81_FR_4321 81 FR 4305 - International Drug Scheduling; Convention on Psychotropic Substances; Single Convention on Narcotic Drugs; World Health Organization; Scheduling Recommendations; Acetylfentanyl; MT-45; para-Methoxymethylamphetamine (PMMA); α-Pyrrolidinovalerophenone (α-PVP); para-Methyl-4-methylaminorex (4,4′-DMAR); Methoxetamine (MXE); Phenazepam; Request for Comments

81 FR 4305 - International Drug Scheduling; Convention on Psychotropic Substances; Single Convention on Narcotic Drugs; World Health Organization; Scheduling Recommendations; Acetylfentanyl; MT-45; para-Methoxymethylamphetamine (PMMA); α-Pyrrolidinovalerophenone (α-PVP); para-Methyl-4-methylaminorex (4,4′-DMAR); Methoxetamine (MXE); Phenazepam; Request for Comments

DEPARTMENT OF HEALTH AND HUMAN SERVICES
Food and Drug Administration

Federal Register Volume 81, Issue 16 (January 26, 2016)

Page Range4305-4310
FR Document2016-01474

The Food and Drug Administration (FDA) is providing interested persons with the opportunity to submit written comments, and to request an informal public meeting concerning recommendations by the World Health Organization (WHO) to impose international manufacturing and distributing restrictions, under international treaties, on certain drug substances. The comments received in response to this notice and/ or public meeting will be considered in preparing the United States' position on these proposals for a meeting of the United Nations Commission on Narcotic Drugs (CND) in Vienna, Austria, in March 2016. This notice is issued under the Controlled Substances Act (the CSA).

Federal Register, Volume 81 Issue 16 (Tuesday, January 26, 2016)
[Federal Register Volume 81, Number 16 (Tuesday, January 26, 2016)]
[Notices]
[Pages 4305-4310]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2016-01474]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Food and Drug Administration

[Docket No. FDA-2016-N-0117]


International Drug Scheduling; Convention on Psychotropic 
Substances; Single Convention on Narcotic Drugs; World Health 
Organization; Scheduling Recommendations; Acetylfentanyl; MT-45; para-
Methoxymethylamphetamine (PMMA); [alpha]-Pyrrolidinovalerophenone 
([alpha]-PVP); para-Methyl-4-methylaminorex (4,4'-DMAR); Methoxetamine 
(MXE); Phenazepam; Request for Comments

AGENCY: Food and Drug Administration, HHS.

ACTION: Notice.

-----------------------------------------------------------------------

SUMMARY: The Food and Drug Administration (FDA) is providing interested 
persons with the opportunity to submit written comments, and to request 
an informal public meeting concerning recommendations by the World 
Health Organization (WHO) to impose international manufacturing and 
distributing restrictions, under international treaties, on certain 
drug substances. The comments received in response to this notice and/
or public meeting will be considered in preparing the United States' 
position on these proposals for a meeting of the United Nations 
Commission on Narcotic Drugs (CND) in Vienna, Austria, in March 2016. 
This notice is issued under the Controlled Substances Act (the CSA).

DATES: Submit either electronic or written comments by February 25, 
2016. Submit requests for a public meeting on or before February 5, 
2016. The short time period for the submission of comments and requests 
for a public meeting is needed to ensure that HHS may, in a timely 
fashion, carry out the required action and be responsive to the United 
Nations. For additional information, see section IV of this document.

ADDRESSES: You may submit comments as follows:

Electronic Submissions

    Submit electronic comments in the following way:
     Federal eRulemaking Portal: http://www.regulations.gov. 
Follow the instructions for submitting comments. Comments submitted 
electronically, including attachments, to http://www.regulations.gov 
will be posted to the docket unchanged. Because your comment will be 
made public, you are solely responsible for ensuring that your comment 
does not include any confidential information that you or a third party 
may not wish to be posted, such as medical information, your or anyone 
else's Social Security number, or confidential business information, 
such as a manufacturing process. Please note that if you include your 
name, contact information, or other information that identifies you in 
the body of your comments, that information will be posted on http://www.regulations.gov.
     If you want to submit a comment with confidential 
information that you do not wish to be made available to the public, 
submit the comment as a written/paper submission and in the manner 
detailed (see ``Written/Paper Submissions'' and ``Instructions'').

Written/Paper Submissions

    Submit written/paper submissions as follows:
     Mail/Hand delivery/Courier (for written/paper 
submissions): Division of Dockets Management (HFA-305), Food and Drug 
Administration, 5630 Fishers Lane, Rm. 1061, Rockville, MD 20852.
     For written/paper comments submitted to the Division of 
Dockets Management, FDA will post your comment, as well as any 
attachments, except for information submitted, marked and identified, 
as confidential, if submitted as detailed in ``Instructions.''
    Instructions: All submissions received must include the Docket No. 
FDA-2015-N-0117 for ``International Drug Scheduling; Convention on 
Psychotropic Substances; Single Convention on Narcotic Drugs; World 
Health Organization; Scheduling Recommendations; Acetylfentanyl; MT-45; 
para-Methoxymethylamphetamine (PMMA); [alpha]-Pyrrolidinovalerophenone 
([alpha]-PVP); para-Methyl-4-methylaminorex (4,4'-DMAR); Methoxetamine 
(MXE); Phenazepam; Request for Comments.'' Received comments will be 
placed in the docket and, except for those submitted as ``Confidential 
Submissions,'' publicly viewable at http://www.regulations.gov or at 
the Division of Dockets Management between 9 a.m. and 4 p.m., Monday 
through Friday.
     Confidential Submissions--To submit a comment with 
confidential information that you do not wish to be made publicly 
available, submit your comments only as a written/paper submission. You 
should submit two copies total. One copy will include the information 
you claim to be confidential with a heading or cover note that states 
``THIS DOCUMENT CONTAINS CONFIDENTIAL INFORMATION.'' The Agency will 
review this copy, including the claimed confidential information, in 
its consideration of comments. The second copy, which will have the 
claimed confidential information redacted/blacked out, will be 
available for public viewing and posted on http://www.regulations.gov. 
Submit both copies to the Division of Dockets Management. If you do not 
wish your name and contact information to be made publicly available, 
you can provide this information on the cover sheet and not in the body 
of your comments and you must identify this information as 
``confidential.'' Any information marked as ``confidential'' will not 
be disclosed except in accordance with 21 CFR 10.20 and other 
applicable disclosure law. For more information about FDA's posting of 
comments to public dockets, see 80 FR 56469, September 18, 2015, or 
access the information at: http://www.fda.gov/regulatoryinformation/dockets/default.htm.
    Docket: For access to the docket to read background documents or 
the electronic and written/paper comments received, go to http://www.regulations.gov and insert the docket number, found in brackets in 
the heading of this document, into the ``Search'' box and follow the 
prompts and/or go to the Division of Dockets Management, 5630 Fishers 
Lane, Rm. 1061, Rockville, MD 20852.

FOR FURTHER INFORMATION CONTACT: James R. Hunter, Center for Drug 
Evaluation and Research, Controlled Substance Staff, Food and Drug 
Administration, 10903 New Hampshire Ave., Bldg. 51, Rm. 5150, Silver 
Spring, MD 20993-0002, 301-796-3156, [email protected].

SUPPLEMENTARY INFORMATION:

I. Background

    The United States is a party to the 1971 Convention on Psychotropic 
Substances (Psychotropic Convention). Section 201(d)(2)(B) of the CSA 
(21 U.S.C. 811(d)(2)(B)) provides that when the United States is 
notified under Article 2 of the Psychotropic Convention that the CND 
proposes to decide whether to add a drug or other

[[Page 4306]]

substance to one of the schedules of the Psychotropic Convention, 
transfer a drug or substance from one schedule to another, or delete it 
from the schedules, the Secretary of State must transmit notice of such 
information to the Secretary of Health and Human Services (Secretary of 
HHS). The Secretary of HHS must then publish a summary of such 
information in the Federal Register and provide opportunity for 
interested persons to submit comments. The Secretary of HHS must then 
evaluate the proposal and furnish a recommendation to the Secretary of 
State that shall be binding on the representative of the United States 
in discussions and negotiations relating to the proposal.
    As detailed in the following paragraphs, the Secretary of State has 
received notification from the Secretary-General of the United Nations 
(the Secretary-General) regarding 5 substances to be considered for 
control under the Psychotropic Convention. This notification reflects 
the recommendation from the 36th WHO Expert Committee for Drug 
Dependence (ECDD), which met in June 2014. In the Federal Register of 
December 30, 2013 (78 FR 79465), FDA announced the WHO ECDD review and 
invited interested persons to submit information for WHO's 
consideration.
    The full text of the notification from the Secretary-General is 
provided in section II of this document. Section 201(d)(2)(B) of the 
CSA requires the Secretary of HHS, after receiving a notification 
proposing scheduling, to publish a notice in the Federal Register to 
provide the opportunity for interested persons to submit information 
and comments on the proposed scheduling action.
    The United States is also a party to the 1961 Single Convention on 
Narcotic Drugs (1961 Single Convention). The Secretary of State has 
received a notification from the Secretary-General regarding 2 
substances to be considered for control under this convention. The CSA 
does not require HHS to publish a summary of such information in the 
Federal Register. Nevertheless, in an effort to provide interested and 
affected persons an opportunity to submit comments regarding the WHO 
recommendations for narcotic drugs, the notification regarding these 
substances is also included in this Federal Register notice. The 
comments will be shared with other relevant Agencies to assist the 
Secretary of State in formulating the position of the United States on 
the control of these substances. The HHS recommendations are not 
binding on the representative of the United States in discussions and 
negotiations relating to the proposal regarding control of substances 
under the 1961 Single Convention.

