MDR Translation Requirements: A Guide for Medical Device Manufacturers

When a regulatory affairs lead scopes package leaflet translation for an EU and UK pharma submission, four questions come up first: which documents have to be translated, into how many languages, how to land them inside the EMA’s 25-day linguistic review, and how to handle the UK as a separate workstream after the Windsor Framework.

The legal framework comes from Directive 2001/83/EC and Regulation (EC) 726/2004 on the EU side, with the MHRA’s Windsor Framework rules covering the UK. The operational artefact is the EMA’s Quality Review of Documents (QRD) template, currently at version 10.4, with version 11 having gone through public consultation.

This guide pulls those pieces into one place: the document type matrix, the procedure-by-procedure language scope, the EMA 25-day linguistic review as an operational table, the Windsor Framework treatment for UK packs, and a vendor evaluation checklist that lifts into a supplier RFP.

If you are the regulatory affairs lead, head of labelling, or quality and compliance manager running EU and UK pharma submissions, the deeper read on quality methodology sits in our article on medical translation quality assurance. For an overview of how we structure pharma-grade medical translation work, see our medical translation service page.

TL;DR

  • Directive 2001/83/EC (Articles 54 to 69 for labelling and leaflet) and Regulation (EC) 726/2004 set the legal framework. The EMA’s QRD template is the working tool: current version 10.4, with version 11 in public consultation until 31 August 2025.
  • Centralised procedure submissions require translation into all 24 EU official languages plus Norwegian and Icelandic. Mutual recognition, decentralised, and national procedures need only the languages of the member states involved.
  • The EMA linguistic review is a 25-day procedure from CHMP positive opinion (Day 0) to final translations submitted (Day 25). The pressure points are Day 5 (MAH submission via Eudralink) and Day 19 (national competent authorities return reviewed files).
  • The CMDh maintains its own annotated QRD template for MRP and DCP submissions (March 2024, correction September 2025), separate from the EMA centralised QRD template.
  • UK pharma operates under MHRA, not EMA. Since 1 January 2025, a single UK-wide pack with a “UK Only” label is required. Stickering was permitted until 30 June 2025, with direct printing required after that. QRD v10.4 deleted “United Kingdom (Northern Ireland)” from the local representatives list.
  • Buyers evaluating a language service provider (LSP) should demand ISO 17100 plus ISO 18587 certification, demonstrable Eudralink experience, QRD-template-fluent terminology management, in-layout artwork review tooling, and a per-project audit trail.

What EU pharma translation requires

EU pharma translation sits under:

  • Directive 2001/83/EC, which sets the rules for medicinal products across all member states, and
  • Regulation (EC) 726/2004, which gives the European Medicines Agency its role in the centralised procedure.

Title V of the Directive (Articles 54 to 69) covers labelling and the package leaflet. Article 63(1) is the language anchor: the particulars on outer packaging and the leaflet must appear in the official language or languages of the member state where the medicinal product is placed on the market. The QRD template, maintained by the EMA’s Working Group on Quality Review of Documents, is the operational artefact through which the regulation gets enforced in practice.

The legal anchor: Directive 2001/83/EC and Regulation (EC) 726/2004

The Directive sets out what must appear in the SmPC (Article 11), the labelling (Article 54), and the patient leaflet (Article 59). Regulation 726/2004 governs the centralised procedure run through the EMA. Both apply at the same time for centrally authorised products.

National competent authorities such as BfArM in Germany, ANSM in France, AEMPS in Spain, AIFA in Italy, the MEB in the Netherlands, the MPA in Sweden, and Lægemiddelstyrelsen in Denmark enforce the Directive at member-state level. The language scope follows the markets where the marketing authorisation is granted, not a blanket EU-wide rule.

The QRD template as the working tool

The QRD template is what your translation agency or LSP works from in practice. It specifies the heading structure, mandatory phrases, formatting conventions, and pre-approved translations for common terms. Versions matter. The current version 10.4 (last updated 25 March 2026 on the EMA site) was specifically revised to delete “United Kingdom (Northern Ireland)” from the local representatives section, aligning with the Windsor Framework. An LSP still working from a pre-v10.4 template is shipping an outdated leaflet.

