( .I# I U.S. FOOD & DRUG
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`,.,. .........
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`ADMINISTRATION
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` NDA 209805/S-10
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`NDA 209806/S-08
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`SUPPLEMENT APPROVAL
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` Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc.
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` Attention: Wendy L. Carofano, Pharm D, RPh, PMP
` Director, Global Regulatory Affairs
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` 126 E. Lincoln Avenue, P.O. Box 2000
` Mail Drop: RY34-B188
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` Rahway, NJ 07065
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` Dear Dr. Carofano:
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`Please refer to your supplemental new drug applications (sNDAs) dated and received
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`November 17, 2021, submitted under section 505(b) and pursuant to section 505(b)(2)
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`of the Federal Food, Drug, and Cosmetic Act (FDCA) for Steglujan (ertugliflozin and
`sitagliptin) tablets and Segluromet (ertugliflozin and metformin hydrochloride) tablets,
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`respectively.
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`These “Changes Being Effected” sNDAs provide for revisions to the Medication Guides
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`for Steglujan and Segluromet to remove the following language: “amputations mainly
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`involve removal of the toe.” The Segluromet Medication Guide was also revised to add
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`the following language: “Call your doctor right away if you have new pain or tenderness,
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`any sores, ulcers, or infections in your leg or foot. Your doctor may decide to stop your
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`SEGLUROMET for a while if you have any of these signs or symptoms. Talk to your
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`doctor about proper foot care.”
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`APPROVAL & LABELING
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`We have completed our review of these applications. They are approved, effective on
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`the date of this letter, for use as recommended in the enclosed agreed-upon labeling.
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`WAIVER OF ½ PAGE LENGTH REQUIREMENT FOR HIGHLIGHTS
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` Please note that we have previously granted a waiver of the requirements of 21 CFR
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` 201.57(d)(8) regarding the length of Highlights of Prescribing Information.
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`Reference ID: 4945846
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` NDA 209805/S-10
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`NDA 209806/S-08
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` Page 2
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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 (text for the
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`Prescribing Information and Medication Guide), with the addition of any labeling
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`changes in pending “Changes Being Effected” (CBE) supplements, as well as annual
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`reportable changes not included in the enclosed labeling. If the content of labeling in
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`SPL format initially submitted with this CBE-0 labeling supplement is identical to the
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`attached approved labeling, an additional submission of content of labeling in SPL
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`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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`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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`REQUIRED PEDIATRIC ASSESSMENTS
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`Under the Pediatric Research Equity Act (PREA) (21 U.S.C. 355c), all applications for
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`new active ingredients (which includes new salts and new fixed combinations), new
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`indications, new dosage forms, new dosing regimens, or new routes of administration
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`are required to contain an assessment of the safety and effectiveness of the product for
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`the claimed indication in pediatric patients unless this requirement is waived, deferred,
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`or inapplicable.
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`Because none of these criteria apply to your applications, you are exempt from this
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`requirement.
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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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`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: 4945846
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` NDA 209805/S-10
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`NDA 209806/S-08
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` Page 3
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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. For information about submitting promotional materials, see the
` final guidance for industry Providing Regulatory Submissions in Electronic and Non-
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` 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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`[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, contact Georgia Rogers, Regulatory Project Manager, at
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`Georgia.Rogers@fda.hhs.gov.
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`Sincerely,
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`{See appended electronic signature page}
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`Monika Houstoun, Pharm.D., M.P.H.
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`Deputy Director for Safety (Acting)
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`Division of Diabetes, Lipid Disorders, and Obesity
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`Office of Cardiology, Hematology, Endocrinology, and
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`Nephrology
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`Office of New Drugs
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`Center for Drug Evaluation and Research
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`ENCLOSURES:
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`• Content of Labeling
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`o Steglujan Prescribing Information (version approved September 17, 2021)
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`o Steglujan Medication Guide
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`o Segluromet Prescribing Information (version approved September 17,
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`2021)
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`o Segluromet Medication Guide
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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
`www.fda.gov
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`Reference ID: 4945846
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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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`MONIKA A HOUSTOUN
`03/02/2022 12:42:46 PM
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`Reference ID: 4945846
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