Subscribe to RSS
DOI: 10.1055/a-1808-9708
Quality Requirements for Medicinal Cannabis and Respective Products in the European Union – Status Quo[ # ]
Abstract
Medicinal cannabis and respective products have been available in EU member states as single-patient prescriptions without regular marketing authorizations for a couple of years. The Netherlands was the first member state to realize this; in the meantime other member states have followed. Today, aside from the Netherlands, Germany is the most important market for such products. The regulatory framework for the approval of medicinal cannabis and its distribution to patients in the EU member states is, however, not harmonized at all, and there are distinct national regulations. Regarding the quality of such products, the general requirements for herbal medicinal products as defined in the European Pharmacopoeia, national pharmacopoeias, and the EMA guidance documents in place beside GMP requirements in the EU are applicable. However, for a couple of aspects, every EU member state follows its own interpretation of these requirements. To facilitate free distribution of such products between EU member states in future and to harmonize requirements for quality and GMP, an EU-wide approach is needed. As a first step, this should be realized by implementing monographs for cannabis medicinal products in the European Pharmacopoeia.
Key words
Cannabis sativa - Cannabaceae - herbal preparation - herbal medicinal product - European Pharmacopoeia - European Medicines Agency - Committee on Herbal Medicinal Products# Dedicated to Professor Dr. Gerhard Franz on the occasion of his 85th birthday.
Publication History
Received: 28 January 2022
Accepted after revision: 22 March 2022
Accepted Manuscript online:
25 March 2022
Article published online:
23 June 2022
© 2022. Thieme. All rights reserved.
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany
-
References
- 1 Clarke RC, Merlin MD. Cannabis Domestication, Breeding History, Present-day Genetic Diversity, and Future Prospects. Critical Reviews in Plant Sciences 2016; 35: 293-327
- 2 Gülck T, Møller BL. Phytocannabinoids: Origins and Biosynthesis. Trends Plant Sci 2020; 25: 985-1004
- 3 Livingston SJ, Quilichini TD, Booth JK, Wong DCJ, Rensing KH, Laflamme-Yonkman J, Castellarin SD, Bohlmann J, Page JE, Samuels AL. Cannabis glandular trichomes alter morphology and metabolite content during flower maturation. Plant J 2020; 101: 37-56
- 4 Atakan Z. Cannabis, a complex plant: different compounds and different effects on individuals. Ther Adv Psychopharmacol 2012; 2: 241-254
- 5 Lim XY, Tan TYC, Muhd Rosli SH, Saʼat MNF, Sirdar Ali S, Syed Mohamed AF. Cannabis sativa subsp. sativaʼs pharmacological properties and health effects: A scoping review of current evidence. PLoS One 2021; 16: e0245471
- 6 European Medicines Agency, Committee on Herbal Medicinal Products (HMPC). EMEA/HMPC/246816/2005. Guideline on Good Agricultural and Collection Practice (GACP) for Starting Materials of Herbal Origin. Accessed May 8, 2022 at: https://www.ema.europa.eu/en/good-agricultural-collection-practice-starting-materials-herbal-origin%23current-effective-version-under-consultation-section
- 7 European Commission. EU-GMP Part I. EU Guidelines for Good Manufacturing Practice for Medicinal Products for Human and Veterinary Use – ANNEX 7. Manufacture of Herbal Medicinal Products. Accessed May 8, 2022 at: https://ec.europa.eu/health/document/download/fd318dd6-2404-4e67-82b0-2324825e4d90_en?filename=vol4_an7_2008_09_en.pdf
- 8 European Commission. EU GMP Part I. EU Guidelines for Good Manufacturing Practice for Medicinal Products for Human and Veterinary Use. Accessed May 8, 2022 at: https://ec.europa.eu/health/medicinal-products/eudralex/eudralex-volume-4_en
- 9 European Commission. CPMP/ICH/4106/00. ICH Topic Q 7. Good Manufacturing Practice for Active Pharmaceutical Ingredients. 2014. Accessed May 8, 2022 at: https://www.ema.europa.eu/en/ich-q7-good-manufacturing-practice-active-pharmaceutical-ingredients%23current-effective-version-section
- 10 European Commission. EU GMP Part I. EU Guidelines for Good Manufacturing Practice for Medicinal Products for Human and Veterinary Use. Part II: Basic Requirements for Active Substances used as Starting Materials. Accessed May 8, 2022 at: https://ec.europa.eu/health/document/download/bd537ccf-9271-4230-bca1-2d8cb655fd83_en?filename=2014-08_gmp_part1.pdf
- 11 European Commission. Guidelines of 19 March 2015 on principles of Good Distribution Practice of active substances for medicinal products for human use (2015/C 95/01). Accessed May 8, 2022 at: https://eur-lex.europa.eu/legal-content/DE/TXT/PDF/?uri=CELEX:52015XC0321(01)&%20from=EN
