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`,.,. .........
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`ADMINISTRATION
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`NDA 202155/S-034
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`SUPPLEMENT APPROVAL
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` Bristol-Myers Squibb Company
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` Attention: Isha Majmudar
` Global Regulatory Strategist, Global Regulatory Strategy & Policy
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` P.O. Box 5326
` Princeton, NJ 08543-5326
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`Dear Ms. Majmudar:
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`Please refer to your supplemental new drug application (sNDA) dated and received
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`September 29, 2021, submitted under section 505(b) of the Federal Food, Drug, and
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`Cosmetic Act (FDCA) for Eliquis (apixaban) Tablets.
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`This “Changes Being Effected” sNDA provides for revisions to the approved Medication
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`Guide to add information regarding abnormal uterine bleeding to the “What should I tell
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`my doctor before taking Eliquis” section.
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`APPROVAL & LABELING
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`We have completed our review of this application. It is approved, effective on the date of
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`this letter, for use as recommended in the enclosed agreed-upon labeling.
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`CONTENT OF LABELING
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`As soon as possible, but no later than 14 days from the date of this letter, submit the
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`content of labeling [21 CFR 314.50(l)] in structured product labeling (SPL) format using
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`the FDA automated drug registration and listing system (eLIST), as described at
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`FDA.gov.1 Content of labeling must be identical to the enclosed labeling (Prescribing
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`Information and Medication Guide), with the addition of any labeling changes in pending
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`“Changes Being Effected” (CBE) supplements, as well as annual reportable changes
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`not included in the enclosed labeling. If the content of labeling in SPL format initially
`submitted with this CBE-0 labeling supplement is identical to the attached approved
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`labeling, an additional submission of content of labeling in SPL format is not required.
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`Information on submitting SPL files using eList may be found in the guidance for
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`industry SPL Standard for Content of Labeling Technical Qs and As.2
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` 1 http://www.fda.gov/ForIndustry/DataStandards/StructuredProductLabeling/default.htm
`2 We update guidances periodically. For the most recent version of a guidance, check the FDA Guidance
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`Documents Database https://www.fda.gov/RegulatoryInformation/Guidances/default.htm.
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`Reference ID: 4870025
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`NDA 202155/S-034
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` Page 2
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` The SPL will be accessible from publicly available labeling repositories.
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`Also within 14 days, amend all pending supplemental applications that include labeling
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`changes for this NDA, including CBE supplements for which FDA has not yet issued an
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`action letter, with the content of labeling [21 CFR 314.50(l)(1)(i)] in Microsoft Word
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`format, that includes the changes approved in this supplemental application, as well as
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`annual reportable changes. To facilitate review of your submission(s), provide a
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`highlighted or marked-up copy that shows all changes, as well as a clean Microsoft
`Word version. The marked-up copy should provide appropriate annotations, including
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` supplement number(s) and annual report date(s).
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`PROMOTIONAL MATERIALS
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`You may request advisory comments on proposed introductory advertising and
`promotional labeling. For information about submitting promotional materials, see the
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`final guidance for industry Providing Regulatory Submissions in Electronic and Non-
`Electronic Format-Promotional Labeling and Advertising Materials for Human
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`Prescription Drugs.3
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`You must submit final promotional materials and Prescribing Information, accompanied
`by a Form FDA 2253, at the time of initial dissemination or publication
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`[21 CFR 314.81(b)(3)(i)]. Form FDA 2253 is available at FDA.gov.4 Information and
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`Instructions for completing the form can be found at FDA.gov.5
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`REPORTING REQUIREMENTS
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`We remind you that you must comply with reporting requirements for an approved NDA
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`(21 CFR 314.80 and 314.81).
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`If you have any questions, please call Lori Anne Wachter, RN, BSN, RAC, Acting
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`Regulatory Project Manager, at 301 796-3975.
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` 3 For the most recent version of a guidance, check the FDA guidance web page at
` https://www.fda.gov/media/128163/download.
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`4 http://www.fda.gov/downloads/AboutFDA/ReportsManualsForms/Forms/UCM083570.pdf
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`5 http://www.fda.gov/downloads/AboutFDA/ReportsManualsForms/Forms/UCM375154.pdf
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`U.S. Food and Drug Administration
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`Silver Spring, MD 20993
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`www.fda.gov
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`Reference ID: 4870025
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`NDA 202155/S-034
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` Page 3
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`ENCLOSURE(S):
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`• Content of Labeling
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`o Medication Guide
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` Sincerely,
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` {See appended electronic signature page}
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` Rosanna Setse, MD, PhD.
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`Deputy Director for Safety
`Office of Cardiology, Hematology, Endocrinology
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`and Nephrology
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`Center for Drug Evaluation and Research
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` U.S. Food and Drug Administration
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` Silver Spring, MD 20993
` www.fda.gov
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`Reference ID: 4870025
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`Signature Page 1 of 1
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`This is a representation of an electronic record that was signed
`electronically. Following this are manifestations of any and all
`electronic signatures for this electronic record.
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`/s/
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`Lori A WACHTER
`10/12/2021 09:40:26 AM
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`Reference ID: 4870025
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`(
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