This application contains the following items: (Check
all that apply) |
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E |
1. Index |
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E |
2.
Labeling (check one) |
( X) Draft Labeling |
( ) Final Printed Labeling |
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3. Summary
(21 CFR 314.50 (c)) |
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E |
4.
Chemistry section |
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E |
A. Chemistry, manufacturing, and controls information
(e.g. 21 CFR 314.50(d)(1): 21 CFR 601.2) |
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B. Samples (21 CFR 314.50 (e)(1); 21 CFR
601.2 (a)) (Submit only upon FDA’s request) |
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C. Methods validation package (e.g., 21 CFR
314.50(e)(2)9i); 21 CFR 601.2) |
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5.
Nonclinical pharmacology and toxicology section (e.g., 21 CFR
314.50(d)(2); 21 CFR 601.2) |
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E |
6. Human
pharmacokinetics and bioavailability section (e.g., CFR 314.50(d)(3); 21 CFR
601.2) |
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7. Clinical
Microbiology (e.g. 21 CFR 314.50(d)(4)) |
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8.
Clinical data section (e.g., 21 CFR 314.50(d)(5); 21 CFR 601.2) |
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E |
9. Safety
update report (e.g., 21 CFR 314.50(d)(5)(vi)(b); 21 CFR 601.2) |
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10. Statistical
section (e.g., 21 CFR 314.50(d)(6); 21 CFR 601.2) |
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11. Case
report tabulations (e.g. 21 CFR 314.50(f)(1); 21 CFR 601.2) |
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12. Case
report forms (e.g., 21 CFR 314.50(f)(2); 21 CFR 601.2) |
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13. Patent
information on any patent which claims the drug (21 U.S.C. 355(b) or (c)) |
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14. A
patent certification with respect to any patent which claims the drug (21
U.S.C. 355 (b)(2) or (j)(2)(A)) |
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15. Establishment
description (21 CFR Part 600, if applicable) |
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16.
Debarment certification (FD&C Act 306 (k)(1)) |
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E |
17. Field
copy certification (21 CFR 314.50 (l)(3)) |
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18. User
Fee Cover Sheet (Form FDA 3397) |
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19.
Financial Information (21 CFR Part 54) |
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E |
20. OTHER
(Specify): Communication
Program for Healthcare Professionals and Patients |
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CERTIFICATION I agree to update this application with new safety
information about the product that may reasonably affect the statement of
contradictions, warnings, precautions, or adverse reactions in the draft
labeling. I agree to submit safety
update reports as provided for by regulation or as requested by FDA. IF this application is approved, I agree
to comply with all applicable laws and regulations that apply to approved
applications, including, but not limited to the following: 1.
Good
manufacturing practice regulations in 21 CFR Parts 210, 211 or applicable
regulations, Parts 606, and/or 820. 2.
Biological
establishment standards in 21 CFR Part 600. 3.
Labeling
regulations in 21 CFR Parts 201, 606, 610, 660, and/or 809. 4.
In
the case of a prescription drug or biological product, prescription drug
advertising regulations in 21 CFR Part 202. 5.
Regulations
on making changes in application in FD&C Act section 506A, 21 CFR 314.71,
314.72, 314.97, 314.99, and 601.12. 6.
Regulations
of Reports in 21 CFR 314.80, 314.81, 600,80, and 600.81. 7.
Local,
state, and Federal environmental impact laws. If this application applies to a drug product that
FDA has proposed for scheduling under the Controlled Substances Act, I agree
not to market the product until the Drug Enforcement Administration makes a
final scheduling decision. The data and information in this submission have
been reviewed and, to the best of my knowledge are certified to be true and
accurate. Warning: A willfully false statement is a criminal
offense, U.S. Code, title 18, section 1001. |
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SIGNATURE OF RESPONSIBLE OFFICIAL
OR AGENT (signature: Mary E.
Martinson) |
TYPED NAME AND TITLE Mary E. Martinson Director Regulatory Affairs, Psychiatry |
DATE: July 3, 2003 |
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ADDRESS (Street, City, State, and ZIP Code) Five Moore Drive Research Triangle Park, NC 27709 |
Telephone Number (919) 483-3763 |
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Public reporting burden for
this collection of information is estimated to average 24 hours per response,
including the time for reviewing instructions, searching existing data
sources, gathering and maintaining the data needed, and completing and
reviewing the collection of information.
Send comments regarding this burden estimate or any other aspect of
this collection of information, including suggestions for reducing this
burden to: |
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Department of Health and
Human Services Food and Drug Administration CBER, HFD-99 [CDER HFD-99] 1401 Rockville Pike Rockville, MD 20852-1448 |
An agency may not conduct
or sponsor, and a person is not required to respond to, a collection of
information unless it displays a currently valid OMB control number. |
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Form FDA 356h (4/00) Page
2
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