The document discusses the FDA drug approval process and lists some drugs that have been withdrawn by the FDA. It describes the multi-phase approval process including pre-clinical testing in animals, followed by three phases of clinical trials in humans. It can take over a decade for a drug to be approved. Several drugs are mentioned that were withdrawn from the market due to serious safety issues discovered after approval, such as thalidomide causing birth defects, phenformin causing fatal lactic acidosis, and rofecoxib increasing heart attack and stroke risk.

1. DRUG APPROVAL PROCESS
&
LIST OF DRUGS WITHDRAWN BY
FDA

3. FDA APPROVAL PROCESS
• FDA – food & drug administration is a
regulatory body which controls the
safety and efficacy of drugs before they
have been released in to the market
• In order for pharmaceutical and
biotech companies to market their
drugs and biologics, companies must
receive FDA approval, a rigorous,
expensive, and time consuming process
that can take over a decade to
complete.

4. •Of 5000 compounds discovered in the pre-clinical
stage, only about 5 will make it through the entire
FDA approval process
•Therefore, companies have to cover not only the cost
of successful development of a single drug, but of
many drugs that never make it to market

5. PHASES IN FDA DRUG
APPROVAL PROCESS

6. PRE-CLINICAL PHASE
•In the pre-clinical or drug discovery phase of the
approval process, researchers look for potential
new compounds to treat targeted diseases.
•Once a compound has been identified and refined
to a formula that can be tolerated by humans, its
toxicology is tested in animals and living tissue
•This process takes nearly three and half years

7. •. During this phase researchers look for:
•correct dosage level
•how frequently it should be administered
•the best delivery system (oral, topical, intravenous, etc.)
•short- and long-term survival of the animals
•After pre-clinical testing is completed, the company
then files an Investigational New Drug Application
(IND) with the FDA. Fast Track Designation is an
expedited review of a drug that is given to a company
whose drug or biologic makes both a product and a
marketing claim that addresses an unmet medical need.
It can be granted at any point after the FDA approves an
IND.

8. PHASE I
•If the FDA approves the IND, the experimental drug
then moves into Phase I human testing.
•In this phase, the drug is tested in a small number
(under 100) of healthy participants.
•Researchers look to see how well the drug is tolerated,
how it is processed by the human body, and the correct
dosing. This process takes a year.

9. PHASE II
•Once a compound is found to be well tolerated
in healthy individuals, it is then tested for
effectiveness for a targeted disease in a small
number of patients.
• In this phase 100-300 people are administered
the investigational drug to see if it actually works,
and to determine its short-term effects.
•This process takes about two years.

10. PHASE III
•Phase III is a large-scale study of the effectiveness and
side effects of the drug in a larger population, usually
ranging from 1000-3000 patients.
•If the drug is submitted to the FDA for approval, the
FDA will look at the Phase III data to determine if the
drug is safe and effective.
• Aside from testing the drug’s viability, the company
producing the drug also determines the logistics
involved in creating a large supply of the treatment.
• Phase III of the FDA approval process takes about three
years.

11. NEW DRUG APPLICATION
•If the drug proves to be safe and effective, the company then
files an NDA with the FDA. NDAs are typically 100,000 pages
long and include results of human and animal trials as well as
information on how the drug is manufactured.
• It usually takes the FDA 1-2 years to complete the review process
and approve a drug.
• However, there are cases when approval can be accelerated.
•At the time of application Priority Review can be granted to
drugs that treat an unmet medical need.
•Orphan Drug Status is granted to drugs that treat rare diseases,
or diseases that have no other available treatments.

12. PHASE IV
•Once a drug has received FDA approval it is then
marketed to the general population.
•Short- and long-term side effects continue to be
monitored a and results are submitted to the FDA.
• Companies will also look for additional indication for
the drug.
•In order for the drug to be approved for a new
indication, it must receive approval from the FDA.

14. LIST OF THE DRUGS WITHDRAWN BY FDA
DRUG: THALIDOMIDE
• it is an anti-nausea & sedative drug.
•Introduced in 1950 to be used as
sleeping pill.
•Sold from 1957-1962.
•Withdrawn because of its teratogen
effects and caused many birth defects.

15. DRUG: phenformin
•It is an anti-hyperglycemic drug
•It belongs to biguanid class
•It was withdrawn from market in 1970
because of its high risk of LACTIC ACIDOSIS
and was found to be fatal in 50% of the cases.

16. DRUG: ZIMELIDINE
•It is an anti-depressent drug .
•It is withdrawn because of its
adverse effect as GULLIAN-
BARRE SYNDROME
sometimes Landry's paralysis
•Guillain–Barré–Strohl
syndrome, is an
acute polyneuropathy, a disorder
affecting the peripheral nervous
system

17. Ascending paralysis, weakness beginning in
the feet and hands and migrating towards the
trunk.
LANDRY PARALYSIS

18. DRUG: CERIVASTATIN
•It belongs to the class statins.
•It is used to lower the cholesterol to prevent
cardiovascular diseases
•It is withdrawn because of its adverse effects as
RHABDOMYOLYSIS

19. •Rhabdomyolysis is a condition in which
damaged skeletal muscle tissue breaks down rapidly.
• Breakdown products of damaged muscle cells are
released into the bloodstream; some of these, such as
the protein myoglobin, are harmful to the kidneys and
may lead to kidney failure.
• The severity of the symptoms, which may
include muscle pains,vomiting and confusion, depends
on the extent of muscle damage and whether kidney
failure develops. The muscle damage may be caused by
physical factors (e.g. crush injury, strenuous
exercise), medications, drug abuse, and infections.
Some people have a hereditary muscle condition that
increases the risk of rhabdomyolysis.

20. DRUG: ROFECOXIB
• It is a non-steroidal anti-inflammatory drug.
•It was marketed to treat OSTEOARTHRITIS,
ACUTE PAIN CONDITIONS, &
DYSMENORRHEA.
• It is withdrawn from market due to its
concerns of heart attack & stoke on long term
and high doses

21. REFERENCE
WWW.USFDA.COM