II. United Nations Notification

    The formal notification from the United Nations that identifies the 
drug substances and explains the basis for the recommendations is 
reproduced as follows:

Reference:
NAR/CL.5/2015
WHO/ECDD37; 1961C-Art.3; 1971C-Art.2
CU 2014/288/DTA/SGB

    The Secretary-General of the United Nations presents his 
compliments to the Secretary of State of the United States of America 
and has the honour to inform the Government that the Director-General 
of the World Health Organization (WHO), pursuant to article 3, 
paragraphs 1 and 3 of the Single Convention on Narcotic Drugs of 1961 
as amended by the 1972 Protocol (1961 Convention) and article 2, 
paragraphs 1 and 4 of the Convention on Psychotropic Substances of 1971 
(1971 Convention) notified the Secretary-General of the following 
recommendations:
    Acetylfentanyl be placed in Schedule I and in Schedule IV of the 
1961 Convention
    and
    MT-45 be placed in Schedule I of the 1961 Convention
    and
    para-Methoxymethylamphetamine (PMMA) be placed in Schedule I of the 
1971 Convention
    and
    [alpha]-Pyrrolidinovalerophenone ([alpha]-PVP); para-Methyl-4-
methylaminorex (4,4'-DMAR) and methoxetamine (MXE) be placed in 
Schedule II of the 1971 Convention
    and
    Phenazepam be placed in Schedule IV of the 1971 Convention.
    In the letter from the Director-General of the World Health 
Organization to the Secretary-General reference is also made to 
Commission on Narcotic Drugs decision 58/2 of 13 March 2015, by which 
the Commission decided to postpone the consideration of the proposal 
concerning the recommendation to place ketamine in Schedule IV of the 
Convention on Psychotropic Substances of 1971 and to request additional 
information from the World Health Organization and other relevant 
sources.

His Excellency
Mr. John Kerry
Secretary of State of the United States of America

    In accordance with the provisions of article 3, paragraph 2 of the 
1961 Convention and article 2, paragraph 2 of the 1971 Convention, the 
Secretary-General hereby transmits the notification as annex I to the 
present note.
    In accordance with the provisions of article 3, paragraph 2 of the 
1961 Convention and article 2, paragraph 2 of the 1971 Convention, the 
notification from WHO will be brought to the attention of the fifty-
ninth session of the Commission on Narcotic Drugs, 14-22 March 2016.
    In connection with the notification, WHO has also submitted the 
relevant extract from the report of the thirty-seventh session of the 
WHO Expert Committee on Drug Dependence which is hereby transmitted as 
annex II.
    In order to assist the Commission in reaching a decision, it would 
be appreciated if the Government could communicate any economic, 
social, legal, administrative or other factors that it considers 
relevant to the possible scheduling of the afore-mentioned substances 
under the 1961 Convention and the 1971 Convention, at the latest by 1 
February 2016 to the Executive Director of the United Nations Office on 
Drugs and Crime, c/o Secretary, Commission on Narcotic Drugs, P.O. Box 
500, 1400 Vienna, Austria, fax: +43-1-26060-5885, email: [email protected].

30 December 2015
NAR/CL.5/2015
Annex I

Annex I

Letter addressed to the Secretary-General of the United Nations from 
the Director-General of the World Health Organization

    ``The Thirty-seventh meeting of the WHO Expert Committee on Drug 
Dependence was convened from 16 to 20 November 2015, at WHO 
headquarters in Geneva.
    With reference to Article 2, paragraphs 1, 4 and 6 of the 
Convention on Psychotropic Substances (1971) and Article 3, paragraphs 
1, 3 and 5 of the Single Convention on Narcotic Drugs (1961), as 
amended by the 1972 Protocol, I am pleased to submit recommendations of 
the World Health Organization as follows:

--Acetylfentanyl be placed in Schedule I and in Schedule IV of the 
Single Convention on Narcotic Drugs (1961), and that:
--MT-45 be placed in Schedule I of the Single Convention on Narcotic 
Drugs (1961), and that:

[[Page 4307]]

--para-Methoxymethylamphetamine (PMMA) be placed in Schedule I of the 
Convention on Psychotropic Substances (1971), and that:
--[alpha]-Pyrrolidinovalerophenone ([alpha]-PVP); para-Methyl-4-
methylaminorex (4,4'- DMAR) and methoxetamine (MXE) be placed in 
Schedule II of the Convention on Psychotropic Substances (1971), and 
that:
--Phenazepam be placed in Schedule IV of the Convention on Psychotropic 
Substances (1971).

    The recommendations and the assessments and findings on which they 
are based are set out in detail in the Report of the 37th Expert 
Committee on Drug Dependence, which is the Committee that advises me on 
these issues. An extract of the Committee's Report is attached in Annex 
1 to this letter.
    In decision 58/2 of 13 March 2015, the Commission on Narcotic Drugs 
decided to postpone the consideration of the proposal concerning the 
recommendation to place ketamine in Schedule IV of the Convention on 
Psychotropic Substances of 1971 and to request additional information 
from the World Health Organization and other relevant sources. 
Consequentially, an update review paper on ketamine was commissioned 
and provided to the Expert Committee. Following its deliberations the 
Committee unanimously agreed that it found nothing in the updates, nor 
in what was disclosed during its deliberations, that would give it 
reason to recommend a new pre-review or critical review of ketamine 
with a view to potentially change its standing recommendation of 2014 
that ketamine should not be placed under international control. The 
current standing recommendation is consistent with the earlier 
recommendation made in 2012.
    I am very pleased with the ongoing collaboration between UNODC, 
INCB and WHO, in particular, the support to the work of the WHO Expert 
Committee on Drug Dependence and preparations for the Special Session 
of the United Nations General Assembly on the World Drug Problem in 
2016.''

NAR/CL.5/2015
Annex II

Annex II

Extract from the Report of the 37th Expert Committee on Drug Dependence
    Substance recommended to be scheduled in Schedule I and Schedule IV 
of the Single Convention on Narcotic Drugs (1961), as amended by the 
1972 Protocol:
Acetylfentanyl
    Chemically, acetylfentanyl is N-phenyl-N-[1-(2-phenylethyl)-4-
piperidinyl]acetamide. It is in the phenylpiperidine class of synthetic 
opioids that includes fentanyl, a Schedule I drug under the UN 1961 
Single Convention on Narcotic Drugs. Acetylfentanyl has also been 
referred to as ``desmethyl fentanyl''.
    Acetylfentanyl has not been previously reviewed by the Committee. A 
critical review was proposed based on information brought to WHO's 
attention that acetylfentanyl is clandestinely manufactured, poses a 
risk to public health and society, and has no recognized therapeutic 
use by any Party.
    Acetylfentanyl has effects similar to those of morphine and 
fentanyl that are included in Schedule I of the 1961 Single Convention 
on Narcotic Drugs. It has no recorded therapeutic use and its use has 
resulted in fatalities. Thus, because it meets the required condition 
of similarity, it is recommended that acetylfentanyl be placed in 
Schedule I of the Single Convention on Narcotic Drugs, 1961, as 
consistent with Article 3, paragraph 3 (iii) of that Convention in that 
the substance is liable to similar abuse and productive of similar ill 
effects as drugs in Schedule I. In addition, in accordance with Article 
3, paragraph 5 of that Convention, considering acetylfentanyl is 
particularly liable to abuse and to produce ill-effects, and its 
liability is not offset by substantial therapeutic advantages, it is 
recommended it be included in Schedule IV of the Single Convention on 
Narcotic Drugs, 1961.
    Substance recommended to be scheduled in Schedule I of the Single 
Convention on Narcotic Drugs (1961), as amended by the 1972 Protocol:
MT-45
    Chemically, MT-45 is 1-cyclohexyl-4-(1,2-diphenylethyl)piperazine. 
MT-45 has two enantiomers and is commonly available as the racemic 
mixture.
    MT-45 has not been previously reviewed by the Committee. A critical 
review was proposed based on information brought to WHO's attention 
that MT-45 is clandestinely manufactured, poses a risk to public health 
and society, and has no recognized therapeutic use by any Party.
    MT-45 is a compound with morphine-like effects. The Committee 
considered that the degree of risk to public health and society 
associated with the abuse liability and accompanying evidence warranted 
its placement under international control. Therapeutic use in humans 
has not been recorded. The Committee recommended that MT-45 be placed 
in Schedule I of the 1961 Single Convention, as amended by the 1972 
Protocol.
    Substance recommended to be scheduled in Schedule I of the 
Convention on Psychotropic Substances (1971):

para-Methoxymethylamphetamine (PMMA)

    Chemically, PMMA (para-methoxymethylamphetamine) is 1-(4-
methoxyphenyl)-N-methylpropan-2-amine. PMMA has two enantiomers and is 
commonly available as the racemic mixture.
    PMMA has not been previously reviewed by the Committee. A critical 
review was proposed based on information brought to WHO's attention 
that PMMA is clandestinely manufactured, poses a risk to public health 
and society, and has no recognized therapeutic use by any Party.
    The Committee considered that the effects of PMMA are similar to 
PMA, a drug listed in Schedule I of the Convention on Psychotropic 
Substances of 1971, and the degree of risk to public health and society 
associated with its abuse is especially serious. The Committee also 
noted it has no recorded therapeutic use. The Committee considered that 
the evidence of its abuse warranted its placement under international 
control and recommended that PMMA be placed in Schedule I of the 1971 
Convention.
    Substances recommended to be scheduled in Schedule II of the 
Convention on Psychotropic Substances (1971):
[alpha]-Pyrrolidinovalerophenone ([alpha]-PVP)
    Chemically, [alpha]-PVP ([alpha]-pyrrolidinovalerophenone) is 1-
phenyl-2-(pyrrolidin-1-yl)pentan-1-one. This synthetic cathinone is the 
desmethyl analogue of pyrovalerone that is listed in Schedule IV of the 
1971 United Nations Convention on Psychotropic Substances. [alpha]-PVP 
has two enantiomers and is commonly available as the racemic mixture. 
[alpha]-PVP is closely related to 3',4'-methylenedioxypyrovalerone 
(MDPV) that has recently been placed in Schedule II of the UN 
Convention on Psychotropic Substances (1971).
    [alpha]-PVP has not been previously reviewed by the Committee. A 
direct critical review was proposed based on information brought to 
WHO's attention that [alpha]-PVP is clandestinely manufactured, poses a 
risk to public health and society, and has no recognized therapeutic 
use by any Party.
    The Committee considered that the degree of risk to public health 
and

