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Manufacture and Supply, Science and Reg ulation Towards High-Qua lity Medicinal Products
The following are some examples of storage conditions (based on WHO Good Storage and Distribution Practice):
Do Not Store Over 30°C (means Store at 2°C to 30°C)
Do Not Store Over 25°C (means Store at 2°C to 25°C)
Do Not Store Over 15°C (means Store at 2°C to 15°C)
Do Not Store Over 8°C (means Store at 2°C to 8°C)
Do Not Store Below 8°C (means Store at 8°C to 25°C)
WHO has divided the world into four climatic zones. They are:
Zone I: Temperate Climate, e.g., UK, US, Russia, North Europe
Zone II: Sub-Tropical and Mediterranean Climate, e.g., South Europe, Japan, South Korea
Zone III: Hot and Dry Climate, e.g., India, Iraq
Zone IVa: Hot and Humid Climate, e.g., Egypt, Iran
Zone IVb: Hot and Very Humid Climate, e.g., Brazil, Singapore
and ASEAN
For medicinal products intended for storage in a refrigerator, the long-term study shall be carried out at 5
o
C +/– 3°C, whilst for medic­inal products intended for storage in a freezer, the long-term study shall be carried out at –20
o
C +/– 5°C.
7.4.4. Test Methods
Test methods for stability testing shall be validated for accuracy,
sensitivity, specificity and reproducibility.
Stability and Shelf-Life Testing of Medicinal Products
They shall be stability-indicating, i.e., the test methods must be able to distinguish active ingredient from any degradation products and be able to make a reliable quantitation of any deg­radation product(s). Examples are the HPLC test methods. Vol­umetric and titration test methods are unsuitable for stability testing.
For manufacturers who rely on contract-testing laboratories for stability testing, specific quality agreements shall be established.
Likewise, re-packers who rely on stability studies performed by the manufacturer must have in place copies of relevant stability study reports necessary to support shelf-life of the product(s).
7.4.5. Container-Closure Systems
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Testing must be performed in the same container-closure sys­tem where the product is sold.
All container sizes should be subjected to stability testing.
However, if a product is marketed in the same container type of
several sizes, e.g., bottles containing 100, 500 and 1,000 tablets, stability testing can be performed on the smallest container size (i.e., bottle of 100), based on the principle of bracketing, which takes into account the worst-case scenario.
The US FDA, ICH, WHO and ASEAN Guidelines on Stability Testing provide guidance on bracketing and matrixing.
By applying the principles of bracketing and matrixing, the testing frequency may be reduced, or certain combination of factors need not be tested at all time points of a stability study schedule, if justified.
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Manufacture and Supply, Science and Reg ulation Towards High-Qua lity Medicinal Products
In bracketing:
The principle of “worst-case scenario” is relied upon. The sta­bility schedule is designed in such a way that only samples at extremes are tested at all time points.
When bracketing is applied to dierent volumes of the same container system, the lowest volume is tested due to its highest surface area-to-volume ratio, and therefore greatest potential for contact with product.
Other examples of bracketing include dierent weights or sizes of tablets with the same formulation, or dierent shell sizes of capsules with the same composition.
In matrixing:
The stability schedule is designed such that a selected subset of product combination factors (e.g., batches, strengths, pack sizes) is tested at a specific time point.
At another time point, another subset of combination factors is tested.
Matrixing assumes that the stability of each subset represents the stability of all samples at a given time point. Over the period of the test schedule, all combinations of factors would have been adequately tested.
Repacking of products into dierent types of containers is a com­mon primary assembly activity. The following considerations are appliable to the repacking of medicinal products:
The US FDA allows repacking into container-closure systems with comparable temperature and RH protection without the need to perform new stability studies.
Stability and Shelf-Life Testing of Medicinal Products
Comparisons may be based on literature references, e.g., studies on moisture or gas permeation properties of dierent container materials.
Re-packing of solid dosage forms from plastic into glass contain­ers is allowed as glass is known to be a more superior moisture and gas barrier.
However, this rationale is not applicable to liquid dosage forms due to pH problems which may arise from the alkaline nature of glass.
In addition to literature references, comparisons may also be based on results of stress testing at high temperature and RH.
7.4.6. Stress Testing as a Component of Stability and Shelf-Life
Study Program
215
Stress testing serves the following purposes:
— Identification of likely degradation products of drug sub-
stances (or APIs).
— Establishment of degradation pathways and intrinsic stabil-
ity of APIs.
— Validating the stability-indicating performance of test meth-
ods used.
— Providing supporting data for the handling of temperature
excursions.
Stress testing is carried out on a single batch of drug substances.
It includes the eects of temperature in 10°C increments (e.g.,
50°C, 60°C, 70°C) above that for accelerated testing (e.g., 40°C), and RH (e.g., 75% RH or greater). Hence, stress testing supple­ments accelerated testing.
For solutions or suspensions, stress testing should also include hydrolysis of drug substances across a wide range of pH values.
216
Manufacture and Supply, Science and Reg ulation Towards High-Qua lity Medicinal Products
Where appropriate, photostability testing and eects of oxida­tion should be an integral part of stress testing.

