21 C.F.R. § 310.503   Requirements regarding certain radioactive drugs.


Title 21 - Food and Drugs


Title 21: Food and Drugs
PART 310—NEW DRUGS
Subpart E—Requirements for Specific New Drugs or Devices

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§ 310.503   Requirements regarding certain radioactive drugs.

(a) On January 8, 1963 (28 FR 183), the Commissioner of Food and Drugs exempted investigational radioactive new drugs from part 312 of this chapter provided they were shipped in complete conformity with the regulations issued by the Nuclear Regulatory Commission. This exemption also applied to investigational radioactive biologics.

(b) It is the opinion of the Nuclear Regulatory Commission, and the Food and Drug Administration that this exemption should not apply for certain specific drugs and that these drugs should be appropriately labeled for uses for which safety and effectiveness can be demonstrated by new drug applications or through licensing under the Public Health Service Act (42 U.S.C. 262 et seq.) in the case of biologics. Continued distribution under the investigational exemption when the drugs are intended for established uses will not be permitted.

(c) Based on its experience in regulating investigational radioactive pharmaceuticals, the Nuclear Regulatory Commission has compiled a list of reactor-produced isotopes for which it considers that applicants may reasonably be expected to submit adequate evidence of safety and effectiveness for use as recommended in appropriate labeling. Such use may include, among others, the uses in this tabulation:

 ------------------------------------------------------------------------        Isotope              Chemical form                 Use------------------------------------------------------------------------Chromium 51...........  Chromate...............  Spleen scans. Do...................  ......do...............  Placenta localization. Do...................  ......do...............  Red blood cell labeling                                                  and survival studies. Do...................  Labeled human serum      Gastrointestinal                         albumin.                 protein loss studies. Do...................  ......do...............  Placenta localization. Do...................  Labeled red blood cells   Do.Cobalt 58 or Cobalt 60  Labeled cyanocobalamin.  Intestinal absorption                                                  studies.Gold 198..............  Colloidal..............  Liver scans. Do...................  ......do...............  Intracavitary treatment                                                  of pleural effusions                                                  and/or ascites. Do...................  ......do...............  Interstitial treatment                                                  of cancer.Iodine 131............  Iodide.................  Diagnosis of thyroid                                                  functions. Do...................  ......do...............  Thyroid scans. Do...................  ......do...............  Treatment of                                                  hyperthyroidism and/or                                                  cardiac dysfunction. Do...................  ......do...............  Treatment of thyroid                                                  carcinoma. Do...................  Iodinated human serum    Blood volume                         albumin.                 determinations. Do...................  ......do...............  Cisternography. Do...................  ......do...............  Brain tumor                                                  localization. Do...................  ......do...............  Placenta localization. Do...................  ......do...............  Cardiac scans for                                                  determination of                                                  pericardial effusions. Do...................  Rose Bengal............  Liver function studies. Do...................  ......do...............  Liver scans. Do...................  Iodopyracet, sodium      Kidney function studies                         iodohippurate, sodium    and kidney scans.                         diatrizoate,                         diatrizoate                         methylglucamine,                         sodium diprotrizoate,                         sodium acetrizoate, or                         sodium iothalamate. Do...................  Labeled fats and/or      Fat absorption studies.                         fatty acids. Do...................  Cholografin............  Cardiac scans for                                                  determination of                                                  pericardial effusions. Do...................  Macroaggregated          Lung scans.                         iodinated human serum                         albumin. Do...................  Colloidal                Liver scans.                         microaggregated human                         serum albumin.Iodine 125............  Iodide.................  Diagnosis of thyroid                                                  function. Do...................  Iodinated human serum    Blood volume                         albumin.                 determinations. Do...................  Rose Bengal............  Liver function studies. Do...................  Iodopyracet, sodium      Kidney function                         iodohippurate, sodium    studies.                         diatrizoate,                         diatrizoate methyl-                         glucamine, sodium                         diprotrizoate, sodium                         acetrizoate, or sodium                         iothalamate. Do...................  Labeled fats and/or      Fat absorption studies.                         fatty acids.Iron 59...............  Chloride, citrate and/   Iron turnover studies.                         or sulfate.Krypton 85............  Gas....................  Diagnosis of cardiac                                                  abnormalities.Mercury 197...........  Chlormerodrin..........  Kidney scans. Do...................  ......do...............  Brain scans.Mercury 203 \1\.......  ......do...............  Kidney scans. Do...................  ......do...............  Brain scans.Phosphorus 32.........  Soluble phosphate......  Treatment of                                                  polycythemia vera. Do...................  ......do...............  Treatment of leukemia                                                  and bone metastasis. Do...................  Colloidal chromic        Intracavitary treatment                         phosphate.               of pleural effusions                                                  and/or ascites. Do...................  ......do...............  Interstitial treatment                                                  of cancer.Potassium 42..........  Chloride...............  Potassium space                                                  studies.Selenium 75...........  Labeled methionine.....  Pancreas scans.Strontium 85..........  Nitrate or chloride....  Bone scans on patients                                                  with diagnosed cancer.Technetium 99m........  Pertechnetate..........  Brain scans. Do...................  ......do...............  Thyroid scans. Do...................  Sulfur colloid.........  Liver and spleen scans. Do...................  Pertechnetate..........  Placenta localization. Do...................  ......do...............  Blood pool scans. Do...................  ......do...............  Salivary gland scans. Do...................  Diethylenetri-amine      Kidney scans.                         pentaacetic acid                         (DTPA).Xenon 133.............  Gas....................  Diagnosis of cardia                                                  abnormalities.                                                  Cerebral bloodflow                                                  studies. Pulmonary                                                  function studies.                                                  Muscle bloodflow                                                  studies.------------------------------------------------------------------------\1\ This item has been removed from the AEC list for kidney scans but is  included as the requirements of this order are applicable.