[[Page 4308]]

society associated with the abuse of [alpha]-PVP is substantial. 
Therapeutic usefulness has not been recorded. Its pharmacological 
effects are similar to methamphetamine and MDPV, psychostimulants 
listed in Schedule II of the 1971 Convention. The Committee considered 
that the evidence of its abuse warranted its placement under 
international control. As per the Guidance on the WHO review of 
psychoactive substances for international control, higher regard was 
accorded to the substantial public health risk than to the lack of 
therapeutic usefulness. The Committee recommended that [alpha]-PVP be 
placed in Schedule II of the 1971 Convention.
para-Methyl-4-methylaminorex (4,4'-DMAR)
    Chemically, 4,4'-DMAR (para-methyl-4-methylaminorex) is 4-methyl-5-
(4-methylphenyl)-4,5-dihydro-1,3- oxazol-2-amine. 4,4'-DMAR has four 
enantiomers and exists as racemic cis- or trans- forms. It is a 
synthetic substituted oxazoline derivative interpretable as an analogue 
of 4-methylaminorex (4-MAR) and aminorex, which are psychostimulants 
listed as Schedule I and Schedule IV substances, respectively, under 
the 1971 United Nations Convention on Psychotropic Substances.
    4,4'-DMAR has not been previously reviewed by WHO. A critical 
review was proposed based on information brought to WHO's attention 
that 4,4'-DMAR is clandestinely manufactured, poses a risk to public 
health and society, and has no recognized therapeutic use by any Party.
    As per the Guidance on the WHO review of psychoactive substances 
for international control, higher regard was accorded to the 
substantial public health risk than to the lack of therapeutic 
usefulness. The Committee considered that the degree of risk to public 
health and society associated with the abuse of 4,4'-DMAR is 
substantial. The Committee recommended that 4,4'-DMAR be placed in 
Schedule II of the 1971 Convention.
Methoxetamine (MXE)
    Chemically, methoxetamine (MXE) is 2-(ethylamino)-2-(3-
methoxyphenyl)cyclohexanone. It is a synthetic drug and belongs to the 
arylcyclohexylamine class like phencyclidine. Methoxetamine has two 
enantiomers and is commonly available as the racemic mixture.
    During its 36th meeting, the WHO Expert Committee on Drug 
Dependence discussed the critical review report on methoxetamine and 
concluded that owing to the insufficiency of data regarding dependence, 
abuse and risks to public health, methoxetamine should not be placed 
under international control at that time, but be kept under 
surveillance. In 2014 the European Union decided to bring methoxetamine 
under control after a risk assessment by the EMCDDA. Furthermore new 
information on its abuse potential and more reports of fatal and non-
fatal intoxications warranted a critical review for the 37th ECDD.
    Methoxetamine has been shown to have effects similar to 
phencyclidine, a compound listed in Schedule II of the Convention on 
Psychotropic Substances of 1971. The Committee considered that the 
degree of risk to public health and society associated with the abuse 
liability of methoxetamine is substantial. The Committee also noted it 
has no recorded therapeutic use. The Committee considered that the 
evidence of its abuse warranted its placement under international 
control. The Committee recommended that methoxetamine be placed in 
Schedule II of the 1971 Convention.
    Substance recommended to be scheduled in Schedule IV of the 
Convention on Psychotropic Substances (1971):
Phenazepam
    Chemically, phenazepam is 7-bromo-5-(2-chlorophenyl)-1,3-dihydro-
2H-1,4-benzodiazepin-2-one.
    Phenazepam has not been previously reviewed by the Committee. The 
Committee undertook a pre-review of the substance and considered that 
the information provided in the pre-review report was sufficient and 
indicated that dependence and harm caused by phenazepam was of such 
magnitude that proceeding directly into critical review within the 
meeting was warranted. All procedural requirements for a critical 
review, including two peer reviews, were fulfilled. Phenazepam has been 
shown to have effects similar to diazepam that is in Schedule IV of the 
Convention on Psychotropic Substances of 1971. The Committee considered 
that the degree of risk to public health and society associated with 
the abuse of phenazepam has a smaller but still significant risk to 
public health compared to substances in Schedules I-III and has a 
therapeutic usefulness from little to great. The Committee considered 
that the evidence of its abuse warranted its placement under 
international control. The Committee further recommended that 
phenazepam be placed in Schedule IV of the 1971 Convention.
    Substance recommended for critical review:
Etizolam (INN)
    Chemically, etizolam is 4-(2-chlorophenyl)-2-ethyl-9-methyl-6H-
thieno[3,2-f][1,2,4]triazolo[4,3-a][1,4]diazepine.
    The Expert Committee on Drug Dependence (ECDD) reviewed etizolam 
for the first time at its 26th meeting in 1989. At that time, the 
Committee rated the abuse liability of etizolam as moderate and the 
therapeutic usefulness as moderate to high. In view of the lack of 
clear-cut abuse, and of public health and social problems associated 
with its use, the Committee was unable to come to a decision concerning 
the scheduling of etizolam and recommended that a decision be deferred 
to the 27th meeting of the Committee.
    At its 27th meeting in 1990, the Committee again rated the abuse 
liability of etizolam as low to moderate and the therapeutic usefulness 
as moderate to high. The Committee noted few public health and social 
problems associated with its use at that time and considered that the 
degree of seriousness of these problems was not great enough to warrant 
international control. Consequently, the Committee did not recommend 
scheduling of etizolam in 1990.
    At the 37 ECDD, on the basis of the evidence available regarding 
dependence, abuse and risks to public health, the Committee recommended 
that a critical review of etizolam is warranted for a future meeting.
    Substance recommended for surveillance:
4-Fluoroamphetamine (4-FA)
    Chemically, 4-FA (4-fluoroamphetamine) is 1-(4-fluorophenyl)propan-
2-amine. 4-FA has two enantiomers and is commonly available as the 
racemic mixture.
    4-FA has not been previously reviewed by the Committee. A critical 
review was proposed based on information brought to WHO's attention 
that 4-FA is clandestinely manufactured, poses a risk to public health 
and society, and has no recognized therapeutic use by any Party.
    Owing to the current insufficiency of data regarding dependence, 
abuse and risks to public health (including risks to the individual), 
the Committee recommended that 4-FA not be placed under international 
control at this time, but be kept under surveillance.
    Update on cannabis:
    The Commission on Narcotic Drugs, in Resolution 52/5, expressed 
that it ``. . . looks forward to an updated

[[Page 4309]]

report on cannabis by the Expert Committee, subject to the availability 
of extra budgetary resources'', and the Report of the International 
Narcotics Control Board for 2014 reiterated, ``. . . its invitation to 
WHO to evaluate the potential medical utility of cannabis and the 
extent to which cannabis poses a risk to human health.'' WHO therefore 
commissioned an update report paper on cannabis and cannabis resin.
    An update on the scientific literature of cannabis was presented 
and reviewed during the session including the pharmacology, toxicology 
and the claimed therapeutic applications. The Committee then 
deliberated about the content of the material presented. The Committee 
requested the Secretariat to begin collecting data towards a pre-review 
of cannabis, cannabis resin, extracts and tinctures of cannabis at a 
future meeting. Furthermore it specifically requested the Secretariat 
to place emphasis on any therapeutic advantages that they may have 
relative to other existing therapeutics.
    Update on ketamine:
    Updates on ketamine were presented in which the levels and 
consequences of its abuse, and new potential medical applications were 
identified. Levels of ketamine abuse appeared to be declining in many 
countries world-wide. Potential new therapeutic uses were identified 
including depression and refractory status epilepticus. Evaluation of 
ketamine for treating depression is in Phase III studies. Ketamine is 
widely used as an anaesthetic agent for human and veterinary use 
globally. Ketamine is the anaesthetic agent of choice in low income 
countries and emergency situations where there are limitations in 
trained medical personnel, anesthesia machines, and consistent sources 
of electricity.
    Following its deliberations, the Committee unanimously agreed that 
it found nothing in the updates, nor that which was disclosed during 
its deliberations, that would give it reason to recommend a new pre-
review or critical review of ketamine with a view to potentially change 
its standing recommendation of 2014 that ketamine should not be placed 
under international control.

III. Discussion

    Although WHO has made specific scheduling recommendations for each 
of the drug substances, the CND is not obliged to follow the WHO 
recommendations. Options available to the CND for substances considered 
for control under the Psychotropic Convention include the following: 
(1) Accept the WHO recommendations; (2) accept the recommendations to 
control, but control the drug substance in a schedule other than that 
recommended; or (3) reject the recommendations entirely.
    Acetylfentanyl (N-(1-phenethylpiperidin-4-yl)-N-phenylacetamide) is 
a potent opioid analgesic in the phenylpiperidine class of synthetic 
opioids. On July 17, 2015, acetylfentanyl was temporarily placed into 
Schedule I of the CSA for 2 years upon finding that it posed an 
imminent hazard to the public safety. The U.S. Attorney General (the 
Attorney General), though, may extend this temporary scheduling for up 
to 1 year. The WHO ECDD met in November 2015 and recommended that 
acetylfentanyl be placed in Schedule I and in Schedule IV of the 1961 
Single Convention. On July 17, 2015, acetylfentanyl was temporarily 
placed in Schedule I of the CSA under the temporary scheduling 
provision of section 201(h) of the CSA. These provisions provide the 
Attorney General with the authority to temporarily place a substance 
into Schedule I of the CSA for 2 years, without regard to the 
requirements of 21 U.S.C. 811(b), if he finds that such action is 
necessary to avoid an imminent hazard to the public safety. In 
addition, if proceedings to control a substance are initiated under 21 
U.S.C. 811(a)(1), the Attorney General may extend the temporary 
scheduling for up to 1 year (21 U.S.C. 811(h)(2)). Therefore, 
considering the previously mentioned time limitations of temporary 
scheduling under section 201(h) of the CSA, it will be necessary to 
adopt non-temporary controls to fulfill U.S. obligations if 
acetylfentanyl is controlled under Schedule I and Schedule IV of the 
1961 Single Convention.
    1-cyclohexyl-4-(1,2-diphenylethyl)-piperazine (MT-45) is a 
synthetic opioid with potent analgesic activity comparable to morphine 
despite being structurally unrelated to most other opioids. MT-45 use 
has been associated with deaths in the United States and in other 
countries. The WHO ECDD met in November 2015 and recommended that MT-45 
be placed in Schedule I of the 1961 Single Convention. MT-45 is not 
currently controlled in the United States under the CSA. As such, 
additional controls will be necessary to fulfill U.S. obligations if 
MT-45 is controlled under Schedule I of the 1961 Single Convention.
    Phenazepam belongs to a class of substances known as 
benzodiazepines. Benzodiazepines produce central nervous system 
depression and are commonly used to treat insomnia, anxiety, and 
seizure disorders. The WHO ECDD at its 37th meeting recommended that 
Phenazepam be placed in Schedule IV of the Psychotropic Convention. 
While Phenazepam is currently prescribed in some countries, it is not 
approved for medical use or controlled in the United States under the 
CSA. Additional controls will be necessary to fulfill U.S. obligations 
if Phenazepam is controlled under Schedule IV of the Psychotropic 
Convention.
    Para-Methoxymethylamphetamine (PMMA) is a substituted amphetamine 
of the phenethylamine class, as well as a structural analog of para-
methoxyamphetamine (PMA) which produces effects similar but not 
identical to that of MDMA. The WHO ECDD at its 37th meeting recommended 
PMMA be placed in Schedule I of the Psychotropic Convention. PMMA is 
not currently controlled in the United States under the CSA. Additional 
controls will be necessary if PMMA is placed in Schedule I of the 
Psychotropic Convention.
    Para-Methyl-4-methylaminorex (4,4'-DMAR) is a derivative of the 
stimulant drug 4-methylaminorex and has been involved in several deaths 
in the United States. The WHO ECDD at its 37th meeting recommended 
4,4'-DMAR be placed in Schedule II of the Psychotropic Convention. 
4,4'-DMAR is not currently controlled in the United States under the 
CSA. Additional controls will be necessary to fulfill U.S. obligations 
if 4,4'-DMAR is controlled under Schedule II of the Psychotropic 
Convention.
    [alpha]-Pyrrolidinovalerophenone ([alpha]-PVP or alpha-PVP) is a 
synthetic cathinone structurally and pharmacologically similar to 
amphetamine; 3,4-methylenedioxymethamphetamine (MDMA); cathinone; and 
other related substances. On March 7, 2014, [alpha]-PVP was temporarily 
placed into Schedule I of the CSA for 2 years upon finding that it 
posed an imminent hazard to the public safety. The Attorney General, 
though, may extend this temporary scheduling for up to 1 year. The WHO 
ECDD at its 37th meeting recommended that [alpha]-PVP be placed in 
Schedule II of the Psychotropic Convention. Therefore, considering the 
previously mentioned time limitations of temporary scheduling under 
section 201(h) of the CSA, additional controls will be necessary to 
fulfill U.S. obligations if [alpha]-PVP is controlled under Schedule II 
of the Psychotropic Convention.
    Methoxetamine (MXE) is a synthetic drug substance and belongs in 
the arylcyclohexamine class. The WHO

