Document ID: FDA-2017-D-5961-0022
Agency: fda
Document Type: Notice
Title: Clinical Drug Interaction Studies - Cytochrome P450 Enzyme- and Transporter-Mediated Drug Interactions and In Vitro Drug Interaction Studies -Cytochrome P450 Enzyme- and Transporter-Mediated Drug Interactions; Guidance for Industry; Availability
Posted Date: 2020-01-23T05:00Z

[Federal Register Volume 85, Number 15 (Thursday, January 23, 2020)]
[Notices]
[Pages 3932-3933]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2020-01064]

[[Page 3932]]

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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Food and Drug Administration

[Docket No. FDA-2017-D-5961]

Clinical Drug Interaction Studies--Cytochrome P450 Enzyme- and 
Transporter-Mediated Drug Interactions and In Vitro Drug Interaction 
Studies--Cytochrome P450 Enzyme- and Transporter-Mediated Drug 
Interactions; Guidance for Industry; Availability

AGENCY: Food and Drug Administration, HHS.

ACTION: Notice of availability.

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SUMMARY: The Food and Drug Administration (FDA or Agency) is announcing 
the availability of two final guidances for industry entitled 
``Clinical Drug Interaction Studies--Cytochrome P450 Enzyme- and 
Transporter-Mediated Drug Interactions'' and ``In Vitro Drug 
Interaction Studies--Cytochrome P450 Enzyme- and Transporter-Mediated 
Drug Interactions.'' These guidances finalize the draft guidances 
entitled ``Clinical Drug Interaction Studies--Study Design, Data 
Analysis, and Clinical Implications'' and ``In Vitro Metabolism- and 
Transporter-Mediated Drug-Drug Interaction Studies'' published in 
October 2017. The final guidances are intended to assist drug 
developers in the planning and evaluation of drug-drug interaction 
(DDI) potential during drug development and describe a systematic, 
risk-based approach to the assessment of DDIs.

DATES: The announcement of the guidance is published in the Federal 
Register on January 23, 2020.

ADDRESSES: You may submit either electronic or written comments on 
Agency guidances at any time as follows:

Electronic Submissions

    Submit electronic comments in the following way:
     Federal eRulemaking Portal: https://www.regulations.gov. 
Follow the instructions for submitting comments. Comments submitted 
electronically, including attachments, to https://www.regulations.gov 
will be posted to the docket unchanged. Because your comment will be 
made public, you are solely responsible for ensuring that your comment 
does not include any confidential information that you or a third party 
may not wish to be posted, such as medical information, your or anyone 
else's Social Security number, or confidential business information, 
such as a manufacturing process. Please note that if you include your 
name, contact information, or other information that identifies you in 
the body of your comments, that information will be posted on https://www.regulations.gov.
     If you want to submit a comment with confidential 
information that you do not wish to be made available to the public, 
submit the comment as a written/paper submission and in the manner 
detailed (see ``Written/Paper Submissions'' and ``Instructions'').

Written/Paper Submissions

    Submit written/paper submissions as follows:
     Mail/Hand Delivery/Courier (for written/paper 
submissions): Dockets Management Staff (HFA-305), Food and Drug 
Administration, 5630 Fishers Lane, Rm. 1061, Rockville, MD 20852.
     For written/paper comments submitted to the Dockets 
Management Staff, FDA will post your comment, as well as any 
attachments, except for information submitted, marked and identified, 
as confidential, if submitted as detailed in ``Instructions.''
    Instructions: All submissions received must include the Docket No. 
FDA-2017-D-5961 for ``Clinical Drug Interaction Studies--Cytochrome 
P450 Enzyme- and Transporter-Mediated Drug Interactions'' and ``In 
Vitro Drug Interaction Studies--Cytochrome P450 Enzyme- and 
Transporter-Mediated Drug Interactions.'' Received comments will be 
placed in the docket and, except for those submitted as ``Confidential 
Submissions,'' publicly viewable at https://www.regulations.gov or at 
the Dockets Management Staff between 9 a.m. and 4 p.m., Monday through 
Friday.
     Confidential Submissions--To submit a comment with 
confidential information that you do not wish to be made publicly 
available, submit your comments only as a written/paper submission. You 
should submit two copies total. One copy will include the information 
you claim to be confidential with a heading or cover note that states 
``THIS DOCUMENT CONTAINS CONFIDENTIAL INFORMATION.'' The Agency will 
review this copy, including the claimed confidential information, in 
its consideration of comments. The second copy, which will have the 
claimed confidential information redacted/blacked out, will be 
available for public viewing and posted on https://www.regulations.gov. 
Submit both copies to the Dockets Management Staff. If you do not wish 
your name and contact information to be made publicly available, you 
can provide this information on the cover sheet and not in the body of 
your comments and you must identify this information as 
``confidential.'' Any information marked as ``confidential'' will not 
be disclosed except in accordance with 21 CFR 10.20 and other 
applicable disclosure law. For more information about FDA's posting of 
comments to public dockets, see 80 FR 56469, September 18, 2015, or 
access the information at: https://www.gpo.gov/fdsys/pkg/FR-2015-09-18/pdf/2015-23389.pdf.
    Docket: For access to the docket to read background documents or 
the electronic and written/paper comments received, go to https://www.regulations.gov and insert the docket number, found in brackets in 
the heading of this document, into the ``Search'' box and follow the 
prompts and/or go to the Dockets Management Staff, 5630 Fishers Lane, 
Rm. 1061, Rockville, MD 20852.
    You may submit comments on any guidance at any time (see 21 CFR 
10.115(g)(5)).
    Submit written requests for single copies of this guidance to the 
Division of Drug Information, Center for Drug Evaluation and Research, 
Food and Drug Administration, 10001 New Hampshire Ave., Hillandale 
Building, 4th Floor, Silver Spring, MD 20993-0002. Send one self-
addressed adhesive label to assist that office in processing your 
requests. See the SUPPLEMENTARY INFORMATION section for electronic 
access to the guidance document.

