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(Version: 2016/08/31)
Brand Name of Drug Product | |
---|---|
Non-proprietary (Proper or common name) Name of Drug Product | |
Non-proprietary or Common Name of Drug Substance (Medicinal Ingredient) | |
Company (Manufacturer/Sponsor) Name | |
Dosage Form(s) | |
Strength(s) | |
Route of Administration | |
Proposed Indication(s) |
(a)Sponsor's Date of CPID:
(b) Administrative Summary: (Health Canada use only)
DocuBridge Identifier | |
---|---|
Control Number | |
Internal Version and/or Date of Acceptance |
(a) Structural formula, including relative and absolute stereochemistry:
(b) Molecular formula:
(c) Molecular mass:
(a) Physical form (for example [e.g.], polymorphic form, solvate, hydrate):
(b) Solubilities and Dose/Solubility Volume over the physiological pH range (1.2-6.8):
(c) pKa:
(a) Name, address, and responsibility of each manufacturer, including contractors, and each proposed production site or facility involved in manufacturing and testing:
Name and Address | Responsibility (for example, fabrication, packaging, labelling, testing, importing, storage, and distribution) |
MF # or CEP # |
---|---|---|
(a) Flow diagram showing reactants, solvents and reagents:
Name and address of sites manufacturing the API starting material(s):
Name and chemical structure of API starting material:
Manufacturer:
Manufacturing site address:
Potential impurities not routinely controlled in the drug substance:
(a) Specification for the drug substance:
Standard Claimed [for example, House, United States Pharmacopeia (USP), British Pharmacopoeia (BP), European Pharmacopoeia (Ph.Eur.)] | ||
---|---|---|
Specification Reference Number and/or Version | ||
Test | Acceptance Criteria | Analytical Procedure (Type/Source/Version) |
(a) Description of the container closure system(s) for the storage and shipment of the drug substance:
(a) Proposed storage conditions and re-test period (or shelf life, as appropriate):
Container Closure System | Storage Conditions | Re-test Period |
---|---|---|
(a) Composition of the dosage form:
(i) Composition, that is (i.e.), list of all components of the dosage form, and their amounts on a per unit basis (including overages, if any):
Component and Quality Standard (and Grade, if applicable) | Strength (label claim) | |||
---|---|---|---|---|
Quantity per unit | % | Quantity per unit | % | |
(ii) Composition of all components that are mixtures (e.g., colourants, coatings, capsule shells, imprinting inks):
(b) Description of accompanying reconstitution diluent(s), if applicable:
Name and Address | Responsibility (for example, fabrication, packaging, labelling, testing, importing, storage, and distribution) |
MF # |
---|---|---|
(a) Name, address, and responsibility of each manufacturer, including contractors, and each proposed production site or facility involved in manufacturing and testing:
(a) List of all components of the dosage form to be used in the manufacturing process, and their amounts on a per batch basis (including overages, if any):
Strength (label claim) | ||
---|---|---|
Master Production Document Reference Number and/or Version |
||
Batch Size(s) (number of dosage units) | ||
Component and Quality Standard (and Grade, if applicable) |
Quantity per batch | Quantity per batch |
(a) Flow diagram of the manufacturing process:
(b) Narrative description of the manufacturing process, including equipment type and working capacity, process parameters:
(a) Summary of controls performed at the critical steps of the manufacturing process and on isolated intermediates:
(a) Summary of process validation information, including any commitments, for the critical steps in the manufacturing process (e.g., protocol number, parameters):
Validation Protocol # / Report # | Description | Status (Commitment / Completed) | Filed with Submission Control No. |
---|---|---|---|
(a) Specification(s) for the drug product:
Specification Reference Number and/or Version | ||
---|---|---|
Test | Acceptance Criteria (release and stability) |
Analytical Procedure (Type/Source/Version) |
(a) Description of the container closure systems, including unit count or fill size, container size or volume:
Strength | Unit Count or Fill Size | Container Size(s) | Description |
---|---|---|---|
(a) Proposed storage conditions and shelf life (and in-use storage conditions and in-use period, if applicable):
Container Closure System | Storage Conditions (and In-use Storage Conditions, if applicable) | Shelf Life (and In-use Period, if applicable) |
---|---|---|
(a) Stability protocol for commitment batches:
Protocol Parameter | Description |
---|---|
Storage conditions (including tolerances) | |
Testing frequency | |
Number of batches per strength and batch sizes | |
Container closure system(s) | |
Tests and acceptance criteria | |
Other |
(b) Stability protocol for continuing (i.e., ongoing) batches:
Protocol Parameter | Description |
---|---|
Storage conditions (including tolerances) | |
Testing frequency | |
Number of batches per strength and batch sizes | |
Container closure system(s) | |
Tests and acceptance criteria | |
Other |
(a) Bracketing and matrixing design for commitment and/or continuing (i.e., ongoing) batches, if applicable: