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MHRA PAR; NAPIERS HERBAL STRESS AND SLEEP AID, THR 15670/0026
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Napiers Herbal Stress and Sleep Aid
THR 15670/0026
UKPAR
TABLE OF CONTENTS
Lay summary
Page 2
Scientific discussion
Page 3
Steps taken for assessment
Page 11
Summary of Product Characteristics
Page 12
Product Information Leaflets
Page 16
Labelling Page 21
MHRA PAR; NAPIERS HERBAL STRESS AND SLEEP AID, THR 15670/0026
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NAPIERS HERBAL STRESS AND SLEEP AID
THR 15670/0026
LAY SUMMARY
The Medicines and Healthcare products Regulatory Agency (MHRA) granted Rickard Lane’s and WH Box Ltd a Traditional Herbal Registration Certificate for the traditional herbal medicinal product Napiers Herbal Stress and Sleep Aid (Traditional Herbal Registration number: THR 15670/0026) on 8 November 2012. Napiers Herbal Stress and Sleep Aid is available without prescription and can be bought from pharmacies and other outlets. Napiers Herbal Stress and Sleep Aid is a traditional herbal medicinal product used for the temporary relief of symptoms associated with stress, such as mild anxiety and to aid sleep, based on traditional use only. This registration is based exclusively upon evidence of the use of Vervain (Verbena officinalis L.) herb Scullcap (Scutellaria lateriflora L.) herb, Passion flower (Passiflora incarnata L.) herb and Oat (Avena sativa L.) seed as traditional herbal medicines and not upon data generated from clinical trials. There is no requirement under the Traditional Herbal Registration scheme to prove scientifically that the product works. No new or unexpected safety concerns arose from this application and it was, therefore, decided that a Traditional Herbal Registration Certificate could be granted.
MHRA PAR; NAPIERS HERBAL STRESS AND SLEEP AID, THR 15670/0026
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NAPIERS HERBAL STRESS AND SLEEP AID
THR 15670/0026
SCIENTIFIC DISCUSSION
TABLE OF CONTENTS
Introduction
Page 4
Pharmaceutical assessment
Page 5
Preclinical assessment
Page 8
Clinical assessment
Page 9
Overall conclusions and risk assessment Page 10
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INTRODUCTION
The MHRA granted a Traditional Herbal Registration Certificate for the traditional herbal medicinal product Napiers Herbal Stress and Sleep Aid (THR 15670/0026) to Rickard Lane’s and WH Box Ltd on 8 November 2012. This product is on the general sales list (GSL). A product licence of right (PLR) was originally granted to Potters Limited for this product. The PLR was reviewed and a product licence (PL 00250/5077R) was granted to Potters Limited on 30 October 1990. The product licence was transferred to Rickard Lane’s and W.H. Box Ltd on 12 October 2011 (PL 15670/0025). PL 15670/0025 was cancelled on 9 November 2012. This THR application was made under Article 16.c of Directive 2001/83 EC in accordance with arrangements to transfer certain herbal products with a Marketing Authorisation to a THR (according to MHRA Guidance dated January 2009). The application falls within the simplified THR application Category A, as no significant changes have been made to the formulation of the product. No new data were submitted, nor was it necessary for this application, as the data are essentially identical to those of the existing product.
MHRA PAR; NAPIERS HERBAL STRESS AND SLEEP AID, THR 15670/0026
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PHARMACEUTICAL ASSESSMENT
HERBAL SUBSTANCE: VERVAIN HERB
Scientific name of the plant: Verbena officinalis L. Plant family: Verbenaceae The herbal substance is in line with that used in the already licensed product. It is, therefore, acceptable.
HERBAL PREPARATION: VERVAIN HERB LIQUID EXTRACT
Drug extract ratio (DER): 1:1 Extraction solvent: Ethanol 21% v/v The herbal preparation specification is in line with that applied to the herbal preparation used in the already licensed product. It is, therefore, acceptable.
HERBAL SUBSTANCE: SCULLCAP HERB
Scientific name of the plant: Scutellaria lateriflora L. Plant family: Lamiaceae The herbal substance is in line with that used in the already licensed product. It is, therefore, acceptable.