(d)(1) In view of the extent of experience with the isotopes listed in paragraph (c) of this section, the Nuclear Regulatory Commission and the Food and Drug Administration conclude that such isotopes should not be distributed under investigational-use labeling when they are actually intended for use in medical practice.

(2) The exemption referred to in paragraph (a) of this section, as applied to any drug or biologic containing any of the isotopes listed in paragraph (c) of this section, in the “chemical form” and intended for the uses stated, is terminated on March 3, 1972, except as provided in paragraph (d)(3) of this section.

(3) The exemption referred to in paragraph (a) of this section, as applied to any drug or biologic containing any of the isotopes listed in paragraph (c) of this section, in the “chemical form” and intended for the uses stated, for which drug a new drug application or a “Investigational New Drug Application” was submitted prior to March 3, 1972, or for which biologic an application for product license or “Investigational New Drug Application” was submitted prior to March 3, 1972, is terminated on August 20, 1976, unless an approvable notice was issued on or before August 20, 1976, in which case the exemption is terminated either upon the subsequent issuance of a nonapprovable notice for the new drug application or on November 20, 1976, whichever occurs first.

(e) No exemption from section 505 of the act or from part 312 of this chapter is in effect or has been in effect for radioactive drugs prepared from accelerator-produced radioisotopes, naturally occurring isotopes, or nonradioactive substances used in conjunction with isotopes.

(f)(1) Based on its experience in regulating investigational radioactive pharmaceuticals, the Nuclear Regulatory Commission has compiled a list of reactor-produced isotopes for which it considers that applicants may reasonably be expected to submit adequate evidence of safety and effectiveness for use as recommended in appropriate labeling; such use may include, among others, the uses in this tabulation:

 ------------------------------------------------------------------------        Isotope              Chemical form                 Use------------------------------------------------------------------------Fluorine 18...........  Fluoride...............  Bone imaging.Indium-113m...........  Diethylenetriamine       Brain imaging; kidney                         pentaacetic acid         imaging.                         (DTPA). Do...................  Chloride...............  Placenta imaging; blood                                                  pool imaging.Technetium 99m........  Human serum albumin      Lung imaging.                         microspheres. Do...................  Diethylenetriamine       Kidney imaging; kidney                         pentaacetic acid (Sn).   function studies. Do...................  ......do...............  Brain imaging. Do...................  Polyphosphates.........  Bone imaging. Do...................  Technetated aggregated   Lung imaging.                         albumin (human). Do...................  Disodium etidronate....  Bone imaging.------------------------------------------------------------------------

(2) In view of the extent of experience with the isotopes listed in paragraph (f)(1) of this section, the Nuclear Regulatory Commission and the Food and Drug Administration conclude that they should not be distributed under investigational-use labeling when they are actually intended for use in medical practice.