7.5. Stability Study Schedule and Report

A Stability Study Schedule needs to be drawn up before proceed­ing with a stability testing program. A typical Stability Study Sched­ule for a Tablet Dosage Form, namely, Paracetamol Tablet 500 mg, is shown below. The storage period of up to 60 months and the storage conditions for long-term as well as for accelerated testing for the three batches under study are indicated.
Typical stability study schedule (for paracetamol tablet 500 mg)
Stability and Shelf-Life Testing of Medicinal Products
Last but not least, a Stability Testing Report containing the follow- ing details is put up:
217
Stability testing report format

7.6. Temperature Excursions and Product Stability

Temperature can fluctuate during storage and transportation. Fluc­tuations include seasonal variations, e.g., lower temperatures during winter and higher temperatures during summer seasons. Hence, stability testing under defined conditions has to consider the cli­matic zone of the countries of export, including excursions during storage and transportation. Storage conditions should be monitored and recorded. Equipment used should be capable of controlling the storage conditions within defined limits. Short-term environmental changes due to transient opening of doors of refrigerators or storage facilities are accepted as part and parcel of the study and are unavoid­able. However, eects of excursions due to equipment failure should
218
Manufacture and Supply, Science and Reg ulation Towards High-Qua lity Medicinal Products
be assessed, addressed and reported if they aect stability results. Excursions that exceed the defined tolerances for more than 24 hours should be described in the study report and their eects assessed.
7.7. Cold Chain Products and Management of
Temperature Excursions
Cold chain products are particularly sensitive to changes in storage and environmental conditions. Cold chain products include vaccines and biopharmaceuticals as well as other medicinal products which are stored in refrigerators and freezers. Some examples of cold chain products and their storage temperature are shown below:
Products Stored in a Refrigerator (2°C to 8°C). Examples of such products include insulin injections, MMR vaccine and many types of eye drops such as Lantanoprost Eye Drops used in the treatment of glaucoma.
Products Stored in a Freezer (−25°C to −10°C). Examples of such products include Varicellar vaccine and Herpes Zorster vaccine.
Products Stored in Ultra-Cold Freezer (−70°C and below). Well­known examples include the Pfizer-BioNTech mRNA vaccine and Ebola vaccine.
There is yet another category of products which needs to be stored in a cool place (i.e., 8°C to 15°C). They are sometimes referred to as “Cool Chain Products”. There are also many medicinal prod­ucts which are required to be stored at controlled room temper­ature (20°C to 25°C/30°C). It is important to specify actual room temperature as the room or ambient temperature varies from one
Stability and Shelf-Life Testing of Medicinal Products
geographical location to another. For example, in Europe, room temperature has to be specified clearly as not exceeding 25
o
C, while in Singapore, room temperature has to be specified, for example, as not exceeding 30
o
C. It must be emphasized that during shipping and transportation of medicinal products across dierent climatic zones, temperature excursions can and do go wrong, especially for cold chain products.

7.8 . Cold Chain Products and Temperature Excursions

The contributing factors for temperature excursions during trans­portation include:
— multiple product transfers during transportation journey; — extreme temperatures while the container with the product is
on the tarmac;
— mishandling of product due to lack of instructions or human
error; and
— delays arising from long custom clearance, transportation
changes and weather conditions.
219
Temperature excursions should be properly managed like any other manufacturing deviation. It is necessary to communicate tem­perature excursions to all parties involved, including the shipper, transportation provider and manufacturer as well. Performance of root cause analysis must include the entire supply chain from pack-out (at manufacturing site) to delivery and receipt. It is to be noted that the implementation of corrective action and preventive action plan may aect or impact the procedures for supply chain
220
Manufacture and Supply, Science and Reg ulation Towards High-Qua lity Medicinal Products
and transportation selection and the choice of transport providers and their contracts. There is a need to monitor the eectiveness of actions taken to prevent recurrence of temperature excursions.
When a temperature excursion occurs, it is important to know what needs to be done to minimize product loss and the business impact. Quite obviously, there is a need to understand the responsibilities of the various stakeholders, namely the shipper, transport provider(s), receiver and, of course, the manufacturer. The temperature excur­sion needs to be communicated to all relevant parties for resolution as quickly as possible. Data from long-term and accelerated stability studies, as well as temperature excursion studies are required to be evaluated. Moreover, the impact of the temperature excursion on product quality during transportation has to be carefully assessed. All these will help to minimize or prevent product loss and any potential adverse business impact.
For cold chain products stored between 2
o
C and 8oC, the following
are some key pointers in managing temperature excursions:
Temperature excursions are allowed from down to 0
o
to 15
C during storage, shipping and distribution.
o
C and up
However, in such cases, the mean kinetic temperature (MKT) must not exceed 8
Transient spikes of up to 25
o
C.
o
C are also permitted for no more than 24 hours, unless there are additional supporting data from the manufacturer.
Stability and Shelf-Life Testing of Medicinal Products
The Arrhenius equation and temperature data collections are used for calculation of MKT and decision-making.
7.9. Use of Mean Kinetic Temperature (MKT) in a
GMP/GDP Environment
The following are some points to note when using MKT in a GMP/ GDP environment:
MKT is a tool for evaluating impact of temperature on product stability, and hence product quality.
It is a known fact that changes in storage temperatures can aect the rate at which products degrade. At the same time, it is challenging to store a product consistently under a fixed temper­ature. Temperatures are bound to fluctuate.
MKT was first proposed (by J.D. Haynes in 1971) to guide sta­bility studies, but is now used as a tool to evaluate temperature excursions.
MKT is really a “virtual temperature” which takes into account the expected temperature variability in a given region.
Haynes used the Arrhenius equation which is commonly employed to show how a chemical reaction rate is aected by temperature. According to this equation, chemical reaction rate at ambient temperatures doubles with every 10oC increase in temperature.
The use of MKT is increasingly being advocated in GMP/GDP environments.
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