[[Page 4310]]

ECDD at its 37th meeting recommended that MXE be placed in Schedule II 
of the Psychotropic Convention. MXE is not currently controlled under 
the CSA in the United States. Additional controls will be necessary to 
fulfill U.S. obligations if MXE is controlled under Schedule II of the 
Psychotropic Convention.
    FDA, on behalf of the Secretary of HHS, invites interested persons 
to submit comments on the notifications from the United Nations 
concerning these drug substances. FDA, in cooperation with the National 
Institute on Drug Abuse, will consider the comments on behalf of HHS in 
evaluating the WHO scheduling recommendations. Then, under section 
201(d)(2)(B) of the CSA, HHS will recommend to the Secretary of State 
what position the United States should take when voting on the 
recommendations for control of substances under the Psychotropic 
Convention at the CND meeting in March 2015.
    Comments regarding the WHO recommendations for control of 
acetylfentanyl and MT-45 under the 1961 Single Convention will also be 
forwarded to the relevant Agencies for consideration in developing the 
U.S. position regarding narcotic substances at the CND meeting.

IV. Opportunity for Public Meeting

    FDA does not presently plan to hold a public meeting. If any person 
believes that, in addition to written comments, a public meeting would 
contribute to the development of the U.S. position on the substances to 
be considered for control under the Psychotropic Convention, a request 
for a public meeting and the reasons for such a request should be sent 
to James R. Hunter (see FOR FURTHER INFORMATION CONTACT) on or before 
February 5, 2016.

    Dated: January 20, 2016.
Leslie Kux,
Associate Commissioner for Policy.
[FR Doc. 2016-01474 Filed 1-25-16; 8:45 am]
BILLING CODE 4164-01-P



                                                                                Federal Register / Vol. 81, No. 16 / Tuesday, January 26, 2016 / Notices                                           4305

                                                  part 601 have been approved under                       Electronic Submissions                                    • Confidential Submissions—To
                                                  OMB control number 0910–0338; and                         Submit electronic comments in the                    submit a comment with confidential
                                                  the collections of information in 21 CFR                following way:                                         information that you do not wish to be
                                                  parts 801 and 809 have been approved                      • Federal eRulemaking Portal: http://                made publicly available, submit your
                                                  under OMB control number 0910–0485.                     www.regulations.gov. Follow the                        comments only as a written/paper
                                                    Dated: January 21, 2016.                              instructions for submitting comments.                  submission. You should submit two
                                                  Leslie Kux,                                             Comments submitted electronically,                     copies total. One copy will include the
                                                                                                          including attachments, to http://                      information you claim to be confidential
                                                  Associate Commissioner for Policy.
                                                                                                          www.regulations.gov will be posted to                  with a heading or cover note that states
                                                  [FR Doc. 2016–01471 Filed 1–25–16; 8:45 am]
                                                                                                          the docket unchanged. Because your                     ‘‘THIS DOCUMENT CONTAINS
                                                  BILLING CODE 4164–01–P
                                                                                                          comment will be made public, you are                   CONFIDENTIAL INFORMATION.’’ The
                                                                                                          solely responsible for ensuring that your              Agency will review this copy, including
                                                                                                          comment does not include any                           the claimed confidential information, in
                                                  DEPARTMENT OF HEALTH AND
                                                                                                          confidential information that you or a                 its consideration of comments. The
                                                  HUMAN SERVICES
                                                                                                          third party may not wish to be posted,                 second copy, which will have the
                                                  Food and Drug Administration                            such as medical information, your or                   claimed confidential information
                                                                                                          anyone else’s Social Security number, or               redacted/blacked out, will be available
                                                  [Docket No. FDA–2016–N–0117]                            confidential business information, such                for public viewing and posted on http://
                                                                                                          as a manufacturing process. Please note                www.regulations.gov. Submit both
                                                  International Drug Scheduling;
                                                                                                          that if you include your name, contact                 copies to the Division of Dockets
                                                  Convention on Psychotropic
                                                                                                          information, or other information that                 Management. If you do not wish your
                                                  Substances; Single Convention on
                                                                                                          identifies you in the body of your                     name and contact information to be
                                                  Narcotic Drugs; World Health
                                                                                                          comments, that information will be                     made publicly available, you can
                                                  Organization; Scheduling
                                                                                                          posted on http://www.regulations.gov.                  provide this information on the cover
                                                  Recommendations; Acetylfentanyl;
                                                                                                            • If you want to submit a comment                    sheet and not in the body of your
                                                  MT–45; para-
                                                                                                          with confidential information that you                 comments and you must identify this
                                                  Methoxymethylamphetamine (PMMA);
                                                                                                          do not wish to be made available to the                information as ‘‘confidential.’’ Any
                                                  α-Pyrrolidinovalerophenone (α-PVP);                     public, submit the comment as a                        information marked as ‘‘confidential’’
                                                  para-Methyl-4-methylaminorex (4,4′-                     written/paper submission and in the                    will not be disclosed except in
                                                  DMAR); Methoxetamine (MXE);                             manner detailed (see ‘‘Written/Paper                   accordance with 21 CFR 10.20 and other
                                                  Phenazepam; Request for Comments                        Submissions’’ and ‘‘Instructions’’).                   applicable disclosure law. For more
                                                  AGENCY:    Food and Drug Administration,                Written/Paper Submissions                              information about FDA’s posting of
                                                  HHS.                                                                                                           comments to public dockets, see 80 FR
                                                  ACTION:   Notice.                                          Submit written/paper submissions as                 56469, September 18, 2015, or access
                                                                                                          follows:                                               the information at: http://www.fda.gov/
                                                  SUMMARY:   The Food and Drug                               • Mail/Hand delivery/Courier (for                   regulatoryinformation/dockets/
                                                  Administration (FDA) is providing                       written/paper submissions): Division of                default.htm.
                                                  interested persons with the opportunity                 Dockets Management (HFA–305), Food                        Docket: For access to the docket to
                                                  to submit written comments, and to                      and Drug Administration, 5630 Fishers                  read background documents or the
                                                  request an informal public meeting                      Lane, Rm. 1061, Rockville, MD 20852.                   electronic and written/paper comments
                                                  concerning recommendations by the                          • For written/paper comments
                                                                                                                                                                 received, go to http://
                                                  World Health Organization (WHO) to                      submitted to the Division of Dockets
                                                                                                                                                                 www.regulations.gov and insert the
                                                  impose international manufacturing and                  Management, FDA will post your
                                                                                                                                                                 docket number, found in brackets in the
                                                  distributing restrictions, under                        comment, as well as any attachments,
                                                                                                                                                                 heading of this document, into the
                                                  international treaties, on certain drug                 except for information submitted,
                                                                                                                                                                 ‘‘Search’’ box and follow the prompts
                                                  substances. The comments received in                    marked and identified, as confidential,
                                                                                                                                                                 and/or go to the Division of Dockets
                                                  response to this notice and/or public                   if submitted as detailed in
                                                                                                          ‘‘Instructions.’’                                      Management, 5630 Fishers Lane, Rm.
                                                  meeting will be considered in preparing                                                                        1061, Rockville, MD 20852.
                                                  the United States’ position on these                       Instructions: All submissions received
                                                                                                          must include the Docket No. FDA–                       FOR FURTHER INFORMATION CONTACT:
                                                  proposals for a meeting of the United                                                                          James R. Hunter, Center for Drug
                                                  Nations Commission on Narcotic Drugs                    2015–N–0117 for ‘‘International Drug
                                                                                                          Scheduling; Convention on                              Evaluation and Research, Controlled
                                                  (CND) in Vienna, Austria, in March                                                                             Substance Staff, Food and Drug
                                                                                                          Psychotropic Substances; Single
                                                  2016. This notice is issued under the                                                                          Administration, 10903 New Hampshire
                                                                                                          Convention on Narcotic Drugs; World
                                                  Controlled Substances Act (the CSA).                                                                           Ave., Bldg. 51, Rm. 5150, Silver Spring,
                                                                                                          Health Organization; Scheduling
                                                  DATES: Submit either electronic or                                                                             MD 20993–0002, 301–796–3156,
                                                                                                          Recommendations; Acetylfentanyl; MT–
                                                  written comments by February 25, 2016.                  45; para-Methoxymethylamphetamine                      james.hunter@fda.hhs.gov.
                                                  Submit requests for a public meeting on                 (PMMA); a-Pyrrolidinovalerophenone                     SUPPLEMENTARY INFORMATION:
                                                  or before February 5, 2016. The short                   (a-PVP); para-Methyl-4-methylaminorex
                                                  time period for the submission of                       (4,4′-DMAR); Methoxetamine (MXE);                      I. Background
                                                  comments and requests for a public                      Phenazepam; Request for Comments.’’                      The United States is a party to the
                                                  meeting is needed to ensure that HHS
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                                                                                                          Received comments will be placed in                    1971 Convention on Psychotropic
                                                  may, in a timely fashion, carry out the                 the docket and, except for those                       Substances (Psychotropic Convention).
                                                  required action and be responsive to the                submitted as ‘‘Confidential                            Section 201(d)(2)(B) of the CSA (21
                                                  United Nations. For additional                          Submissions,’’ publicly viewable at                    U.S.C. 811(d)(2)(B)) provides that when
                                                  information, see section IV of this                     http://www.regulations.gov or at the                   the United States is notified under
                                                  document.                                               Division of Dockets Management                         Article 2 of the Psychotropic
                                                  ADDRESSES: You may submit comments                      between 9 a.m. and 4 p.m., Monday                      Convention that the CND proposes to
                                                  as follows:                                             through Friday.                                        decide whether to add a drug or other