(3) Any manufacturer or distributor interested in continuing to ship in interstate commerce drugs containing the isotopes listed in paragraph (f)(1) of this section for any of the indications listed, shall submit, on or before August 25, 1975 to the Center for Drug Evaluation and Research, Food and Drug Administration, 5600 Fishers Lane, Rockville, MD 20857, a new drug application or a “Investigational New Drug Application” for each such drug for which the manufacturer or distributor does not have an approved new drug application pursuant to section 505(b) of the act. If the drug is a biologic, a “Investigational New Drug Application” or an application for a license under section 351 of the Public Health Service Act shall be submitted to the Center for Biologics Evaluation and Research, Food and Drug Administration, 8800 Rockville Pike, Bethesda, MD 20014, in lieu of any submission to the Center for Drug Evaluation and Research.

(4) The exemption referred to in paragraph (a) of this section, as applied to any drug or biologic containing any of the isotopes listed in paragraph (f)(1) of this section, in the “chemical form” and intended for the uses stated, is terminated on August 26, 1975 except as provided in paragraph (f)(5) of this section.

(5)(i) Except as provided in paragraph (f)(5)(ii) of this section, the exemption referred to in paragraph (a) of this section, as applied to any drug containing any of the isotopes listed in paragraph (f)(1) of this section, in the “chemical form” and intended for the uses stated, for which drug a new drug application or “Investigational New Drug Application” was submitted to the Center for Drug Evaluation and Research on or before August 25, 1975 is terminated on August 20, 1976, unless an approvable notice was issued on or before August 20, 1976, in which case the exemption is terminated either upon the subsequent issuance of a nonapprovable notice for the new drug application or on November 20, 1976, whichever occurs first.

(ii) The exemption referred to in paragraph (a) of this section, as applied to any biologic containing any of the isotopes listed in paragraph (f)(1) of this section in the “chemical form” and intended for the uses stated, for which biologic an application for product license or “Investigational New Drug Application” was submitted to the Center for Biologics Evaluation and Research on or before August 25, 1975 is terminated on October 20, 1976, unless an approvable notice was issued on or before October 20, 1976, in which case the exemption is terminated either upon the subsequent issuance of a nonapprovable notice for the new drug application or on January 20, 1977, whichever occurs first.

(g) The exemption referred to in paragraph (a) of this section, as applied to any drug intended solely for investigational use as part of a research project, which use had been approved on or before July 25, 1975 in accordance with 10 CFR 35.11 (or equivalent regulation of an Agreement State) is terminated on February 20, 1976 if the manufacturer of such drug or the sponsor of the investigation of such drug submits on or before August 25, 1975 to the Food and Drug Administration, Bureau of Drugs, HFD–150, 5600 Fishers Lane, Rockville, MD 20857, the following information:

(1) The research project title;

(2) A brief description of the purpose of the project;

(3) The name of the investigator responsible;

(4) The name and license number of the institution holding the specific license under 10 CFR 35.11 (or equivalent regulation of an Agreement State);

(5) The name and maximum amount per subject of the radionuclide used;

(6) The number of subjects involved; and

(7) The date on which the administration of the radioactive drugs is expected to be completed.

(h) The exemption referred to in paragraph (a) of this section, as applied to any drug not referred to in paragraphs (d), (f), and (g) of this section, is terminated on August 26, 1975.

[39 FR 11680, Mar. 29, 1974, as amended at 40 FR 31307, July 25, 1975; 40 FR 44543, Sept. 29, 1975; 41 FR 35171, Aug. 20, 1976; 41 FR 42947, Sept. 29, 1976; 50 FR 8996, Mar. 6, 1985; 55 FR 11578, Mar. 29, 1990; 64 FR 56449, Oct. 20, 1999]

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