ZĀĻU VALSTS AĢENTŪRA STATE AGENCY OF MEDICINES PUBLIC ASSESSMENT REPORT Scientific Discussion Somnols 7,5 mg film-coated tablets (Zopiclone) LV/H/0104/001/MR Applicant: JSC Grindeks, Latvia Date of the PAR: April 2011 Public Assessment report Page 1/4 Information about the initial procedure: Application type/Legal basis Name of the product Active substance Pharmaceutical form, strength Pharmacotherapeutic group ATC code Applicant’s name and address EU-procedure number Reference Member State Member States Concerned Generic application Art.10.1 Dir.2001/83/EC Somnols 7,5 mg film-coated tablets Zopiclone Film-coated tablets, 7,5 mg Hypnotics and sedatives N05CF01 JSC Grindeks, 53 Krustpils Street, Riga, LV-1057, Latvia LV/H/0104/001/MR Latvia DK, NO, ES, SK, RO End of procedure 22 February 2011 1. INTRODUCTION Based on the review of the data on quality, safety and efficacy, the State Agency of Medicines (SAM) considered that the application for Somnols 7,5 mg film-coated tablets indicated for treatment of transient, short-term insomnia for adults (including difficulties in falling asleep, nocturnal awakening and early awakening) and a support therapy for a limited period of time in the treatment of chronic insomnia, could be approvable. Zopiclone is only indicated when the disorder is severe, which limits patient activity or is subjecting the individual to extreme distress. National marketing authorisation for the above mentioned product was granted on April 14 1999. This mutual recognition procedure concerns a generic application claiming essential similarity with the reference product Imovane 7,5 mg film-coated tablets (LV MA number – 98-0590) which has been authorised in Latvia by Sanofi-aventis Latvia Ltd. since 14th October 1998. The marketing authorisation is granted based on article 10.1 of Directive 2001/83/EC. This type of application refers to information that is contained in the pharmacological-toxicological and clinical part of the dossier of the authorisation of the reference product. A reference product is a medicinal product authorised and marketed on the basis of a full dossier, i.e. including chemical, biological, pharmaceutical pharmacological-toxicological and clinical data. This information is not fully available in the public domain. Authorisations for generic products are therefore linked to the ‘original’ authorised medicinal product, which is legally allowed once the data protection time of the dossier of the reference product has expired. For this kind of application, it has to be demonstrated that the pharmacokinetic profile of the product is similar to the pharmacokinetic profile of the reference product. To this end the applicant has submitted a bioequivalence study in which the pharmacokinetic profile of the product is compared with the pharmacokinetic profile of the reference product Imovane 7,5 mg film-coated tablets registered in Latvia. The active component Zopiclone is a hypnotic and sedative agent. It also exhibits anticonvulsant, muscle relaxant and hypnosedative properties in animals. It is a gamma amino butyric agonist (GABA), which binds to receptor subtype GABAA. Public Assessment report Page 2/4 Zopiclone possesses high affinity for benzodiazepine receptors in rat brain region (cerebral cortex, cerebellum and hippocampus) and inhibits the binding of diazepam and nitrazepam to benzodiazepine receptors. The clinical efficacy of Somnols 7,5 mg film-coated tablets for the indications stated in the Summary of Product Characteristics may be concluded without any reasonable doubt. The clinical overview on the clinical pharmacology, efficacy and safety is adequate. The adverse events that can be expected are listed in the SmPC. 2. QUALITY ASPECTS The chemical-pharmaceutical documentation and Quality Overall Summary in relation to Somnols 7,5 mg film-coated tablets are of sufficient quality in view of the present European regulatory requirements. Drug substance The drug substance zopiclone is known substance described in a Ph. Eur. monograph. Drug substance is manufactured by JSC Grindeks, Ph. Eur. certificate of suitability (CEP) is available. Drug substance specification and control tests have been developed according to the Ph.Eur. requirements. The proposed retest period of 5 years is justified and stated in the CEP. Medicinal product The development of the product has been described, the choice of excipients is justified and their functions explained. The manufacturing process is adequately described. The used in-process controls and the performed validation studies are considered as sufficient to