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                                                  4306                          Federal Register / Vol. 81, No. 16 / Tuesday, January 26, 2016 / Notices

                                                  substance to one of the schedules of the                discussions and negotiations relating to                  In accordance with the provisions of
                                                  Psychotropic Convention, transfer a                     the proposal regarding control of                      article 3, paragraph 2 of the 1961
                                                  drug or substance from one schedule to                  substances under the 1961 Single                       Convention and article 2, paragraph 2 of
                                                  another, or delete it from the schedules,               Convention.                                            the 1971 Convention, the Secretary-
                                                  the Secretary of State must transmit                                                                           General hereby transmits the
                                                                                                          II. United Nations Notification
                                                  notice of such information to the                                                                              notification as annex I to the present
                                                  Secretary of Health and Human Services                     The formal notification from the                    note.
                                                  (Secretary of HHS). The Secretary of                    United Nations that identifies the drug                   In accordance with the provisions of
                                                  HHS must then publish a summary of                      substances and explains the basis for the              article 3, paragraph 2 of the 1961
                                                  such information in the Federal                         recommendations is reproduced as                       Convention and article 2, paragraph 2 of
                                                  Register and provide opportunity for                    follows:                                               the 1971 Convention, the notification
                                                  interested persons to submit comments.                  Reference:                                             from WHO will be brought to the
                                                  The Secretary of HHS must then                          NAR/CL.5/2015                                          attention of the fifty-ninth session of the
                                                  evaluate the proposal and furnish a                     WHO/ECDD37; 1961C-Art.3; 1971C-                        Commission on Narcotic Drugs, 14–22
                                                  recommendation to the Secretary of                           Art.2                                             March 2016.
                                                  State that shall be binding on the                      CU 2014/288/DTA/SGB                                       In connection with the notification,
                                                  representative of the United States in                     The Secretary-General of the United                 WHO has also submitted the relevant
                                                  discussions and negotiations relating to                Nations presents his compliments to the                extract from the report of the thirty-
                                                  the proposal.                                           Secretary of State of the United States of             seventh session of the WHO Expert
                                                     As detailed in the following                         America and has the honour to inform                   Committee on Drug Dependence which
                                                  paragraphs, the Secretary of State has                  the Government that the Director-                      is hereby transmitted as annex II.
                                                  received notification from the Secretary-               General of the World Health                               In order to assist the Commission in
                                                  General of the United Nations (the                      Organization (WHO), pursuant to article                reaching a decision, it would be
                                                  Secretary-General) regarding 5                          3, paragraphs 1 and 3 of the Single                    appreciated if the Government could
                                                  substances to be considered for control                 Convention on Narcotic Drugs of 1961                   communicate any economic, social,
                                                  under the Psychotropic Convention.                      as amended by the 1972 Protocol (1961                  legal, administrative or other factors that
                                                  This notification reflects the                          Convention) and article 2, paragraphs 1                it considers relevant to the possible
                                                  recommendation from the 36th WHO                        and 4 of the Convention on                             scheduling of the afore-mentioned
                                                  Expert Committee for Drug Dependence                    Psychotropic Substances of 1971 (1971                  substances under the 1961 Convention
                                                  (ECDD), which met in June 2014. In the                  Convention) notified the Secretary-                    and the 1971 Convention, at the latest
                                                  Federal Register of December 30, 2013                   General of the following                               by 1 February 2016 to the Executive
                                                  (78 FR 79465), FDA announced the                        recommendations:                                       Director of the United Nations Office on
                                                  WHO ECDD review and invited                                Acetylfentanyl be placed in Schedule                Drugs and Crime, c/o Secretary,
                                                  interested persons to submit                            I and in Schedule IV of the 1961                       Commission on Narcotic Drugs, P.O.
                                                  information for WHO’s consideration.                    Convention
                                                     The full text of the notification from                                                                      Box 500, 1400 Vienna, Austria, fax:
                                                                                                             and                                                 +43–1–26060–5885, email: sgb@
                                                  the Secretary-General is provided in                       MT–45 be placed in Schedule I of the
                                                  section II of this document. Section                                                                           unodc.org.
                                                                                                          1961 Convention
                                                  201(d)(2)(B) of the CSA requires the                       and                                                 30 December 2015
                                                  Secretary of HHS, after receiving a                        para-Methoxymethylamphetamine                       NAR/CL.5/2015
                                                  notification proposing scheduling, to                   (PMMA) be placed in Schedule I of the                  Annex I
                                                  publish a notice in the Federal Register                1971 Convention
                                                                                                                                                                 Annex I
                                                  to provide the opportunity for interested                  and
                                                  persons to submit information and                          a-Pyrrolidinovalerophenone (a-PVP);                 Letter addressed to the Secretary-
                                                  comments on the proposed scheduling                     para-Methyl-4-methylaminorex (4,4′-                    General of the United Nations from the
                                                  action.                                                 DMAR) and methoxetamine (MXE) be                       Director-General of the World Health
                                                     The United States is also a party to                 placed in Schedule II of the 1971                      Organization
                                                  the 1961 Single Convention on Narcotic                  Convention
                                                                                                                                                                   ‘‘The Thirty-seventh meeting of the
                                                  Drugs (1961 Single Convention). The                        and
                                                                                                             Phenazepam be placed in Schedule IV                 WHO Expert Committee on Drug
                                                  Secretary of State has received a
                                                                                                          of the 1971 Convention.                                Dependence was convened from 16 to
                                                  notification from the Secretary-General
                                                  regarding 2 substances to be considered                    In the letter from the Director-General             20 November 2015, at WHO
                                                  for control under this convention. The                  of the World Health Organization to the                headquarters in Geneva.
                                                  CSA does not require HHS to publish a                   Secretary-General reference is also made                 With reference to Article 2,
                                                  summary of such information in the                      to Commission on Narcotic Drugs                        paragraphs 1, 4 and 6 of the Convention
                                                  Federal Register. Nevertheless, in an                   decision 58/2 of 13 March 2015, by                     on Psychotropic Substances (1971) and
                                                  effort to provide interested and affected               which the Commission decided to                        Article 3, paragraphs 1, 3 and 5 of the
                                                  persons an opportunity to submit                        postpone the consideration of the                      Single Convention on Narcotic Drugs
                                                  comments regarding the WHO                              proposal concerning the                                (1961), as amended by the 1972
                                                  recommendations for narcotic drugs, the                 recommendation to place ketamine in                    Protocol, I am pleased to submit
                                                  notification regarding these substances                 Schedule IV of the Convention on                       recommendations of the World Health
                                                                                                                                                                 Organization as follows:
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                                                  is also included in this Federal Register               Psychotropic Substances of 1971 and to
                                                  notice. The comments will be shared                     request additional information from the                —Acetylfentanyl be placed in Schedule
                                                  with other relevant Agencies to assist                  World Health Organization and other                      I and in Schedule IV of the Single
                                                  the Secretary of State in formulating the               relevant sources.                                        Convention on Narcotic Drugs (1961),
                                                  position of the United States on the                    His Excellency                                           and that:
                                                  control of these substances. The HHS                    Mr. John Kerry                                         —MT–45 be placed in Schedule I of the
                                                  recommendations are not binding on the                  Secretary of State of the United States of               Single Convention on Narcotic Drugs
                                                  representative of the United States in                       America                                             (1961), and that:


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                                                                                Federal Register / Vol. 81, No. 16 / Tuesday, January 26, 2016 / Notices                                            4307