- 12 European Commission. Guidelines of 5 November 2013 on Good Distribution Practice of medicinal products for human use (2013/C 343/01). Accessed May 8, 2022 at: https://eur-lex.europa.eu/legal-content/EN/TXT/HTML/?uri=CELEX:52013XC1123(01)&%20from=EN
- 13 Committee on Herbal Medicinal Products (HMPC). CPMP/QWP/2820/00 Rev. 3. Specifications: Test procedures and Acceptance Criteria for Herbal Substances, Herbal Preparations and Herbal Medicinal Products/Traditional Herbal Medicinal Products. Accessed May 8, 2022 at: https://www.ema.europa.eu/en/specifications-test-procedures-acceptance-criteria-herbal-substances-herbal-preparations-herbal%23document-history-revision-3-(in-progress)-section
- 14 European Commission. Document Nº SANTE/11312/2021. Analytical Quality Control and Method Validation Procedures for Pesticide Residues Analysis in Food and Feed (Implemented by 01.01.2022). Accessed May 12, 2022 at: https://www.eurl-pesticides.eu/userfiles/file/EurlALL/SANTE_11312_2021.pdf
- 15 Committee on Herbal Medicinal Products (HMPC). EMEA/HMPC/125562/2006. Reflection paper on the use of fumigants. Accessed May 5, 2022 at: https://www.ema.europa.eu/documents/scientific-guideline/reflection-paper-use-fumigants_en.pdf
- 16 Danish Medicines Agency. Dansk monografi – Cannabisblomst. Danske Lægemiddelstandarder 2020. København: Danish Medicines Agency; 2020
- 17 Dutch Office for Medicinal Cannabis. Monograph Cannabis Flos Version 7.1. Den Haag: Dutch Office for Medicinal Cannabis; 2014
- 18 WHO Expert Committee on Drug Dependence. Cannabis plant and cannabis resin. Fortieth report WHO Technical Report Series, No. 1013. 2018. Accessed May 8, 2022 at: https://www.drugsandalcohol.ie/30211/1/WHO%2520Expert%2520Committee%2520on%2520Drug%2520Dependence%252C.pdf
- 19 Sarma ND, Waye A, ElSohly MA, Brown PN, Elzinga S, Johnson HE, Marles RJ, Melanson JE, Russo E, Deyton L, Hudalla C, Vrdoljak GA, Wurzer JH, Khan IA, Kim NC, Giancaspro GI. Cannabis Inflorescence for Medical Purposes: USP Considerations for Quality Attributes. J Nat Prod 2020; 83: 1334-1351
- 20 Giancaspro GI, Kim NC, Venema J, de Mars S, Devine J, Celestino C, Feaster CE, Firschein BA, Waddell MS, Gardner SM, Jones jr. E. The Advisability and Feasibility of Developing USP Standards for Cannabis. Pharmacopeial Forum 2016; 42
- 21 Avoxa – Media Group of German Pharmacists GmbH. German Drug Codex (DAC)/Neues Rezeptur Formularium (NRF). 2nd ed. Eschborn: Avoxa – Media Group of German Pharmacists GmbH.
- 22 United Nations Office on Drugs and Crime. Recommended methods for the identification and analysis of cannabis and cannabis products. Vienna: United Nations Office on Drugs and Crime; 2009. Accessed May 08, 2022 at: https://www.unodc.org/documents/scientific/ST-NAR-40-Ebook_1.pdf
- 23 McPartland JM, McKernan KJ. Contaminants of Concern in Cannabis: Microbes, Heavy Metals and Pesticides. In: Chandra S, Lata H, ElSohly MA. eds. Cannabis sativa L. – Botany and Biotechnology. Cham: Springer; 2017
- 24 Committee on Herbal Medicinal Products (HMPC). EMA/HMPC/95714/2013. Reflection paper on microbiological aspects of herbal medicinal products and traditional herbal medicinal products. Accessed May 8, 2022 at: https://www.ema.europa.eu/en/microbiological-aspects-herbal-medicinal-products-traditional-herbal-medicinal-products%23current-version-section
- 25 Taschwer M, Schmid MG. Determination of the relative percentage distribution of THCA and Δ(9)-THC in herbal cannabis seized in Austria – Impact of different storage temperatures on stability. Forensic Sci Int 2015; 254: 167-171
- 26 ASTM International. Standard Practice for Determination of Water Activity (aw) in Cannabis Flower. D8196-20 (2020). Accessed May 8, 2022 at: https://www.astm.org/d8196-20.html
- 27 ASTM International. Standard Practice for Sampling of Cannabis/Hemp Post-Harvest Batches for Laboratory Analyses. D8334-20 (2020). Accessed May 8, 2022 at: https://www.technormen.de/norm/astm-d8334-d8334m-20-1.11.2020.html
- 28 Schrenk D, Gao L, Lin G, Mahony C, Mulder PPJ, Peijnenburg A, Pfuhler S, Rietjens IMCM, Rutz L, Steinhoff B, These A. Pyrrolizidine alkaloids in food and phytomedicine: Occurrence, exposure, toxicity, mechanisms, and risk assessment – A review. Food Chem Toxicol 2020; 136: 111107
- 29 Committee for Medicinal Products for Human Use (EMA/CHMP/ICH/82260/2006). ICH guideline Q3C (R8) on impurities: guideline for residual solvents. Accessed May 8, 2022 at: https://www.ema.europa.eu/documents/regulatory-procedural-guideline/ich-guideline-q3c-r8-impurities-guideline-residual-solvents-step-5_en.pdf
- 30 Ziegler AS. ed. Cannabis. Ein Handbuch für Wissenschaft und Praxis. Stuttgart: Deutscher Apotheker Verlag; 2022
- 31 European Commission. EU Guidelines to Good Manufacturing Practice. Medicinal Products for Human and Veterinary Use. Annex 7. Manufacture of Herbal Medicinal Products. Accessed May 18, 2022 at: https://ec.europa.eu/health/system/files/2016-11/vol4_an7_2008_09_en_0.pdf