FOR FURTHER INFORMATION CONTACT: Lauren Milligan, Center for Drug 
Evaluation and Research, Food and Drug Administration, 10903 New 
Hampshire Ave., Bldg. 51, Rm. 3159, Silver Spring, MD 20903-0002, 301-
796-5008, or OCP@fda.hhs.gov.

SUPPLEMENTARY INFORMATION:

I. Background

    FDA is announcing the availability of two final guidances for 
industry entitled ``Clinical Drug Interaction Studies--Cytochrome P450 
Enzyme- and Transporter-Mediated Drug Interactions'' and ``In Vitro 
Drug Interaction Studies--Cytochrome P450 Enzyme- and Transporter-
Mediated Drug Interactions.'' The concomitant use of more than one 
medication in a patient is common. Unanticipated, unrecognized, or 
mismanaged DDIs are an important cause of morbidity and mortality 
associated with prescription drug use and have occasionally been the 
basis for withdrawal of approved drugs from the market. In some 
instances, understanding how to safely manage a DDI can allow approval 
of a drug that

[[Page 3933]]

would otherwise have an unacceptable level of risk.
    Clinically relevant DDIs between an investigational drug and other 
drugs should therefore: (1) Be defined during drug development as part 
of an adequate assessment of the drug's overall benefit/risk profile; 
(2) be known at the time of the drug's approval; and (3) be 
communicated in labeling. These two final guidances are intended to 
assist drug developers in the planning and evaluation of DDI potential 
during drug development. The in vitro DDI guidance focuses on in vitro 
experimental approaches for evaluating metabolizing enzyme- and 
transporter-based drug interaction potential and how to extrapolate in 
vitro data to decide on the need for clinical DDI studies. The clinical 
DDI guidance focuses on clinical studies that evaluate DDIs that alter 
a drug's pharmacokinetics by modulating the effects of drug 
metabolizing enzymes and/or transporters and advises sponsors on the 
timing and design of the clinical studies, interpretation of the 
results, and options for DDI management in patients.
    Revisions to the draft guidances include clarification on the scope 
of the guidances, additional considerations for prospective drug 
interaction studies, and when DDI studies are needed for drugs 
identified as transporter substrates from in vitro studies. Together, 
the two final guidances describe a systematic, risk-based approach to 
evaluation and communication of DDIs.
    These guidances are being issued consistent with FDA's good 
guidance practices regulation (21 CFR 10.115). The guidances represent 
the current thinking of FDA on the topics they address. They do not 
establish any rights for any person and are not binding on FDA or the 
public. You can use an alternative approach if it satisfies the 
requirements of the applicable statutes and regulations.

II. Paperwork Reduction Act of 1995

    These guidances refer to previously approved collections of 
information found in FDA regulations. These collections of information 
are subject to review by the Office of Management and Budget (OMB) 
under the Paperwork Reduction Act of 1995 (44 U.S.C. 3501-3521). The 
collections of information in 21 CFR 314.50(d) have been approved under 
OMB control number 0910-0001.

III. Electronic Access

    Persons with access to the internet may obtain the guidance at 
either https://www.fda.gov/drugs/guidance-compliance-regulatory-information/guidances-drugs or https://www.regulations.gov.

    Dated: January 16, 2020.
Lowell J. Schiller,
Principal Associate Commissioner for Policy.
[FR Doc. 2020-01064 Filed 1-22-20; 8:45 am]
BILLING CODE 4164-01-P