Fig. 3
From: Supplying a pharmacy for NASA exploration spaceflight: challenges and current understanding
To date, there have been few studies of pharmaceuticals flown in the space environment. Du et al. (dark blue) compared active pharmaceutical ingredient (API) concentration and physical alterations in four flown payloads to ground controls.15 Wotring (green) identified degradation, impurity products, and API concentrations in an opportunistic sample of flown drugs without an available ground control.1 Zwart et al. (light blue) studied the vitamin content (API) of flown multivitamins compared to ground controls.19 Chuong et al. (orange) compared the API of B-complex vitamins in flown multivitamins, with ground controls available; a subset of these ground controls were irradiated with either hydrogen or iron ions at high dose and dose-rate dissimilar to the space environment.18 Finally, Cory et al. and Wu et al. (gray) analyzed an opportunistic sample of flown pharmaceuticals; these results have yet to be published, but early reports suggest variable results.16,17 Drugs highlighted in red were found to have alterations of API, physical characteristics, or contain significant concentrations of degradants or impurities after flight in one or more preparation of the indicated pharmaceutical. *Multivitamin preparations were analyzed only for B-complex API stability. **Drugs contained API concentrations within acceptable limits at time of study analysis, but would fail API analysis according to current standards. Drugs contained unspecified or unidentified impurity products of unknown significance. •Multivitamin content demonstrated time-related instability but showed no alteration specifically related to spaceflight exposure
