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` SUPPLEMENT APPROVAL
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` NDA 208082/S-004
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`Teva Branded Pharmaceutical Products R&D, Inc.
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`Attention: David Truong, PharmD, MS
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`Associate Director, Regulatory Affairs
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`41 Moores Road
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`Frazer, PA 19355
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`Dear Dr. Truong:
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`Please refer to your supplemental new drug application (sNDA) dated and received on
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`May 2, 2019, and your amendments, submitted under section 505(b)(2) of the Federal
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`Food, Drug, and Cosmetic Act (FDCA) for Austedo (deutetrabenazine) 6 mg, 9 mg, and
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`12 mg tablets.
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`We also refer to our letter dated April 3, 2019, notifying you, under Section 505(o)(4) of
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`the FDCA, of new safety information that we believe should be included in the labeling
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`for Austedo. This information pertains to the risk of parkinsonism in patients treated with
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`Austedo for tardive dyskinesia.
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`This supplemental new drug application provides for revisions to the labeling for
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`Austedo, consistent with our April 3, 2019, Safety Labeling Change Notification letter.
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`APPROVAL & LABELING
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`We have completed our review of this application, as amended. It is approved, effective
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`on the date of this letter, for use as recommended in the enclosed agreed-upon
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`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
`FDA.gov.1 Content of labeling must be identical to the enclosed labeling (text for the
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`Prescribing Information and Medication Guide) with the addition of any labeling changes
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`in pending “Changes Being Effected” (CBE) supplements, as well as annual reportable
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`changes not included in the enclosed labeling.
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` 1 http://www.fda.gov/ForIndustry/DataStandards/StructuredProductLabeling/default.htm
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`Reference ID: 4459719
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` NDA 208082/S-004
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`Page 2
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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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`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
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`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
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`promotional labeling. To do so, submit the following, in triplicate, (1) a cover letter
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`requesting advisory comments, (2) the proposed materials in draft or mock-up form with
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`annotated references, and (3) the Prescribing Information to:
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`OPDP Regulatory Project Manager
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`Food and Drug Administration
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`Center for Drug Evaluation and Research
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`Office of Prescription Drug Promotion (OPDP)
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`5901-B Ammendale Road
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`Beltsville, MD 20705-1266
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`Alternatively, you may submit a request for advisory comments electronically in eCTD
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`format. For more information about submitting promotional materials in eCTD format,
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`see the draft guidance for industry Providing Regulatory Submissions in Electronic and
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`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
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`by a Form FDA 2253, at the time of initial dissemination or publication
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` 2 We update guidances periodically. For the most recent version of a guidance, check the FDA Guidance
`Documents Database https://www.fda.gov/RegulatoryInformation/Guidances/default.htm.
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`3 When final, this guidance will represent the FDA’s current thinking on this topic. For the most recent
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`version of a guidance, check the FDA guidance web page at
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`https://www.fda.gov/RegulatoryInformation/Guidances/default.htm.
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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: 4459719
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` NDA 208082/S-004
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`Page 3
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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 For more information
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`about submission of promotional materials to the Office of Prescription Drug Promotion
`(OPDP), see FDA.gov.6
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` All promotional materials that include representations about your drug product must be
` promptly revised to be consistent with the labeling changes approved in this
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` supplement, including any new safety information [21 CFR 314.70(a)(4)]. The revisions
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` in your promotional materials should include prominent disclosure of the important new
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` safety information that appears in the revised labeling. Within 7 days of receipt of this
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` letter, submit your statement of intent to comply with 21 CFR 314.70(a)(4) to the
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` address above, by fax to 301-847-8444, or electronically in eCTD format. For more
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` information about submitting promotional materials in eCTD format, see the draft
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`guidance for industry Providing Regulatory Submissions in Electronic and Non-
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` Electronic Format-Promotional Labeling and Advertising Materials for Human
`Prescription Drugs.
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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 contact Stacy Metz, PharmD, Senior Regulatory
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`Project Manager, at stacy.metz@fda.hhs.gov.
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`Sincerely,
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`{See appended electronic signature
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`page}
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`Alice Hughes, MD
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`Deputy Director for Safety
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`Division of Neurology Products
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`Office of Drug Evaluation I
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`Center for Drug Evaluation and
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`Research
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`ENCLOSURES:
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`• Content of Labeling
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`o Prescribing Information
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`4http://www.fda.gov/downloads/AboutFDA/ReportsManualsForms/Forms/UCM083570.pdf
`5http://www.fda.gov/downloads/AboutFDA/ReportsManualsForms/Forms/UCM375154.pdf
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`6 http://www.fda.gov/AboutFDA/CentersOffices/CDER/ucm090142.htm
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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: 4459719
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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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`CHRISTINE K PHIPPS
`07/09/2019 02:15:49 PM
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`Reference ID: 4459719
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