guarantee an appropriate quality of the drug product. The product specifications cover appropriate parameters for this dosage form. Validation of the analytical methods has been presented. Specifications and tests are described adequately. Batch analysis has been performed on 3 pilot batches and 2 production batches. The batch analysis results show that the finished product meet the specification proposed. The conditions used in the stability studies are according to the ICH stability guideline. The control tests and specifications for drug product are adequately drawn up. The proposed shelf-life of 2 years with storage conditions “Do not store above 25°C. Store in original packaging in order to protect from light and moisture” for the drug product is considered acceptable. 3. NON CLINICAL ASPECTS This product is a generic formulation of Imovane 7,5 mg film-coated tablets, which is available on the European market. Pharmacodynamics, pharmacokinetics, toxicology and interactions of zopiclone are well known. No new data have been submitted, and therefore the application has not undergone preclinical assessment. In the view of the long-term clinical experience, presentation of new data is not necessary for approval of the Marketing Application. Overview based on literature review is thus appropriate. Information on pharmacokinetics is comprehensively presented in the clinical section. Public Assessment report Page 3/4 4. CLINICAL ASPECTS Zopiclone is a well-known active substance with established efficacy and tolerability. No new data have been submitted. No new data are required for an essentially similar product. Provided bioequivalence has been satisfactorily demonstrated. The use of zopiclone is based on the fact that it is a cyclopyrrolone agent that enhances the inhibitory effects of gamma aminobutyric acid (GABA) as a result of its agonist activity at GABAA receptors. Zopiclone and the benzodiazepines appear to bind to the same recognition site, enhancing the function of the GABAA receptor. Zopiclone binds to specific benzodiazepine receptor subtypes, with greater affinity for ω1 than ω2 receptors. It has been shown that zopiclone and other cyclopyrrolones act on a different site to those of benzodiazepines including different conformational changes in the receptor complex. Zopiclone rapidly initiates and sustains sleep without reduction of total REM sleep and with preservation of slow wave sleep. The safety profile of zopiclone is well known through its extensive use in clinical practice. The side effects of zopiclone are well known. The SPC adequately reflects current knowledge on the safety of zopiclone and provides details of precautions and possible side effects. Safety data are adequately summarised in the clinical expert report. Pharmacokinetics To support the application, the applicant has submitted one bioequivalence study performed on the 7.5 mg strength under fasting conditions. The study was a randomized, single centre, single dose, two-way crossover design in healthy male and female subjects. The test product Zopiclone 7.5 mg film-coated tablet is considered equivalent to the reference product Imovane 7.5 mg film-coated tablet. 5. BENEFIT RISK ASSESSMENT Somnols 7,5 mg film-coated tablets has a proven chemical-pharmaceutical quality and is a generic form of Imovane 7,5 mg film-coated tablets. Imovane 7,5 mg film-coated tablets is a well-known medicinal product with an established favourable efficacy and safety profile. Bioequivalence has been shown to be in complience with the requirements of European guidance documents. As Somnols is subject of a generic application, no additional pharmacovigilance activities and/or risk minimisation measures are proposed for this product by the applicant, which the RMS finds acceptable. Based on the data on quality, safety and efficacy the SAM considered that the benefit risk balance could be favourable for Somnols 7,5 mg film-coated tablets. No additional toxicological or clinical studies were deemed necessary for this application. The summary of product characteristics, package leaflet and labelling are in the agreement with other zopiclone containing products. A European harmonised birth date has been allocated on 10 December 1984 and subsequently the next data lock point (DLP) for zopiclone is May 2012 and the PSUR should be submitted no later than 60 days after this date. A 3- yearly PSUR cycle will apply hereafter. Therefore, the second PSUR will cover the period May 2012 until May 2015. The date for the first renewal will be: 21.02.2016. Public Assessment report Page 4/4