                                                  —para-Methoxymethylamphetamine                          Acetylfentanyl                                         recorded. The Committee recommended
                                                     (PMMA) be placed in Schedule I of                       Chemically, acetylfentanyl is N-                    that MT–45 be placed in Schedule I of
                                                     the Convention on Psychotropic                       phenyl-N-[1-(2-phenylethyl)-4-                         the 1961 Single Convention, as
                                                     Substances (1971), and that:                         piperidinyl]acetamide. It is in the                    amended by the 1972 Protocol.
                                                  —a-Pyrrolidinovalerophenone (a-PVP);                                                                              Substance recommended to be
                                                                                                          phenylpiperidine class of synthetic
                                                     para-Methyl-4-methylaminorex (4,4′-                                                                         scheduled in Schedule I of the
                                                                                                          opioids that includes fentanyl, a
                                                     DMAR) and methoxetamine (MXE) be                                                                            Convention on Psychotropic Substances
                                                                                                          Schedule I drug under the UN 1961
                                                     placed in Schedule II of the                                                                                (1971):
                                                                                                          Single Convention on Narcotic Drugs.
                                                     Convention on Psychotropic                           Acetylfentanyl has also been referred to               para-Methoxymethylamphetamine
                                                     Substances (1971), and that:                         as ‘‘desmethyl fentanyl’’.                                (PMMA)
                                                  —Phenazepam be placed in Schedule IV                       Acetylfentanyl has not been                            Chemically, PMMA (para-
                                                     of the Convention on Psychotropic                    previously reviewed by the Committee.                  methoxymethylamphetamine) is 1-(4-
                                                     Substances (1971).                                   A critical review was proposed based on                methoxyphenyl)-N-methylpropan-2-
                                                     The recommendations and the                          information brought to WHO’s attention                 amine. PMMA has two enantiomers and
                                                  assessments and findings on which they                  that acetylfentanyl is clandestinely                   is commonly available as the racemic
                                                  are based are set out in detail in the                  manufactured, poses a risk to public                   mixture.
                                                  Report of the 37th Expert Committee on                  health and society, and has no                            PMMA has not been previously
                                                  Drug Dependence, which is the                           recognized therapeutic use by any Party.               reviewed by the Committee. A critical
                                                  Committee that advises me on these                         Acetylfentanyl has effects similar to               review was proposed based on
                                                  issues. An extract of the Committee’s                   those of morphine and fentanyl that are                information brought to WHO’s attention
                                                  Report is attached in Annex 1 to this                   included in Schedule I of the 1961                     that PMMA is clandestinely
                                                  letter.                                                 Single Convention on Narcotic Drugs. It                manufactured, poses a risk to public
                                                     In decision 58/2 of 13 March 2015,                   has no recorded therapeutic use and its                health and society, and has no
                                                  the Commission on Narcotic Drugs                        use has resulted in fatalities. Thus,                  recognized therapeutic use by any Party.
                                                  decided to postpone the consideration                   because it meets the required condition                   The Committee considered that the
                                                  of the proposal concerning the                          of similarity, it is recommended that                  effects of PMMA are similar to PMA, a
                                                  recommendation to place ketamine in                     acetylfentanyl be placed in Schedule I                 drug listed in Schedule I of the
                                                  Schedule IV of the Convention on                        of the Single Convention on Narcotic                   Convention on Psychotropic Substances
                                                  Psychotropic Substances of 1971 and to                  Drugs, 1961, as consistent with Article                of 1971, and the degree of risk to public
                                                  request additional information from the                 3, paragraph 3 (iii) of that Convention in             health and society associated with its
                                                                                                          that the substance is liable to similar                abuse is especially serious. The
                                                  World Health Organization and other
                                                                                                          abuse and productive of similar ill                    Committee also noted it has no recorded
                                                  relevant sources. Consequentially, an
                                                                                                          effects as drugs in Schedule I. In                     therapeutic use. The Committee
                                                  update review paper on ketamine was
                                                                                                          addition, in accordance with Article 3,                considered that the evidence of its abuse
                                                  commissioned and provided to the
                                                                                                          paragraph 5 of that Convention,                        warranted its placement under
                                                  Expert Committee. Following its
                                                                                                          considering acetylfentanyl is                          international control and recommended
                                                  deliberations the Committee
                                                                                                                                                                 that PMMA be placed in Schedule I of
                                                  unanimously agreed that it found                        particularly liable to abuse and to
                                                                                                                                                                 the 1971 Convention.
                                                  nothing in the updates, nor in what was                 produce ill-effects, and its liability is
                                                                                                                                                                    Substances recommended to be
                                                  disclosed during its deliberations, that                not offset by substantial therapeutic                  scheduled in Schedule II of the
                                                  would give it reason to recommend a                     advantages, it is recommended it be                    Convention on Psychotropic Substances
                                                  new pre-review or critical review of                    included in Schedule IV of the Single                  (1971):
                                                  ketamine with a view to potentially                     Convention on Narcotic Drugs, 1961.
                                                  change its standing recommendation of                      Substance recommended to be                         a-Pyrrolidinovalerophenone (a-PVP)
                                                  2014 that ketamine should not be placed                 scheduled in Schedule I of the Single                    Chemically, a-PVP (a-
                                                  under international control. The current                Convention on Narcotic Drugs (1961), as                pyrrolidinovalerophenone) is 1-phenyl-
                                                  standing recommendation is consistent                   amended by the 1972 Protocol:                          2-(pyrrolidin-1-yl)pentan-1-one. This
                                                  with the earlier recommendation made                    MT–45                                                  synthetic cathinone is the desmethyl
                                                  in 2012.                                                                                                       analogue of pyrovalerone that is listed
                                                     I am very pleased with the ongoing                     Chemically, MT–45 is 1-cyclohexyl-4-                 in Schedule IV of the 1971 United
                                                  collaboration between UNODC, INCB                       (1,2-diphenylethyl)piperazine. MT–45                   Nations Convention on Psychotropic
                                                  and WHO, in particular, the support to                  has two enantiomers and is commonly                    Substances. a-PVP has two enantiomers
                                                  the work of the WHO Expert Committee                    available as the racemic mixture.                      and is commonly available as the
                                                  on Drug Dependence and preparations                       MT–45 has not been previously                        racemic mixture. a-PVP is closely
                                                  for the Special Session of the United                   reviewed by the Committee. A critical                  related to 3’,4’-
                                                  Nations General Assembly on the World                   review was proposed based on                           methylenedioxypyrovalerone (MDPV)
                                                  Drug Problem in 2016.’’                                 information brought to WHO’s attention                 that has recently been placed in
                                                                                                          that MT–45 is clandestinely                            Schedule II of the UN Convention on
                                                  NAR/CL.5/2015
                                                                                                          manufactured, poses a risk to public                   Psychotropic Substances (1971).
                                                  Annex II
                                                                                                          health and society, and has no                           a-PVP has not been previously
                                                  Annex II                                                recognized therapeutic use by any Party.               reviewed by the Committee. A direct
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                                                                                                            MT–45 is a compound with                             critical review was proposed based on
                                                  Extract from the Report of the 37th                     morphine-like effects. The Committee
                                                  Expert Committee on Drug Dependence                                                                            information brought to WHO’s attention
                                                                                                          considered that the degree of risk to                  that a-PVP is clandestinely
                                                    Substance recommended to be                           public health and society associated                   manufactured, poses a risk to public
                                                  scheduled in Schedule I and Schedule                    with the abuse liability and                           health and society, and has no
                                                  IV of the Single Convention on Narcotic                 accompanying evidence warranted its                    recognized therapeutic use by any Party.
                                                  Drugs (1961), as amended by the 1972                    placement under international control.                   The Committee considered that the
                                                  Protocol:                                               Therapeutic use in humans has not been                 degree of risk to public health and


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                                                  4308                          Federal Register / Vol. 81, No. 16 / Tuesday, January 26, 2016 / Notices

                                                  society associated with the abuse of a-                 owing to the insufficiency of data                       Substance recommended for critical
                                                  PVP is substantial. Therapeutic                         regarding dependence, abuse and risks                  review:
                                                  usefulness has not been recorded. Its                   to public health, methoxetamine should
                                                                                                                                                                 Etizolam (INN)
                                                  pharmacological effects are similar to                  not be placed under international
                                                  methamphetamine and MDPV,                               control at that time, but be kept under                   Chemically, etizolam is 4-(2-
                                                  psychostimulants listed in Schedule II                  surveillance. In 2014 the European                     chlorophenyl)-2-ethyl-9-methyl-6H-
                                                  of the 1971 Convention. The Committee                   Union decided to bring methoxetamine                   thieno[3,2-f][1,2,4]triazolo[4,3-
                                                  considered that the evidence of its abuse               under control after a risk assessment by               a][1,4]diazepine.
                                                  warranted its placement under                           the EMCDDA. Furthermore new                               The Expert Committee on Drug
                                                  international control. As per the                       information on its abuse potential and                 Dependence (ECDD) reviewed etizolam
                                                  Guidance on the WHO review of                           more reports of fatal and non-fatal                    for the first time at its 26th meeting in
                                                  psychoactive substances for                             intoxications warranted a critical review              1989. At that time, the Committee rated
                                                  international control, higher regard was                for the 37th ECDD.                                     the abuse liability of etizolam as
                                                  accorded to the substantial public                         Methoxetamine has been shown to                     moderate and the therapeutic usefulness
                                                  health risk than to the lack of                         have effects similar to phencyclidine, a               as moderate to high. In view of the lack
                                                  therapeutic usefulness. The Committee                   compound listed in Schedule II of the                  of clear-cut abuse, and of public health
                                                  recommended that a-PVP be placed in                     Convention on Psychotropic Substances                  and social problems associated with its
                                                  Schedule II of the 1971 Convention.                     of 1971. The Committee considered that                 use, the Committee was unable to come
                                                                                                          the degree of risk to public health and                to a decision concerning the scheduling
                                                  para-Methyl-4-methylaminorex (4,4′-                                                                            of etizolam and recommended that a
                                                  DMAR)                                                   society associated with the abuse
                                                                                                          liability of methoxetamine is                          decision be deferred to the 27th meeting
                                                     Chemically, 4,4′-DMAR (para-methyl-                  substantial. The Committee also noted it               of the Committee.
                                                  4-methylaminorex) is 4-methyl-5-(4-                     has no recorded therapeutic use. The                      At its 27th meeting in 1990, the
                                                  methylphenyl)-4,5-dihydro-1,3- oxazol-                  Committee considered that the evidence                 Committee again rated the abuse
                                                  2-amine. 4,4′-DMAR has four                             of its abuse warranted its placement                   liability of etizolam as low to moderate
                                                  enantiomers and exists as racemic cis-                  under international control. The                       and the therapeutic usefulness as
                                                  or trans- forms. It is a synthetic                      Committee recommended that                             moderate to high. The Committee noted
                                                  substituted oxazoline derivative                        methoxetamine be placed in Schedule II                 few public health and social problems
                                                  interpretable as an analogue of 4-                      of the 1971 Convention.                                associated with its use at that time and
                                                  methylaminorex (4–MAR) and                                                                                     considered that the degree of
                                                                                                             Substance recommended to be
                                                  aminorex, which are psychostimulants                                                                           seriousness of these problems was not
                                                                                                          scheduled in Schedule IV of the
                                                  listed as Schedule I and Schedule IV                                                                           great enough to warrant international
                                                                                                          Convention on Psychotropic Substances
                                                  substances, respectively, under the 1971                                                                       control. Consequently, the Committee
                                                                                                          (1971):
                                                  United Nations Convention on                                                                                   did not recommend scheduling of
                                                  Psychotropic Substances.                                Phenazepam                                             etizolam in 1990.
                                                     4,4′-DMAR has not been previously                                                                              At the 37 ECDD, on the basis of the
                                                  reviewed by WHO. A critical review                         Chemically, phenazepam is 7-bromo-
                                                                                                                                                                 evidence available regarding
                                                  was proposed based on information                       5-(2-chlorophenyl)-1,3-dihydro-2H-1,4-
                                                                                                                                                                 dependence, abuse and risks to public
                                                  brought to WHO’s attention that 4,4′-                   benzodiazepin-2-one.
                                                                                                                                                                 health, the Committee recommended
                                                  DMAR is clandestinely manufactured,                        Phenazepam has not been previously
                                                                                                                                                                 that a critical review of etizolam is
                                                  poses a risk to public health and society,              reviewed by the Committee. The
                                                                                                                                                                 warranted for a future meeting.
                                                  and has no recognized therapeutic use                   Committee undertook a pre-review of                       Substance recommended for
                                                  by any Party.                                           the substance and considered that the                  surveillance:
                                                     As per the Guidance on the WHO                       information provided in the pre-review
                                                  review of psychoactive substances for                   report was sufficient and indicated that               4-Fluoroamphetamine (4-FA)
                                                  international control, higher regard was                dependence and harm caused by                             Chemically, 4-FA (4-
                                                  accorded to the substantial public                      phenazepam was of such magnitude                       fluoroamphetamine) is 1-(4-
                                                  health risk than to the lack of                         that proceeding directly into critical                 fluorophenyl)propan-2-amine. 4-FA has
                                                  therapeutic usefulness. The Committee                   review within the meeting was                          two enantiomers and is commonly
                                                  considered that the degree of risk to                   warranted. All procedural requirements                 available as the racemic mixture.
                                                  public health and society associated                    for a critical review, including two peer                 4-FA has not been previously
                                                  with the abuse of 4,4′-DMAR is                          reviews, were fulfilled. Phenazepam has                reviewed by the Committee. A critical
                                                  substantial. The Committee                              been shown to have effects similar to                  review was proposed based on
                                                  recommended that 4,4′-DMAR be placed                    diazepam that is in Schedule IV of the                 information brought to WHO’s attention
                                                  in Schedule II of the 1971 Convention.                  Convention on Psychotropic Substances                  that 4-FA is clandestinely
                                                                                                          of 1971. The Committee considered that                 manufactured, poses a risk to public
                                                  Methoxetamine (MXE)                                     the degree of risk to public health and                health and society, and has no
                                                    Chemically, methoxetamine (MXE) is                    society associated with the abuse of                   recognized therapeutic use by any Party.
                                                  2-(ethylamino)-2-(3-                                    phenazepam has a smaller but still                        Owing to the current insufficiency of
                                                  methoxyphenyl)cyclohexanone. It is a                    significant risk to public health                      data regarding dependence, abuse and
                                                  synthetic drug and belongs to the                       compared to substances in Schedules I–                 risks to public health (including risks to
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                                                  arylcyclohexylamine class like                          III and has a therapeutic usefulness from              the individual), the Committee
                                                  phencyclidine. Methoxetamine has two                    little to great. The Committee                         recommended that 4-FA not be placed
                                                  enantiomers and is commonly available                   considered that the evidence of its abuse              under international control at this time,
                                                  as the racemic mixture.                                 warranted its placement under                          but be kept under surveillance.
                                                    During its 36th meeting, the WHO                      international control. The Committee                      Update on cannabis:
                                                  Expert Committee on Drug Dependence                     further recommended that phenazepam                       The Commission on Narcotic Drugs,
                                                  discussed the critical review report on                 be placed in Schedule IV of the 1971                   in Resolution 52/5, expressed that it
                                                  methoxetamine and concluded that                        Convention.                                            ‘‘. . . looks forward to an updated