Version 11 was open for public consultation until 31 August 2025, with the revision focused on improving package leaflet readability for patients. Any pharma RA team without visibility into which QRD version their supplier is loaded onto is carrying unnecessary submission risk.

Which documents need translation

Four document types fall inside EU pharma translation scope:

  • the Summary of Product Characteristics (SmPC),
  • the package leaflet (PL or PIL),
  • the labelling, and
  • Annex II of the marketing authorisation.

Each has its own purpose, its own readership, and its own translation rules. Most pharma buyers know the SmPC and PIL split. Labelling and Annex II are the workstreams that get under-resourced.

Document typePrimary readerRegulatory functionKey translation requirement
SmPC (Annex I)Healthcare professionalsPrescribing information; Article 11 of Directive 2001/83/ECMedDRA terms in section 4.8; EMA Standard Terms in section 3
Package leaflet (Annex IIIB)PatientsPatient information; Article 59 of the DirectivePlain language; readability tested; EMA readability guideline
Outer carton labellingPatients, dispensersArticle 54 of the DirectiveSpace-constrained; EMA Standard Terms; multilingual layout
Immediate packaging labellingPatients, dispensersArticle 55 of the DirectiveMinimum particulars; abbreviation rules; small-container exemption
Blister foil textPatients, dispensersArticle 55(2) of the DirectiveSevere space constraint; standard particulars only
Annex II: conditions of MARegulators, MAHConditions of supply, classification, local representativesLocal representatives section updated in QRD v10.4 (UK NI removed)
Labelling for multilingual cartonPatients across marketsSingle carton for multiple marketsConsistent translation across all panel languages; artwork-aware
National blue box contentNational competent authorityCountry-specific information added to labelMember-state-specific text; national CA preferences
“UK Only” label (UK only)UK regulators and supply chainWindsor Framework; effective 1 January 2025Minimum 7-point font per EU Regulation 2023/1182 Article 5

 

SmPC: for healthcare professionals

The SmPC is the expert-to-expert document, used by prescribers and pharmacists, with content requirements defined in Article 11 of the Directive. Two sections drive most of the terminology work. Section 4.8 covers adverse reactions and has to use MedDRA Preferred Terms in each language. 

Section 3 covers the pharmaceutical form, route of administration, and container type, and has to use the EMA Standard Terms maintained by the EDQM. Linguists working on the SmPC need both glossaries loaded into the workflow before the first sentence is translated, which makes a terminology management setup that carries MedDRA and the EMA Standard Terms together as the operational foundation for SmPC work.

Package leaflet: for patients

The package leaflet is the patient-facing counterpart to the SmPC, with its content defined by Article 59 of the Directive and its readability governed by the EMA readability guideline. Centrally authorised products go further: the leaflet text has to pass user testing before authorisation.

The most common reason a leaflet fails is the linguist writing it in the same medical register as the SmPC, which preserves clinical accuracy but loses the patient. The 2024 joint position paper from Medicines for Europe, EFPIA, and AESGP on patient information is the current industry reference on this and is worth reading in full for any RA team building a readability programme.

Labelling: outer carton, immediate packaging, blister foil

Labelling sits under Article 54 of the Directive, with immediate-packaging rules carved out in Article 55. The operational constraint is space, particularly on blister foils and small immediate containers where standard particulars compete with regulator-required warnings for the same square centimetre.

Multilingual cartons are common across pharma, and the layout work that follows translation has to be artwork-aware from the first round rather than reconciled at the end. The EMA Standard Terms apply here as they do on the SmPC, and each member state maintains its own national blue box section for country-specific information that the LSP handles separately per market.

