Document ID: FDA-2022-P-2842-0004
Agency: fda
Document Type: Notice
Title: Determination That Dihydroergotamine Mesylate 45 Injection USP, 1 Milligram/ Milliliter, Was Not Withdrawn From Sale for Reasons of Safety or Effectiveness
Posted Date: 2023-02-17T05:00Z

[Federal Register Volume 88, Number 33 (Friday, February 17, 2023)]
[Notices]
[Page 10344]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2023-03381]

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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Food and Drug Administration

[Docket No. FDA-2022-P-2842]

Determination That Dihydroergotamine Mesylate 45 Injection USP, 1 
Milligram/Milliliter, Was Not Withdrawn From Sale for Reasons of Safety 
or Effectiveness

AGENCY: Food and Drug Administration, HHS.

ACTION: Notice.

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SUMMARY: The Food and Drug Administration (FDA or Agency) has 
determined that D.H.E. 45 (dihydroergotamine mesylate) injection USP, 1 
milligram (mg)/milliliter (mL), was not withdrawn from sale for reasons 
of safety or effectiveness. This determination means that FDA will not 
begin procedures to withdraw approval of abbreviated new drug 
applications (ANDAs) that refer to this drug product, and it will allow 
FDA to continue to approve ANDAs that refer to the product as long as 
they meet relevant legal and regulatory requirements.

FOR FURTHER INFORMATION CONTACT: Donna Tran, Center for Drug Evaluation 
and Research, Food and Drug Administration, 10903 New Hampshire Ave., 
Bldg. 51, Rm. 6213, Silver Spring, MD 20993-0002, 301-796-3600, 
[email protected].

SUPPLEMENTARY INFORMATION: Section 505(j) of the Federal Food, Drug, 
and Cosmetic Act (FD&C Act) (21 U.S.C. 355(j)) allows the submission of 
an ANDA to market a generic version of a previously approved drug 
product. To obtain approval, the ANDA applicant must show, among other 
things, that the generic drug product: (1) has the same active 
ingredient(s), dosage form, route of administration, strength, 
conditions of use, and (with certain exceptions) labeling as the listed 
drug, which is a version of the drug that was previously approved, and 
(2) is bioequivalent to the listed drug. ANDA applicants do not have to 
repeat the extensive clinical testing otherwise necessary to gain 
approval of a new drug application (NDA).
    Section 505(j)(7) of the FD&C Act requires FDA to publish a list of 
all approved drugs. FDA publishes this list as part of the ``Approved 
Drug Products With Therapeutic Equivalence Evaluations,'' which is 
known generally as the ``Orange Book.'' Under FDA regulations, drugs 
are removed from the list if the Agency withdraws or suspends approval 
of the drug's NDA or ANDA for reasons of safety or effectiveness or if 
FDA determines that the listed drug was withdrawn from sale for reasons 
of safety or effectiveness (21 CFR 314.162).
    A person may petition the Agency to determine, or the Agency may 
determine on its own initiative, whether a listed drug was withdrawn 
from sale for reasons of safety or effectiveness. This determination 
may be made at any time after the drug has been withdrawn from sale, 
but must be made prior to approving an ANDA that refers to the listed 
drug (Sec.  314.161 (21 CFR 314.161)). FDA may not approve an ANDA that 
does not refer to a listed drug.
    D.H.E. 45 (dihydroergotamine mesylate) injection USP, 1 mg/mL, is 
the subject of NDA 005929, held by Bausch Health US, LLC, and initially 
approved on April 12, 1946. D.H.E. 45 (dihydroergotamine mesylate) is 
indicated for the acute treatment of migraine headaches with or without 
aura and the acute treatment of cluster headache episodes.
    In a letter dated June 13, 2022, Bausch Health US, LLC notified FDA 
that D.H.E. 45 (dihydroergotamine mesylate) injection USP, 1 mg/mL, was 
being discontinued, and FDA moved the drug product to the 
``Discontinued Drug Product List'' section of the Orange Book.
    Baxter Healthcare Corporation submitted a citizen petition dated 
November 11, 2022 (Docket No. FDA-2022-P-2842), under 21 CFR 10.30, 
requesting that the Agency determine whether D.H.E. 45 
(dihydroergotamine mesylate) injection USP, 1 mg/mL, was withdrawn from 
sale for reasons of safety or effectiveness.
    After considering the citizen petition and reviewing Agency records 
and based on the information we have at this time, FDA has determined 
under Sec.  314.161 that D.H.E. 45 (dihydroergotamine mesylate) 
injection USP, 1 mg/mL, was not withdrawn for reasons of safety or 
effectiveness. The petitioner has identified no data or other 
information suggesting that D.H.E. 45 (dihydroergotamine mesylate) 
injection USP, 1 mg/mL, was withdrawn for reasons of safety or 
effectiveness. We have carefully reviewed our files for records 
concerning the withdrawal of D.H.E. 45 (dihydroergotamine mesylate) 
injection USP, 1 mg/mL, from sale. We have also independently evaluated 
relevant literature and data for possible postmarketing adverse events. 
We have found no information that would indicate that this drug product 
was withdrawn from sale for reasons of safety or effectiveness.
    Accordingly, the Agency will continue to list D.H.E. 45 
(dihydroergotamine mesylate) injection USP, 1 mg/mL, in the 
``Discontinued Drug Product List'' section of the Orange Book. The 
``Discontinued Drug Product List'' delineates, among other items, drug 
products that have been discontinued from marketing for reasons other 
than safety or effectiveness. FDA will not begin procedures to withdraw 
approval of approved ANDAs that refer to this drug product. Additional 
ANDAs for this drug product may also be approved by the Agency as long 
as they meet all other legal and regulatory requirements for the 
approval of ANDAs. If FDA determines that labeling for this drug 
product should be revised to meet current standards, the Agency will 
advise ANDA applicants to submit such labeling.

    Dated: February 13, 2023.
Lauren K. Roth,
Associate Commissioner for Policy.
[FR Doc. 2023-03381 Filed 2-16-23; 8:45 am]
BILLING CODE 4164-01-P