Current Edition

The Preservative Predicament

Nasal sprays have become an important route of delivery for a variety of indications and as their use becomes more widespread, regulatory bodies across the globe have issued various guidelines and recommendations to ensure their safety and efficacy. However, the landscape of these regulations, particularly concerning preservatives, remains complex, leading to confusion and inconsistency of application.

This article delves into the current guidance on the use of preservatives in nasal sprays, explores the market trends, and discusses the manufacturing requirements essential for producing safe and effective nasal spray products.

Regulatory Perspectives on Preservatives in Nasal Sprays

In Europe, the regulatory landscape for nasal sprays is influenced significantly by the recommendations of the European Medicines Agency (EMA) and the German Federal Institute for Drugs and Medical Devices (BfArM). Both agencies have recommended the removal of one preservative – benzalkonium chloride (BAK or BAC) – in nasal sprays, citing potential long-term adverse effects on patients. However, it is crucial to note that these are recommendations rather than mandates. The EMA has also updated its requirements for patient labelling on formulations containing BAK, reflecting a growing awareness of preservative-related concerns.

Despite these recommendations, there has been no definitive guidance mandating the development of preservative-free nasal formulations. This regulatory ambiguity has led to a perception that the trend towards preservative-free formulations is more of a regulatory compulsion, rather than an industry-driven tendency.

Similarly, the BfArM has echoed the EMA’s stance on BAK, recommending its removal but stopping short of enforcing a mandate. This cautious approach highlights the ongoing debate within regulatory circles about the necessity and feasibility of eliminating preservatives from nasal formulations.

Across the Atlantic, the U.S. Food and Drug Administration (FDA) has provided more detailed guidance on various aspects of nasal spray development. According to the latest FDA guidelines, numerous factors need to be considered during the development programme of nasal sprays. These include formulation, container closure systems, manufacturing processes, stability, and controls of critical steps and intermediates. The FDA emphasises that any changes in these aspects can significantly impact the product’s ability to deliver reproducible doses to patients throughout its shelf life but stops short of recommending or issuing guidance on removing preservatives in formulations.

The FDA acknowledges that if a formulation is preservative-free, it requires the use of a preservative-free device designed to prevent microbial ingress. This can be achieved using .22 sterile filters and other closure mechanisms in the nasal devices.