Pharma labelling and medical device labelling are different regimes

The pharma label sits under Directive 2001/83/EC and the EMA QRD template. The medical device label sits under Regulation (EU) 2017/745 (the MDR) and Annex I Section 23. The two regimes share nothing but the word “label.” A pharma RA team that lifts a medical device translation supplier across to a pharma submission, or vice versa, will get review comments. For the medical device side, see our article on MDR translation requirements.

Annex II: supply conditions and local representatives

Annex II is the EMA-specific section of the marketing authorisation. It covers the conditions of supply (prescription-only, restricted, or otherwise), the classification, and the list of local representatives by member state. The v10.4 update deleted “United Kingdom (Northern Ireland)” from the local representatives list, aligning with the Windsor Framework. For back-catalogue products, Annex II is often where the cleanup work happens during a variation cycle. The translation of Annex II changes follows the same QRD versioning as the leaflet and labelling.

How procedure type changes the language scope and workflow

Four EU procedure types apply to medicinal products:

  • the centralised procedure (EMA-led),
  • mutual recognition (MRP),
  • decentralised (DCP), and
  • the national procedure.

Each carries a different language scope and uses a different template. The LSP needs to know which procedure a submission is using before scoping translation work, because that determines both the language matrix and (for MRP and DCP) which template version is the reference.

ProcedureRegulatorLanguage scopeTemplate
CentralisedEMA + ECAll 24 EU official languages plus Norwegian and Icelandic (26 versions)EMA QRD template (v10.4)
Mutual recognition (MRP)Reference + concerned MSReference member state language plus each concerned member state languageCMDh annotated QRD for MRP/DCP
Decentralised (DCP)Reference + concerned MSReference member state language plus each concerned member state languageCMDh annotated QRD for MRP/DCP
NationalSingle NCAOfficial language(s) of the single member stateNational variant of the QRD template
Variation (any procedure)Follows parent procedureSame language scope as the parent procedureSame template as the parent procedure

 

Centralised procedure: 26 language versions

The centralised procedure is the most demanding in language scope, requiring all 24 EU official languages plus Norwegian and Icelandic. That works out to 26 language versions of the SmPC, PIL, and labelling per product, all required before the European Commission grants the marketing authorisation. The 25-day linguistic review covered in the next section is specific to this procedure, and any language service provider operating at full 26-language footprint is running at scale on every centralised submission they touch.

Mutual recognition and decentralised: CMDh templates

MRP and DCP are run by the Co-ordination Group for Mutual Recognition and Decentralised Procedures (CMDh), with a smaller language scope than the centralised procedure: the reference member state language plus the official language of each concerned member state. The CMDh maintains its own annotated QRD template for these procedures, last updated in March 2024 with a correction in September 2025, distinct from the EMA centralised template. The distinction matters operationally. An LSP that submits an MRP file using the centralised template will produce comments from the reference member state assessor, so the version-control discipline that applies in centralised work applies here just as strictly.

National procedures: single member state

National procedures cover one member state at a time, with the language scope following that country, and are often used for generics or for products with limited geographic distribution. The language complexity is lower than in the multi-state procedures, but each national agency carries its own local style and terminology preferences. Lægemiddelstyrelsen, BfArM, the MEB, the MPA, and ANSM each have their own review traditions, and an LSP running national-procedure work without local awareness will accumulate comments that a more attuned supplier avoids.

The EMA 25-day linguistic review timeline

The EMA linguistic review for centrally authorised products is a 25-day procedure that begins at the CHMP positive opinion.

The pressure points sit at Day 5 (the MAH submits annotated translations to national competent authorities via Eudralink) and Day 19 (the NCAs return reviewed files). Final translations are submitted on Day 25. The schedule is fixed. A language service provider that has not been working ahead of the opinion cannot recover the timeline.