HERBAL PREPARATION: SCULLCAP HERB LIQUID EXTRACT
Drug extract ratio (DER): 1:1 Extraction solvent: Ethanol 21% v/v The herbal preparation specification is in line with that applied to the herbal preparation used in the already licensed product. It is, therefore, acceptable. HERBAL PREPARATION: SCULLCAP HERB TINCTURE
Drug extract ratio (DER): 1:5 Extraction solvent: Ethanol 41% v/v The herbal preparation specification is in line with that applied to the herbal preparation used in the already licensed product. It is, therefore, acceptable.
HERBAL SUBSTANCE: PASSION FLOWER HERB
Scientific name of the plant: Passiflora incarnata L. Plant family: Passifloraceae
MHRA PAR; NAPIERS HERBAL STRESS AND SLEEP AID, THR 15670/0026
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The herbal substance is in line with that used in the already licensed product. It is, therefore, acceptable.
HERBAL PREPARATION: PASSION FLOWER HERB LIQUID
EXTRACT
Drug extract ratio (DER): 1:1 Extraction solvent: Ethanol 21% v/v The herbal preparation specification is in line with that applied to the herbal preparation used in the already licensed product. It is, therefore, acceptable.
HERBAL SUBSTANCE: OAT SEED
Scientific name of the plant: Avena sativa L. Plant family: Poaceae The herbal substance is in line with that used in the already licensed product. It is, therefore, acceptable.
HERBAL PREPARATION: OAT SEED LIQUID EXTRACT
Drug extract ratio (DER): 1:1 Extraction solvent: Ethanol 21% v/v The herbal preparation specification is in line with that applied to the herbal preparation used in the already licensed product. It is, therefore, acceptable.
HERBAL PRODUCT: NAPIERS HERBAL STRESS AND SLEEP
AID
Description and Composition of the Herbal Product Napiers Herbal Stress and Sleep Aid is a dark brown, mobile, oral liquid. 5 ml of the oral liquid contains 0.812 ml of liquid extract from Vervain herb, 0.188 ml of liquid extract from Scullcap herb, 0.4 ml of tincture from dried Scullcap herb, 0.425ml of liquid extract from Passion flower herb and 0.213ml of liquid extract from Oat seed. The other ingredients in the herbal product are liquid extract wild thyme, orange oil, lemon oil, coriander oil, aniseed oil, 90 % ethanol and water. The formulation is identical to that of the already licensed product. It is, therefore, acceptable.
Manufacture The manufacturing process is in line with that of the already licensed product and is satisfactory. Finished Product Specification The finished product specification is in line with that of the already licensed product and is satisfactory.
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Container Closure System Napiers Herbal Stress and Sleep Aid is contained in a glass bottle with child-resistant safety cap placed in a cardboard carton. The product is available in 100ml and 200ml bottles. This type of packaging has been used to store the already licensed product and is satisfactory. Stability The product shelf-life of 3 years was applied to the already licensed product and is appropriate. Summary of Product Characteristics, product labelling and Patient Information Leaflet All product literature is in line with that of the already licensed product, with some details amended in line with other products registered under the THR scheme. A package leaflet has been submitted to the MHRA along with results of consultations with target patient groups ("user testing"), in accordance with Article 59 of Council Directive 2001/83/EC. The results indicate that the package leaflet is well-structured and organised, easy to understand and written in a comprehensive manner. The test shows that the patients/users are able to act upon the information that it contains. ASSESSOR’S OVERALL CONCLUSIONS It is recommended that a Traditional Herbal Registration can be granted.
MHRA PAR; NAPIERS HERBAL STRESS AND SLEEP AID, THR 15670/0026
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PRECLINICAL ASSESSMENT
INTRODUCTION No new preclinical data have been supplied with this application and none is required for an application of this type. Assurance has been given that the results of genotoxicity testing will be provided by the renewal date of the Traditional Herbal Registration.