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                                                                                Federal Register / Vol. 81, No. 16 / Tuesday, January 26, 2016 / Notices                                             4309

                                                  report on cannabis by the Expert                        Accept the WHO recommendations; (2)                    commonly used to treat insomnia,
                                                  Committee, subject to the availability of               accept the recommendations to control,                 anxiety, and seizure disorders. The
                                                  extra budgetary resources’’, and the                    but control the drug substance in a                    WHO ECDD at its 37th meeting
                                                  Report of the International Narcotics                   schedule other than that recommended;                  recommended that Phenazepam be
                                                  Control Board for 2014 reiterated, ‘‘. . .              or (3) reject the recommendations                      placed in Schedule IV of the
                                                  its invitation to WHO to evaluate the                   entirely.                                              Psychotropic Convention. While
                                                  potential medical utility of cannabis and                  Acetylfentanyl (N-(1-                               Phenazepam is currently prescribed in
                                                  the extent to which cannabis poses a                    phenethylpiperidin-4-yl)-N-                            some countries, it is not approved for
                                                  risk to human health.’’ WHO therefore                   phenylacetamide) is a potent opioid                    medical use or controlled in the United
                                                  commissioned an update report paper                     analgesic in the phenylpiperidine class                States under the CSA. Additional
                                                  on cannabis and cannabis resin.                         of synthetic opioids. On July 17, 2015,                controls will be necessary to fulfill U.S.
                                                     An update on the scientific literature               acetylfentanyl was temporarily placed                  obligations if Phenazepam is controlled
                                                  of cannabis was presented and reviewed                  into Schedule I of the CSA for 2 years                 under Schedule IV of the Psychotropic
                                                  during the session including the                        upon finding that it posed an imminent                 Convention.
                                                  pharmacology, toxicology and the                        hazard to the public safety. The U.S.                     Para-Methoxymethylamphetamine
                                                  claimed therapeutic applications. The                   Attorney General (the Attorney                         (PMMA) is a substituted amphetamine
                                                  Committee then deliberated about the                    General), though, may extend this                      of the phenethylamine class, as well as
                                                  content of the material presented. The                  temporary scheduling for up to 1 year.                 a structural analog of para-
                                                  Committee requested the Secretariat to                  The WHO ECDD met in November 2015                      methoxyamphetamine (PMA) which
                                                  begin collecting data towards a pre-                    and recommended that acetylfentanyl                    produces effects similar but not
                                                  review of cannabis, cannabis resin,                     be placed in Schedule I and in Schedule                identical to that of MDMA. The WHO
                                                  extracts and tinctures of cannabis at a                 IV of the 1961 Single Convention. On                   ECDD at its 37th meeting recommended
                                                  future meeting. Furthermore it                          July 17, 2015, acetylfentanyl was                      PMMA be placed in Schedule I of the
                                                  specifically requested the Secretariat to               temporarily placed in Schedule I of the                Psychotropic Convention. PMMA is not
                                                  place emphasis on any therapeutic                       CSA under the temporary scheduling                     currently controlled in the United States
                                                  advantages that they may have relative                  provision of section 201(h) of the CSA.                under the CSA. Additional controls will
                                                  to other existing therapeutics.                         These provisions provide the Attorney                  be necessary if PMMA is placed in
                                                     Update on ketamine:                                  General with the authority to                          Schedule I of the Psychotropic
                                                     Updates on ketamine were presented                   temporarily place a substance into                     Convention.
                                                  in which the levels and consequences of                 Schedule I of the CSA for 2 years,                        Para-Methyl-4-methylaminorex (4,4′-
                                                  its abuse, and new potential medical                    without regard to the requirements of 21               DMAR) is a derivative of the stimulant
                                                  applications were identified. Levels of                 U.S.C. 811(b), if he finds that such                   drug 4-methylaminorex and has been
                                                  ketamine abuse appeared to be                           action is necessary to avoid an                        involved in several deaths in the United
                                                  declining in many countries world-                      imminent hazard to the public safety. In               States. The WHO ECDD at its 37th
                                                  wide. Potential new therapeutic uses                    addition, if proceedings to control a                  meeting recommended 4,4′-DMAR be
                                                  were identified including depression                    substance are initiated under 21 U.S.C.                placed in Schedule II of the
                                                  and refractory status epilepticus.                      811(a)(1), the Attorney General may                    Psychotropic Convention. 4,4′-DMAR is
                                                  Evaluation of ketamine for treating                     extend the temporary scheduling for up                 not currently controlled in the United
                                                  depression is in Phase III studies.                     to 1 year (21 U.S.C. 811(h)(2)).                       States under the CSA. Additional
                                                  Ketamine is widely used as an                           Therefore, considering the previously                  controls will be necessary to fulfill U.S.
                                                  anaesthetic agent for human and                         mentioned time limitations of                          obligations if 4,4′-DMAR is controlled
                                                  veterinary use globally. Ketamine is the                temporary scheduling under section                     under Schedule II of the Psychotropic
                                                  anaesthetic agent of choice in low                      201(h) of the CSA, it will be necessary                Convention.
                                                  income countries and emergency                          to adopt non-temporary controls to                        a-Pyrrolidinovalerophenone (a-PVP
                                                  situations where there are limitations in               fulfill U.S. obligations if acetylfentanyl             or alpha-PVP) is a synthetic cathinone
                                                  trained medical personnel, anesthesia                   is controlled under Schedule I and                     structurally and pharmacologically
                                                  machines, and consistent sources of                     Schedule IV of the 1961 Single                         similar to amphetamine; 3,4-
                                                  electricity.                                            Convention.                                            methylenedioxymethamphetamine
                                                     Following its deliberations, the                        1-cyclohexyl-4-(1,2-diphenylethyl)-                 (MDMA); cathinone; and other related
                                                  Committee unanimously agreed that it                    piperazine (MT-45) is a synthetic opioid               substances. On March 7, 2014, a-PVP
                                                  found nothing in the updates, nor that                  with potent analgesic activity                         was temporarily placed into Schedule I
                                                  which was disclosed during its                          comparable to morphine despite being                   of the CSA for 2 years upon finding that
                                                  deliberations, that would give it reason                structurally unrelated to most other                   it posed an imminent hazard to the
                                                  to recommend a new pre-review or                        opioids. MT-45 use has been associated                 public safety. The Attorney General,
                                                  critical review of ketamine with a view                 with deaths in the United States and in                though, may extend this temporary
                                                  to potentially change its standing                      other countries. The WHO ECDD met in                   scheduling for up to 1 year. The WHO
                                                  recommendation of 2014 that ketamine                    November 2015 and recommended that                     ECDD at its 37th meeting recommended
                                                  should not be placed under                              MT-45 be placed in Schedule I of the                   that a-PVP be placed in Schedule II of
                                                  international control.                                  1961 Single Convention. MT-45 is not                   the Psychotropic Convention. Therefore,
                                                                                                          currently controlled in the United States              considering the previously mentioned
                                                  III. Discussion                                         under the CSA. As such, additional                     time limitations of temporary
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                                                     Although WHO has made specific                       controls will be necessary to fulfill U.S.             scheduling under section 201(h) of the
                                                  scheduling recommendations for each of                  obligations if MT-45 is controlled under               CSA, additional controls will be
                                                  the drug substances, the CND is not                     Schedule I of the 1961 Single                          necessary to fulfill U.S. obligations if a-
                                                  obliged to follow the WHO                               Convention.                                            PVP is controlled under Schedule II of
                                                  recommendations. Options available to                      Phenazepam belongs to a class of                    the Psychotropic Convention.
                                                  the CND for substances considered for                   substances known as benzodiazepines.                      Methoxetamine (MXE) is a synthetic
                                                  control under the Psychotropic                          Benzodiazepines produce central                        drug substance and belongs in the
                                                  Convention include the following: (1)                   nervous system depression and are                      arylcyclohexamine class. The WHO


