 40 µg/spray). Additional information (e.g., 0.1% solution) may also be
included.
In all cases, the target should be consistent with the results for batches used in vivo (pivotal clinical
and/or comparative) studies and, if available, recent production batches. In addition, the use of the term
"per dose" should be avoided since a dose may, for example, consist of two sprays.
The declaration of strength for a subsequent market entry product should, in all cases, be consistent
with the Canadian Reference Product in order to avoid confusion.
For pressurised products, the labels should include instructions to avoid heat and puncturing the
container.
For liquid products, the labels should include an instruction to avoid freezing. For solutions prone to
frothing, the labels should include an instruction to avoid shaking before use.
For all metered products, the number of actuations in the container should be included on the label.
Where applicable, information on the effect of flow rate on the performance of the product should be
included (see Section 3.1(e) Drug Product Pharmaceutical Development: Inhalation Products). The
appropriate Non-clinical/Clinical evaluation division should be contacted for guidance in this regard.
Where applicable, information on the effect of a spacer or holding chamber on the performance of the
product should be included (see Section 3.1(f) Drug Product Pharmaceutical Development: Inhalation
Products). Examples of acceptable statements regarding spacer/holding chamber use are:
(i) “In vitro test results suggest that the use of spacers/holding chambers may alter the amount of drug
reaching the lung. Therefore, for patients whose asthma has been stabilized without the use of a
spacer/holding chamber, continuation of therapy with a spacer/holding chamber may require a dosage
adjustment.”
(ii) “The effect of spacers/holding chambers on the amount of drug reaching the lung has not been tested
in in vitro or in vivo studies. Therefore, for patients whose asthma has been stabilized without the use
of a spacer/holding chamber, continuation of therapy with a spacer/holding chamber may require a
dosage adjustment.”
Where applicable, information should be given on the nebuliser system(s) and settings that were
demonstrated to be effective and safe in the in vivo studies, including information on the particle /
droplet size distribution, drug delivery rate, and total drug delivered.
For pressurised products, the Information of the Consumer should include instructions to avoid heat
and puncturing the container.
Instructions for shaking, initial and re-priming of the container, cleaning, low temperature use,
spacer/holding chamber use, the need to count the number of doses used, and general care of the
product should also be included where appropriate (see Sections 3.1 and 3.2 Drug Product
Pharmaceutical Development: Inhalation Products and Nasal Products).
To allow a full assessment of the Information for the Consumer, two samples of the drug product
(active or placebo), including any accompanying components used for delivery (e.g., actuator), should
be available upon request.