PRODUCT LITERATURE All product literature is satisfactory from a preclinical point of view. ASSESSOR’S OVERALL CONCLUSIONS It is recommended that a Traditional Herbal Registration can be granted.
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CLINICAL ASSESSMENT
INTRODUCTION The clinical particulars for Napiers Herbal Stress and Sleep Aid are identical to those for the already licensed product. This is satisfactory. PRODUCT LITERATURE All product literature is medically satisfactory. ASSESSOR’S OVERALL CONCLUSIONS It is recommended that a Traditional Herbal Registration can be granted.
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OVERALL CONCLUSION AND BENEFIT-RISK ASSESSMENT QUALITY Napiers Herbal Stress and Sleep Aid is identical to an already licensed product. It is, therefore, pharmaceutically satisfactory. PRECLINICAL No new preclinical data were submitted and none are required for an application of this type. The results of genotoxicity testing will be provided before the THR is renewed. EFFICACY No clinical efficacy data are required for registration of Traditional Herbal Medicinal Products. SAFETY No new or unexpected safety concerns arose from this application. BENEFIT-RISK ASSESSMENT The quality of the product is acceptable and no new preclinical or clinical safety concerns have been identified. The benefit: risk balance is acceptable and a THR should be granted.
MHRA PAR; NAPIERS HERBAL STRESS AND SLEEP AID, THR 15670/0026
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NAPIERS HERBAL STRESS AND SLEEP AID
THR 15670/0026
STEPS TAKEN FOR ASSESSMENT
1 The MHRA received the Traditional Herbal Registration application on 11 October 2010
2 Following standard checks and communication with the applicant the MHRA considered the application valid on 2 December 2010
3 Following assessment of the application the MHRA requested further information relating to the dossier on 9 December 2010
4 The applicant responded to the MHRA’s requests, providing further information on the dossier on 1 October 2012
5 A THR was granted on 8 November 2012
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SUMMARY OF PRODUCT CHARACTERISTICS 1 NAME OF THE MEDICINAL PRODUCT
Napiers Herbal Stress and Sleep Aid 2 QUALITATIVE AND QUANTITATIVE COMPOSITION Each 5 ml of oral liquid contains: -
0.812 ml of extract (as liquid extract) from Vervain herb (Verbena officinalis L.) (1:1) (equivalent to 812 mg of Vervain) Extraction Solvent: Ethanol 21% v/v 0.188 ml of extract (as liquid extract) from Scullcap herb (Scutellaria lateriflora L.) (1:1) (equivalent to 188 mg of Scullcap) Extraction Solvent: Ethanol 21% v/v 0.4 ml of tincture from dried Scullcap herb (Scutellaria lateriflora L.) (1:5) (equivalent to 80 mg of Scullcap) Extraction Solvent: Ethanol 41% v/v 0.425ml of extract (as liquid extract) from Passion Flower herb (Passiflora incarnata L.) (1:1) (equivalent to 425 mg of Passion Flower) Extraction Solvent: Ethanol 21% v/v 0.213ml of extract (as liquid extract) from Oat seed (Avena sativa L.) (1:1) (equivalent to 213 mg of Oat seed) Extraction Solvent: Ethanol 21% v/v 5 ml of oral liquid contains approximately 0.7 ml of ethanol (alcohol) equivalent to14 ml of beer or 5.8 ml of wine. For a full list of excipients, see section 6.1.
3 PHARMACEUTICAL FORM
Oral liquid. A dark brown mobile liquid.
4 CLINICAL PARTICULARS
4.1 Therapeutic indications
A traditional herbal medicinal product used for the temporary relief of symptoms associated with stress, such as mild anxiety and to aid sleep, based on traditional use only.
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4.2 Posology and method of administration For short term oral use only. Adults and the elderly: For temporary relief of mild anxiety: One 5 ml teaspoonful in water three times day. To aid sleep: One 5 ml teaspoonful in water at bed time. An extra 5 ml in water can be taken during the night if needed. Not recommended for use in children or adolescents under 18 years (see section 4.4 ‘Special warnings and precautions for use’). If the symptoms worsen or persist after 4 weeks of using of this medicinal product, a doctor or a qualified health care practitioner should be consulted.