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                                                  4310                          Federal Register / Vol. 81, No. 16 / Tuesday, January 26, 2016 / Notices

                                                  ECDD at its 37th meeting recommended                    ACTION:   Notice.                                      NDA 204822, held by Alcon
                                                  that MXE be placed in Schedule II of the                                                                       Laboratories, Inc., and initially
                                                  Psychotropic Convention. MXE is not                     SUMMARY:    The Food and Drug                          approved on May 15, 2014. IZBA is
                                                  currently controlled under the CSA in                   Administration (FDA or Agency) has                     indicated for the reduction of elevated
                                                  the United States. Additional controls                  determined that IZBA (travoprost                       intraocular pressure in patients with
                                                  will be necessary to fulfill U.S.                       ophthalmic solution), 0.003 percent,                   open-angle glaucoma or ocular
                                                  obligations if MXE is controlled under                  was not withdrawn from sale for reasons                hypertension.
                                                  Schedule II of the Psychotropic                         of safety or effectiveness. This                          In a letter dated September 4, 2015,
                                                  Convention.                                             determination will allow FDA to                        Alcon Laboratories, Inc. notified FDA
                                                     FDA, on behalf of the Secretary of                   approve abbreviated new drug                           that IZBA (travoprost ophthalmic
                                                  HHS, invites interested persons to                      applications (ANDAs) for travoprost                    solution), 0.003 percent, was
                                                  submit comments on the notifications                    ophthalmic solution/drops, 0.003                       discontinued. IZBA (travoprost
                                                  from the United Nations concerning                      percent, if all other legal and regulatory             ophthalmic solution), 0.003 percent, is
                                                  these drug substances. FDA, in                          requirements are met.                                  currently listed in the ‘‘Discontinued
                                                  cooperation with the National Institute                 FOR FURTHER INFORMATION CONTACT: Kate                  Drug Product List’’ section of the Orange
                                                  on Drug Abuse, will consider the                        Greenwood, Center for Drug Evaluation                  Book.
                                                  comments on behalf of HHS in                            and Research, Food and Drug                               Jonathan Goodman of Florek & Endres
                                                  evaluating the WHO scheduling                           Administration, 10903 New Hampshire                    PLLC submitted a citizen petition dated
                                                  recommendations. Then, under section                    Ave., Bldg. 51, Rm. 6286, Silver Spring,               August 20, 2015 (Docket No. FDA–
                                                  201(d)(2)(B) of the CSA, HHS will                       MD 20993–0002, 240–402–1748.                           2015–P–3053), under 21 CFR 10.30,
                                                  recommend to the Secretary of State                     SUPPLEMENTARY INFORMATION: In 1984,                    requesting that the Agency determine
                                                  what position the United States should                  Congress enacted the Drug Price                        whether IZBA (travoprost ophthalmic
                                                  take when voting on the                                 Competition and Patent Term                            solution), 0.003 percent, was withdrawn
                                                  recommendations for control of                          Restoration Act of 1984 (Pub. L. 98–417)               from sale for reasons of safety or
                                                  substances under the Psychotropic                       (the 1984 amendments), which                           effectiveness.
                                                  Convention at the CND meeting in                        authorized the approval of duplicate                      After considering the citizen petition
                                                  March 2015.                                             versions of drug products under an                     and reviewing Agency records and
                                                     Comments regarding the WHO                           ANDA procedure. ANDA applicants                        based on the information we have at this
                                                  recommendations for control of                          must, with certain exceptions, show that               time, FDA has determined under
                                                  acetylfentanyl and MT-45 under the                      the drug for which they are seeking                    § 314.161 that IZBA (travoprost
                                                  1961 Single Convention will also be                     approval contains the same active                      ophthalmic solution), 0.003 percent,
                                                  forwarded to the relevant Agencies for                  ingredient in the same strength and                    was not withdrawn for reasons of safety
                                                  consideration in developing the U.S.                    dosage form as the ‘‘listed drug,’’ which              or effectiveness. The petitioner has
                                                  position regarding narcotic substances                  is a version of the drug that was                      identified no data or other information
                                                  at the CND meeting.                                     previously approved. ANDA applicants                   suggesting that IZBA (travoprost
                                                                                                          do not have to repeat the clinical testing             ophthalmic solution), 0.003 percent,
                                                  IV. Opportunity for Public Meeting                                                                             was withdrawn for reasons of safety or
                                                                                                          otherwise necessary to gain approval of
                                                    FDA does not presently plan to hold                   a new drug application (NDA).                          effectiveness. We have carefully
                                                  a public meeting. If any person believes                   The 1984 amendments include what                    reviewed our files for records
                                                  that, in addition to written comments, a                is now section 505(j)(7) of the Federal                concerning the withdrawal of IZBA
                                                  public meeting would contribute to the                  Food, Drug, and Cosmetic Act (21 U.S.C.                (travoprost ophthalmic solution), 0.003
                                                  development of the U.S. position on the                 355(j)(7)), which requires FDA to                      percent, from sale. We have also
                                                  substances to be considered for control                 publish a list of all approved drugs.                  independently evaluated relevant
                                                  under the Psychotropic Convention, a                    FDA publishes this list as part of the                 literature and data for possible
                                                  request for a public meeting and the                    ‘‘Approved Drug Products With                          postmarketing adverse events. We have
                                                  reasons for such a request should be                    Therapeutic Equivalence Evaluations,’’                 found no information that would
                                                  sent to James R. Hunter (see FOR                        which is known generally as the                        indicate that this product was
                                                  FURTHER INFORMATION CONTACT) on or                      ‘‘Orange Book.’’ Under FDA regulations,                withdrawn from sale for reasons of
                                                  before February 5, 2016.                                drugs are removed from the list if the                 safety or effectiveness.
                                                    Dated: January 20, 2016.                              Agency withdraws or suspends                              Accordingly, the Agency will
                                                  Leslie Kux,                                             approval of the drug’s NDA or ANDA                     continue to list IZBA (travoprost
                                                                                                          for reasons of safety or effectiveness or              ophthalmic solution), 0.003 percent, in
                                                  Associate Commissioner for Policy.
                                                                                                          if FDA determines that the listed drug                 the ‘‘Discontinued Drug Product List’’
                                                  [FR Doc. 2016–01474 Filed 1–25–16; 8:45 am]
                                                                                                          was withdrawn from sale for reasons of                 section of the Orange Book. The
                                                  BILLING CODE 4164–01–P
                                                                                                          safety or effectiveness (21 CFR 314.162).              ‘‘Discontinued Drug Product List’’
                                                                                                             A person may petition the Agency to                 delineates, among other items, drug
                                                                                                          determine, or the Agency may                           products that have been discontinued
                                                  DEPARTMENT OF HEALTH AND
                                                                                                          determine on its own initiative, whether               from marketing for reasons other than
                                                  HUMAN SERVICES
                                                                                                          a listed drug was withdrawn from sale                  safety or effectiveness. ANDAs that refer
                                                  Food and Drug Administration                            for reasons of safety or effectiveness.                to IZBA (travoprost ophthalmic
                                                                                                          This determination may be made at any                  solution), 0.003 percent, may be
                                                  [Docket No. FDA–2015–P–3053]
mstockstill on DSK4VPTVN1PROD with NOTICES




                                                                                                          time after the drug has been withdrawn                 approved by the Agency as long as they
                                                                                                          from sale, but must be made prior to                   meet all other legal and regulatory
                                                  Determination That IZBA (Travoprost
                                                                                                          approving an ANDA that refers to the                   requirements for the approval of
                                                  Ophthalmic Solution), 0.003 Percent,
                                                                                                          listed drug (§ 314.161 (21 CFR 314.161)).              ANDAs. If FDA determines that labeling
                                                  Was Not Withdrawn From Sale for
                                                                                                          FDA may not approve an ANDA that                       for this drug product should be revised
                                                  Reasons of Safety or Effectiveness
                                                                                                          does not refer to a listed drug.                       to meet current standards, the Agency
                                                  AGENCY:    Food and Drug Administration,                   IZBA (travoprost ophthalmic                         will advise ANDA applicants to submit
                                                  HHS.                                                    solution), 0.003 percent, is the subject of            such labeling.


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Document Created: 2018-02-02 12:38:17
Document Modified: 2018-02-02 12:38:17
CategoryRegulatory Information
CollectionFederal Register
sudoc ClassAE 2.7:
GS 4.107:
AE 2.106:
PublisherOffice of the Federal Register, National Archives and Records Administration
SectionNotices
ActionNotice.
DatesSubmit either electronic or written comments by February 25, 2016. Submit requests for a public meeting on or before February 5, 2016. The short time period for the submission of comments and requests for a public meeting is needed to ensure that HHS may, in a timely fashion, carry out the required action and be responsive to the United Nations. For additional information, see section IV of this document.
ContactJames R. Hunter, Center for Drug Evaluation and Research, Controlled Substance Staff, Food and Drug Administration, 10903 New Hampshire Ave., Bldg. 51, Rm. 5150, Silver Spring, MD 20993-0002, 301-796-3156, [email protected]
FR Citation81 FR 4305 

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