DayWhat happensWho is responsibleTranslation workflow position
Day −180 to Day 0Rolling translation against draft SmPC and PIL versionsMAH + LSPGlossary build, draft translations of all language versions, in-country reviewer set-up
Day 0CHMP issues positive opinion; annotated English product information is lockedCHMPFinal-version translation kick-off across all 26 language versions
Day 5MAH submits annotated translations of SmPC, PIL, and labelling to national competent authoritiesMAH (via Eudralink)All 26 language versions complete, reviewed, formatted, and submitted
Days 5 to 19National competent authorities review the translated documents (14 calendar days)NCAs in each member stateLSP on standby for query response and revision turnaround
Day 19NCAs return reviewed files to the MAH with commentsNCAsComment-resolution and final revision cycle begins
Days 19 to 25MAH and LSP address comments; final translations finalisedMAH + LSPRevision, retranslation where needed, in-country reviewer sign-off
Day 25Final translations submitted to the EMAMAH (via Eudralink)Submission complete; marketing authorisation can be granted

 

What an MAH does between Day 0 and Day 25

The work does not start at Day 0. Sensible MAHs have the LSP running drafts against the rolling submission text from roughly Day −180 onwards. By Day 0, the SmPC and PIL are in their final reference form, the glossary is locked, and the 26 language versions are close to ready for final review. At AdHoc Translations, our SmartDesk carries the per-project audit trail that NCA reviewers and EMA inspectors expect to see during and after the linguistic review. Project visibility for the MAH’s internal regulatory team sits in the same tool.

Common review comments and how to avoid them

Four review comments recur:

  • SmPC inconsistency with the PIL: adverse reaction terminology or frequency descriptions differ between section 4.8 of the SmPC and section 4 of the PIL.
  • Non-adapted medical language: PIL written in clinical register that a patient cannot parse.
  • Structural deviations: mandatory QRD sections missing, headings reordered, warning boxes not reproduced.
  • INN handling: International Nonproprietary Names not rendered correctly per the per-language INN list. Each of these is a workflow issue rather than a translator skill issue. Building the checks into the workflow up front, before Day 0, is straightforward. Catching them in the Day 19 to Day 25 window is hard.

The UK and the Windsor Framework

UK pharma operates under the MHRA, not the EMA. The Windsor Framework restructured how the UK handles labelling and packaging for medicines, replacing the dual-EU/UK approach with a single UK-wide marketing authorisation, a single UK-wide pack, and a “UK Only” labelling requirement. The translation implication is that the UK is a separate workstream from the EU centralised procedure, with its own template handling and its own variation lifecycle.

What “UK Only” means in practice

Since 1 January 2025, all medicinal products on the UK market must carry a “UK Only” label on the outer packaging. The text must be at least 7-point font under Article 5 of EU Regulation 2023/1182, conspicuous, and clearly legible. There is no prescribed location.

The MHRA permitted stickering as a transitional measure until 30 June 2025, after which direct printing onto packaging is required. The EU Falsified Medicines Directive is disapplied for UK packs. For multinational MAHs, the 2025 work was a stickering programme; from mid-2025 onwards, new launches go straight to direct print. The QRD template v10.4 reflects this by removing “United Kingdom (Northern Ireland)” from the list of local representatives in the package leaflet.

Why a UK programme is its own translation workstream

The UK leaflet is in English only, which makes the language scope small compared with a 26-language centralised submission. But the variation lifecycle is separate. Each EU variation that affects the leaflet or labelling needs the parallel UK variation, and MHRA timelines do not synchronise with EMA timelines. LSPs that treat the UK as “the English version we already have” miss UK-specific safety updates and Annex II changes.

UK pharma is not EU pharma plus “UK Only”

It is a separate marketing authorisation, run by the MHRA, on a separate variation track, with its own template handling. Plan the UK programme as a parallel workstream from the start of the marketing authorisation programme.

Pharma translation vendor evaluation checklist

A pharma-ready translation supplier holds ISO 17100 and ISO 18587 certifications, has demonstrable Eudralink and EMA linguistic review experience, runs QRD-template-fluent terminology workflows with version tracking, supports in-country reviewers in final layout for carton artwork and PIL pagination, and produces a per-project audit trail. The checklist below lifts directly into a supplier RFP.