4.3 Contraindications
Hypersensitivity to any of the active ingredients, or oat preparations or to any of the excipients.
4.4 Special warnings and precautions for use
Do not exceed the stated dose. Not recommended for use in children or adolescents under 18 years of age due to the lack of adequate data and medical advice should be sought. Caution is advised when used in patients with coeliac disease because data on the protein content of Avena are not available. This medicinal product contains approximately 14 % v/v ethanol (alcohol), i.e. up to 560 mg per dose, equivalent to 14 ml beer, 5.8 ml wine per dose. Harmful for those suffering from alcoholism. To be taken into account in pregnant or breast-feeding women, children and high-risk groups such as patients with liver disease or epilepsy. If the symptoms worsen or persist after 4 weeks during the use of this medicinal product, a doctor or a qualified health care practitioner should be consulted.
4.5 Interaction with other medicinal products and other forms of interaction
Although no clinical data about interactions with synthetic sedatives are available, concomitant use with synthetic sedatives (such as benzodiazepines) is not recommended unless advised by a doctor. Contains alcohol and should be avoided in patients taking other medicines known to interact with alcohol (e.g metronidazole).
4.6 Fertility, pregnancy and lactation
The safety of this product during pregnancy and lactation has not been established. In the absence of sufficient data, the use during pregnancy and lactation is not recommended.
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Studies on the effects on fertility have not been performed. 4.7 Effects on ability to drive and use machines
May impair ability to drive and use machines. If affected, patients should not drive or operate machinery. This product contains alcohol (See Section 4.4 “Special warnings and precautions for use”.)
4.8 Undesirable effects
There has been one report of nausea and tachycardia (increased heart beat) and one report of hypersensitivity (vasculitis) in patients using Passion flower herb. Other possible side effects include allergic skin reactions, such as itching, redness or blistering of the skin. If other adverse reactions not mentioned above occur, a doctor or a qualified health care practitioner should be consulted.
4.9 Overdose
No cases have been reported with this product. Overdose of this product may result in alcohol intoxication: the amount of alcohol in a full bottle (10 g in 100 ml; 20 g in 200 ml: equivalent to 0.4 or 0.8 glass of wine respectively or 0.98 or 1.9 glass of beer, respectively) may result in intoxication and should be treated accordingly.
5 PHARMACOLOGICAL PROPERTIES
5.1 Pharmacodynamic properties
Not required as per Article 16c(1)(a)(iii) of Directive 2001/83/EC as amended. 5.2 Pharmacokinetic properties
Not required as per Article 16c(1)(a)(iii) of Directive 2001/83/EC as amended. 5.3 Preclinical safety data
Tests on reproductive toxicity, genotoxicity and carcinogenicity have not been performed.
6 PHARMACEUTICAL PARTICULARS
6.1 List of excipients
Liquid Extract Wild Thyme Orange Oil Lemon Oil Coriander Oil Aniseed Oil 90 % ethanol Water
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6.2 Incompatibilities
Not applicable. 6.3 Shelf life
Three years. 6.4 Special precautions for storage
This medicinal product does not require any special storage conditions. 6.5 Nature and contents of container
Glass bottle with child-resistant safety cap placed in a cardboard carton: 100ml and 200ml.
6.6 Special precautions for disposal
Not special requirements.
7 MARKETING AUTHORISATION HOLDER
Rickard Lane’s and WH Box Ltd. 24 Tennant Street Edinburgh, EH6 5ND UK
8 MARKETING AUTHORISATION NUMBER(S)
THR 15670/0026 9 DATE OF FIRST AUTHORISATION/RENEWAL OF THE
AUTHORISATION 08/11/2012 10 DATE OF REVISION OF THE TEXT
08/11/2012
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PRODUCT INFORMATION LEAFLETS
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LABELLING Label:
MHRA PAR; NAPIERS HERBAL STRESS AND SLEEP AID, THR 15670/0026
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Carton:
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Label:
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Carton: