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Fixed-Combinations and Single-Entity Versions of Previously Approved Antiretrovirals for the Treatment or Prevention of Human Immunodeficiency Virus-One Under the President’s Emergency Plan for Acquired Immunodeficiency Syndrome Relief

DraftCenter for Drug Evaluation and Research08/01/2023

Description

The Food and Drug Administration (FDA or Agency) is announcing the availability of a draft guidance for industry entitled “Fixed-Combinations and Single-Entity Versions of Previously Approved Antiretrovirals for the Treatment or Prevention of HIV-1 Under PEPFAR.” This draft guidance provides recommendations for applications for single-entity antiretroviral (ARV) and ARV fixed-combination (FC) drug products for the treatment or prevention of human immunodeficiency virus-one (HIV-1) infection that are intended for procurement under the President’s Emergency Plan for AIDS Relief (PEPFAR). Specifically, this draft guidance addresses versions of ARV drug products for which the individual ARV drug product components are already FDA-approved and for which substantial evidence of safety and efficacy of the specific drug product or combination drug product already exists. When finalized, this draft guidance will replace the previous final guidance for industry entitled “Fixed Dose Combinations, Co-Packaged Drug Products, and Single-Entity Versions of Previously Approved Antiretrovirals for the Treatment of HIV” issued in October 2006.

Scope & Applicability

Product Classes

7
Antiretroviral Drug Products

ARV drug products for HIV treatment or prevention

ARV drug product

Antiretroviral drug products for HIV treatment; eligible for procurement under PEPFAR

Fixed-Combination

Drug product containing two or more active ingredients; Drug products containing multiple active ingredients

Fixed-combination antiretroviral drug product

two or more antiretroviral drugs combined in a single dosage form

Single-entity antiretroviral

SE versions of previously approved antiretrovirals

SE ARV

Single-entity antiretroviral drug products needed under PEPFAR

FC ARV

Fixed-combination antiretroviral drug products needed under PEPFAR

Stakeholders

3
Drug Substance Manufacturer

Addition of a new manufacturing site

DMF Holder

Entity that owns and maintains a Drug Master File

Applicant

Entity submitting development data and knowledge; Entity performing the work process for change

Regulatory Context

Attributes

7
Expiration Dating Period

CMC changes after tentative approval; shelf-life period supported by stability data; proposing to extend the expiration dating period for the drug product

climatic zones III and IV

hot and dry or hot and humid conditions

Weight Band

Categorization for pediatric dosing recommendations

Minor Change

Changes with minimal potential to adversely affect drug identity, strength, quality, purity, or potency.

Moderate Change

Change with moderate potential to affect product quality

Major Change

Change with high potential to affect product quality

Safe and Effective

Statutory standard for drug approval and retention

Identified Hazards

Hazards

1
Genotoxic Substructure

Structural alert suggesting potential DNA damage

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See Also (8)

Fixed-Combinations and Single-Entity Versions of Previously Approved Antiretrovirals for the Treatment or Prevention of Human Immunodeficiency Virus-One Under the President’s Emergency Plan for Acquired Immunodeficiency Syndrome Relief | Guideline Explorer | BioRegHub