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M12 – Drug Interaction Studies

Guideline number: M12
Status: Implementation (Step 5)
Adopted (Step 4): 21 May 2024

This topic was endorsed by the ICH Assembly in June 2018.

The ICH M12 Guideline reached Step 4 of the ICH process on 21 May 2024.

The M12 Guideline:

  • Is limited to pharmacokinetic interactions, with a focus on metabolic enzyme- and transporter-mediated interactions;
  • Provides recommendations on how to investigate interactions mediated by inhibition or induction of enzymes or transporters, both in vitro and in vivo (the terms ‘clinical’ and ‘in vivo’ are used interchangeably in this document), and on how to translate the results to appropriate treatment recommendations and also includes recommendations on how to address metabolite-mediated interactions;
  • Provides recommendation for consistent approach to reduce uncertainty for the pharmaceutical industry to meet the requirements of multiple regulatory agencies and lead to more efficient utilization of resources.

The ICH Harmonised Guideline was finalised under Step 4 in July 1997. This document covers the preclinical safety testing requirements for biotechnological products. It addresses the use of animal models of disease, determination of when genotoxicity assays and carcinogenicity studies should be performed, and the impact of antibody formation on duration of toxicology studies.

An addendum was proposed to provide clarification on S6 and an update of the following topics discussed in the original ICH S6 Guideline: species selection, study design, immunogenicity, reproductive and developmental toxicity and assessment of carcinogenic potential. The Harmonised addendum provides further complementary guidance to the S6 Guideline and helps to define the current recommendations and reduce the likelihood that substantial differences will exist among regions.

The addendum reached Step 4 of the harmonisation process in June 2011 and was integrated as part II in the core Guideline that was then renamed S6(R1).

Guideline
WG Presentations / Trainings

Annexes

No results found.

Guideline implementation

ANMAT, Argentina

-

Not yet implemented;
ANVISA, Brazil

-

Not yet implemented;
COFEPRIS, Mexico

-

Not yet implemented;
EC, Europe

-

Implemented; Date: 30 November 2024; Reference: EMA/CHMP/ICH/652460/2022
EDA, Egypt

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Implemented; Date: 25 September 2024; Reference: Regulatory Guide for mechanisms, procedures and rules of implementing the Decree of Egyptian Drug Authority No.343 of 2021
FDA, United States

-

Implemented; Date: 2 August 2024; Reference: 89 FR 63205
HSA, Singapore

-

In the process of implementation;
Health Canada, Canada

-

Implemented; Date: 20 December 2024; Reference: File # 24-110987-619
JFDA, Jordan

-

Not yet implemented;
MFDS, Republic of Korea

-

Not yet implemented; Date: 31 December 2026;
MHLW/PMDA, Japan

-

Implemented; Date: 27 November 2024; Reference: PSB/PED Notification No. 1127-2
MHRA, UK

-

Not yet implemented;
NAFDAC, Nigeria

-

Not yet implemented;
NMPA, China

-

Implemented; Date: 29 October 2024; Reference: NMPA, China Announcement No. 130 (2024)
SAHPRA, South Africa

-

In the process of implementation;
SFDA, Saudi Arabia

-

Implemented; Date: 15 April 2026;
Swissmedic, Switzerland

-

Implemented; Date: 21 May 2024; Reference: ICH Guidelines apply in Switzerland automatically upon reaching Step 4: Swissmedic Journal 05/2006, p. 504
TFDA, Chinese Taipei

-

Implemented; Date: 19 June 2025; Reference: Updated-Announcement for ICH Guidelines Recognition List
TITCK, Türkiye

-

Not yet implemented;

Q+A

Q+A number: M12 Q&As
Q+A Status: Implementation (Step 5)
Q+A Adopted (Step X): 21 May 2024
Documents

Q+A implementation

ICH M12 Questions and Answers (Q&As) have been developed to provide clarity around some of the concepts related to evaluation of drug interaction covered in the Guideline.

This Q&A is intended to provide additional clarification and improve harmonization of drug interaction assessment.

The scope and organization of this Q&A document follow that of ICH M12.