CriterionWhy it matters for pharma packaging and PIL workWhat to ask in the RFP
ISO 17100Process foundation for human translationPlease attach your current ISO 17100 certificate and certification body.
ISO 18587Required when MTPE is usedDo you hold ISO 18587 for any post-edited MT workflows? Please attach the certificate.
ISO 27001Information security for regulated contentPlease confirm ISO 27001 certification and attach evidence.
QRD template fluency with version trackingv10.4 is the current centralised template; v11 in consultation; CMDh has its own for MRP/DCPDescribe how you track QRD template versions and confirm which version is loaded into your current workflows.
EMA Standard Terms expertiseSmPC section 3 (pharmaceutical form, route, container) demands consistencyHow do your linguists access and apply the EMA Standard Terms maintained by the EDQM?
INN handlingINN per language must follow the WHO INN list, not free translationDescribe your INN reference process for active substances.
MedDRA terminologyAdverse reactions in section 4.8 of the SmPC and section 4 of the PILHow do you handle MedDRA Preferred Terms across all 26 EMA languages?
Eudralink submission experienceDay 5 submission tool for the MAHProvide three examples of centralised procedure submissions where your translations were delivered into the Day 5 Eudralink workflow.
NCA review track recordDay 5 to Day 19 review by national authoritiesProvide named examples of national competent authorities you have worked with and the volume of comments per submission.
Readability and user testingRequired for centrally authorised productsDescribe your readability methodology and any user testing or bridging study support you provide.
Variation lifecycle and TM reuseVariations recur; TM keeps cost and turnaround downHow do you maintain TM across variations for the same product, and what TM reuse do typical variations achieve?
In-layout artwork reviewCarton artwork and PIL pagination require final-layout reviewCan in-country reviewers edit translated content in final layout via your platform, without an InDesign licence?
Per-project audit trailEvidence for EMA, NCA, and MHRA reviewWhat per-project audit records do you produce, and for how long do you retain them?

 

At AdHoc Translations, we hold current ISO 17100 and ISO 18587 certifications, with the certificates hosted on our site for direct verification. Our SmartDesk carries the per-project audit trail that EMA linguistic review and MHRA inspections expect. Our SmartEdit lets in-country reviewers edit translated leaflets and cartons in the final layout without an InDesign licence, which removes the licensing friction that slows the Day 5 deadline. For the deeper read on the QA stack, see medical translation quality assurance.

Frequently asked questions

What is a package leaflet under EU law?

A package leaflet is the printed information document that accompanies every medicinal product authorised in the EU. It is the patient-facing companion to the Summary of Product Characteristics, governed by Articles 54 to 69 of Directive 2001/83/EC, and must appear in the official language or languages of every member state where the product is placed on the market.

How many EU languages are required for a centralised procedure submission?

Centralised procedure submissions require translation into all 24 EU official languages plus Norwegian and Icelandic, giving 26 language versions per product. Mutual recognition, decentralised, and national procedures need only the languages of the member states involved in the submission, which can be as few as one or two.

How long does the EMA linguistic review take?

Twenty-five calendar days. The clock starts on Day 0, the date of the CHMP positive opinion. The marketing authorisation holder submits annotated translations to national competent authorities via Eudralink by Day 5. The authorities return reviewed files by Day 19. Final translations are submitted to the EMA by Day 25.

Do I need a separate UK package leaflet after the Windsor Framework?

Yes. The UK operates under MHRA, not EMA. Since 1 January 2025, UK packs require a “UK Only” label, and the EU Falsified Medicines Directive does not apply. The QRD template v10.4 specifically deleted UK (Northern Ireland) from the local representatives section. The UK leaflet is its own variation workstream, on a separate MHRA timeline.

Speak with our localisation team

If your current translation supplier cannot answer the checklist questions with documented evidence, a structured supplier review is the next step. Speak with our localisation team about how we handle package leaflet, SmPC, and labelling translation for pharma manufacturers across the EU and the UK.

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