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Patient In-Use Stability Testing of FDA-Approved Metformin Combination Products for N-Nitrosamine Impurity

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Abstract

Between February 2020 and January 2022, the Food and Drug Administration (FDA) recalled 281 metformin extended-release products due to the presence of N-nitrosodimethylamine (NDMA) above the acceptable daily intake (ADI, 96 ng/day). Our previous studies indicated presence of NDMA levels above ADI in both metformin immediate and extended-release products. When metformin products have NDMA impurities, it is indispensable to check for the same impurities in metformin combination products. Therefore, the objective of the present study was to evaluate in-use stability of commercial metformin combination products for NDMA. For this purpose, metformin products in combination with glyburide (GB1-GB12), glipizide (GP1-GP8), pioglitazone (P1-P3), alogliptin (A1, A2), and linagliptin (L1, L2) were repacked in pharmacy vials, stored at 30°C/75% RH for 3 months, and monitored for NDMA impurity. The NDMA level varied from 0 to 156.8 ± 32.8 ng/tablet initially and increased to 25.4 ± 5.1 to 455.0 ± 28.4 ng/tablet after 3 months of exposure to in-use condition. Initially, 18 products have NDMA level below ADI limit before exposure which decreased to 7 products (GB5, GP3, GP5, A1, A2, L1, and L2) meeting specification. In conclusion, in-use stability study provides quality and safety risk assessment of drug products where nitroso impurities are detected in the probable condition of use.

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Data Availability

The data that support the findings of this study are not openly available due to reasons of sensitivity and are available from the corresponding author upon reasonable request.

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Authors and Affiliations

  1. Irma Lerma Rangel College of Pharmacy, Texas A&M Health Science Center, Texas A&M University, 159 Reynolds Medical Sciences Building, College Station, Texas, 77843-1114, USA

    Sathish Dharani, Eman M. Mohamed, Ziyaur Rahman & Mansoor A. Khan

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  1. Sathish Dharani
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  2. Eman M. Mohamed
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  3. Ziyaur Rahman
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  4. Mansoor A. Khan
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Contributions

S.D.: validation, investigation, and visualization. E.M.M.: validation, investigation, and visualization. Z.R.: conceptualization, formal analysis, writing—review and editing, supervision, and project administration. M.A.K.: conceptualization, formal analysis, writing—review and editing, supervision, and project administration.

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Correspondence to Mansoor A. Khan.

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Dharani, S., Mohamed, E.M., Rahman, Z. et al. Patient In-Use Stability Testing of FDA-Approved Metformin Combination Products for N-Nitrosamine Impurity. AAPS PharmSciTech 25, 19 (2024). https://doi.org/10.1208/s12249-023-02724-3

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