ANNEX III ASEAN GUIDELINES ON LIMITS OF CONTAMINANTS FOR TRADITIONAL MEDICINES

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Association of South East Asian Nations (ASEAN) ANNEX III ASEAN GUIDELINES ON LIMITS OF CONTAMINANTS FOR TRADITIONAL MEDICINES Disclaimer: This document is provided for information purpose only and subject to changes, pending the finalisation of the ASEAN Agreement on Regulatory Framework for Traditional Medicines. Official references to this document can only be made once the said Agreement has been finalised.

DOCUMENT INFORMATION This version is adopted at the 27th ACCSQ TRADITIONAL MEDICINES AND HEALTH SUPPLEMENTS SCIENTIFIC COMMITTEE MEETING (ATSC) 1-2 June 2015, Kuala Lumpur, Malaysia and endorsed at the 23rd ACCSQ TRADITIONAL MEDICINES AND HEALTH SUPPLEMENTS PRODUCT WORKING GROUP (TMHSPWG) MEETING 4-5 June 2015, Kuala Lumpur, Malaysia. Version No. 1 History of adoption and endorsement ATSC adoption date TMHSPWG endorsement date 18 th ATSC Meeting 11 14 March 2013 19 th TMHSPWG Meeting 28-29 June 2013 Reasons for revision - 2 27 th ATSC Meeting 1-2 June 2015 23 rd TMHSPWG Meeting 4-5 June 2015 To include a table of History of Changes under Document Information To replace litre to L and ml to ml To remove Task Force s for examples of International guidelines/standards on pesticide residue 1 of 8

CONTENTS Introduction... 3 Objective... 3 ASEAN Limits of Contaminants for TM... 3 1. Limit on heavy metals:... 3 2. Limit for Microbial Contaminations... 4 3. Pesticide Residues... 7 2 of 8

Introduction The ASEAN Guidelines on Limits of Contaminants for Traditional Medicines (TM) is developed by taking into consideration the safety and quality requirements of TM. Other limits of contaminants may be reviewed and included into the guideline as deemed necessary. In determining the limits of microbial contamination, the following was taken into consideration: The nature of the product whether it is a pure compound, an extract, raw material or its combination. The route of administration. The method of preparation, e.g boiling. Objective The objective of these guidelines is to provide specifications on the limits of heavy metals and microbial contaminants of the various dosage forms to ensure their quality and safety. These guidelines also provide guidance notes on the control of pesticides in TM. ASEAN LIMITS OF CONTAMINANTS FOR TM 1. Limit on heavy metals: Maximum limit for heavy metals: 1.1. Lead: NMT 10.0 mg/kg or 10.0 mg/l (10.0ppm) 1.2. Arsenic: NMT 5.0 mg/kg or 5.0 mg/l (5.0ppm)* 1.3. Mercury: NMT 0.5 mg/kg or 0.5 mg/l (0.5ppm) 1.4. Cadmium: NMT 0.3 mg/kg or 0.3 mg/l (0.3ppm) Note: *Due to special circumstances such as national regulatory requirement, the limits of arsenic in the Philippines is 0.3 mg/kg or 0.3 mg/l (0.3 ppm) 3 of 8

2. Limit for Microbial Contaminations The limit used is based on British Pharmacopoeia (2013). Hence, the specifications may change as required according to the compendium requirements from time to time. The list is not necessarily exhaustive and for a given preparation, it may be necessary to test for other micro-organisms depending on the nature of the starting materials and in the manufacturing process. Test for Microbial Contamination Table I Microbiological Quality of Traditional Medicines Acceptable criteria for microbiological quality Route of Administration TAMC (CFU/g or CFU/ ml) TYMC (CFU/g or CFU/ ml) Specified Microorganisms For Oral Use A. Herbal medicinal products containing herbal drugs, with or without excipients, intended for the preparation of infusions and decoctions using boiling water (for example herbal teas, with or without added flavourings) B. Herbal medicinal products containing, for example, extracts and/or herbal drugs, with or without excipients, where the method of processing (for example, extraction) or, where appropriate, in the case of herbal drugs, of pre-treatment reduces the levels of organisms to below those stated for this category NMT 5 x 10 7 NMT 5 x 10 5 NMT 5 x 10 4 NMT 5 x 10 2 - NMT 10 3 CFU of Escherichia coli in 1g or 1mL Salmonella in 25g or 25mL - NMT 10 2 CFU of biletolerant gram-negative bacteria in 1g or 1mL Escherichia coli in 1g or 1mL Salmonella in 25g or 25mL 4 of 8

C. Herbal medicinal products containing, for example, extracts and/or herbal drugs, with or without excipients, where it can be demonstrated that the method of processing (for example, extraction with low strength ethanol or water that is not boiling or low temperature concentration) or, in the case of herbal drugs, of pre-treatment, would not reduce the level of organisms sufficiently to reach the criteria required under B D. Traditional medicines containing materials of natural (animal, plant or mineral) origin for which antimicrobial pretreatment is not feasible and for which the competent authority accepts TAMC of the material exceeding 10 3 CFU/gram or CFU/mL* For External Use NMT 5 x 10 5 NMT 5 x 10 4 NMT 2 x 10 4 NMT 2 x 10 2 - NMT 10 4 CFU of biletolerant gram-negative bacteria in 1g or 1mL Escherichia coli in 1g or 1mL Salmonella in 25g or 25mL - NMT 10 2 CFU of biletolerant gram negative bacteria in 1g or 1mL Salmonella in 10g or 10mL Escherichia coli in 1g or 1mL Staphylococcus aureus in 1g or 1mL Rectal NMT 2 x 10 3 NMT 2 x 10 2 - Oromucosal Gingival Cutaneous Nasal Auricular NMT 2 x 10 2 NMT 2 x 10 Staphylococcus aureus in 1g or 1mL Pseudomonas 5 of 8

aeruginosa in 1g or 1mL Staphylococcus aureus in 1g or 1mL Vaginal NMT 2 x 10 2 NMT 2 x 10 Pseudomonas aeruginosa in 1g or 1mL Transdermal Patches (limits for one patch including adhesive layer and backing) NMT 2 x 10 2 NMT 2 x 10 Candida albicans in 1g or 1mL Staphylococcus aureus in 1 patch Pseudomonas aeruginosa in 1 patch biletolerant gram negative bacteria in 1g or 1mL Inhalation Use (Special Requirement apply to liquid preparations for nebulisation) NMT 2 x 10 2 NMT 2 x 10 Staphylococcus aureus in 1g or 1mL Pseudomonas aeruginosa in 1g or 1mL Not all member states will allow all the route of administration mentioned above. 6 of 8

Notes: 1. Due to special circumstances such as national regulatory requirement, the limits of microbial contaminants in Indonesia are as in the WHO guidelines. 2. *As for category D for TM, Thailand will apply different limits from the above Table I Microbiological Quality of Traditional Medicines The limits for microbial contamination for Traditional Medicines routes of administration not specified above shall be determined by the regulatory authority of each Member State. 3. Pesticide Residues The safety and quality of medicinal plant materials and finished herbal medicinal products have become a major concern for health authorities, pharmaceutical industries and the public. Undesirable and/or undeclared substances have been present or have been purported to be present in herbal medicines or medicinal plants in many parts of the world. These substances have included pesticides, radioactive particles, microbes including pathogens, mycotoxins and heavy metals. The control on pesticides will not be on finished products as: - the risk is very low due to the small unit size and also the dilution effect from other non-pesticide containing ingredients and excipients. - pesticides are internationally regulated and there are global harmonizations on regulations currently in process. - currently no other economic bloc has regulations on pesticide residues in traditional medicines The onus is on the suppliers of raw materials and manufacturers of TM products to ensure that the raw materials supplied and used comply with the law. The control of pesticide residues in raw materials should be covered under Good Agriculture Practice (GAP). 7 of 8

Emphasis is on the raw material supply and reliance is thus placed on horizontal legislation rather than vertical legislation. Recommendations Pesticide Residue limits should remain under review and if conditions change in the future, for example, from post marketing surveillance data, a new assessment for the need of the limits for the finished product can be conducted, taking into consideration international guidelines/standards. 1 Steps to be taken by each member country on pesticide control: 1. To promote closer cooperation and liaison between Ministry of Health and the ministries responsible for control of pesticides and GAP in agricultural products (in most countries it will be the Ministry of Agriculture). 2. To reinforce, during GMP training on the need for manufacturers to be responsible and not to accept raw materials that do not comply with applicable pesticide residue limits. 8 of 8

GLOSSARY NMT Not More Than TAMC Total Aerobic Microbial Count TYMC Total Combined Yeasts/Moulds Count CFU Colony Forming Unit 1 Below are examples of International guidelines/standards on pesticide residues for reference: A. WHO has suggested that the limits for pesticide residues to be established following the recommendations of the Food and Agriculture Organization of United Nations and WHO for food and animal feed. Analytical methodology for the assessment of specific pesticides residues for medicinal plant materials are described in the WHO guidelines on QC methods for medicinal plants. B. EMEA guideline on specifications; test procedures and acceptance criteria for herbal substances, herbal preparations and herbal medicinal products/traditional herbal medicinal products (CPMP/QWP/2820/00 Rev 1). The guideline states that where possible, the limit of pesticide residues should be controlled at the herbal substance and/or herbal preparations (e.g. extraction) level. C. BP has established limits for pesticide residues in herbal drug (i.e. whole, fragmented, or cut plants parts of plants, algae, fungi or lichen, in an unprocessed state, usually in dried form but sometimes fresh). USP also has established analytical methods and limits for pesticide residues in articles of botanical origin. 9 of 8