[Federal Register Volume 65, Number 1 (Monday, January 3, 2000)]
[Rules and Regulations]
[Pages 7-9]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 99-34040]



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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Food and Drug Administration

21 CFR Parts 201, 341, and 369

[Docket Nos. 98N-0337, 96N-0420, 95N-0259, 90P-0201]
RIN 0910-AA79


Over-The-Counter Human Drugs; Labeling Requirements; Final Rule; 
Technical Amendment

AGENCY: Food and Drug Administration, HHS.

ACTION: Final rule; technical amendment.

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SUMMARY: The Food and Drug Administration (FDA) is amending the 
regulation that established a standardized format and standardized 
content requirements for the labeling of over-the-counter (OTC) drug 
products, and is amending several related OTC drug product labeling 
regulations. This amendment corrects and conforms several aspects of 
the new labeling requirements to other regulatory provisions and 
eliminates unnecessary text from the new labeling regulation.

DATES: This regulation is effective January 3, 2000. Submit written 
comments by March 18, 2000.

ADDRESSES: Submit written comments to the Dockets Management Branch 
(HFA-305), Food and Drug Administration, 5630 Fishers Lane, rm. 1061, 
Rockville, MD 20852.
FOR FURTHER INFORMATION CONTACT: Cazemiro R. Martin or Gerald M. 
Rachanow, Center for Drug Evaluation and Research (HFD-560), Food and 
Drug Administration, 5600 Fishers Lane, Rockville, MD 20857, 301-827-
2222.

SUPPLEMENTARY INFORMATION: 

I. Background

    In the Federal Register of March 17, 1999 (64 FR 13254), FDA 
published a final rule establishing a standardized format and 
standardized content requirements for the labeling of OTC drug 
products. The final rule is codified primarily in Sec. 201.66 (21 CFR 
201.66). The rule was effective on May 16, 1999 (64 FR 18571, April 15, 
1999), but is subject to a detailed implementation plan outlined in the 
final rule (64 FR 13254 at 13273 to 13274).

II. Technical Amendments

     1. Section 201.66(c) states that the information in paragraphs 
(c)(1) through (c)(8) must appear in the order listed. Section 
201.66(c)(5)(ii)(A) contains the ``Allergy alert'' warning, followed by 
Sec. 201.66(c)(5)(ii)(B), which contains the ``Reye's syndrome'' 
warning required under Sec. 201.314(h)(1) (21 CFR 201.314(h)(1)). The 
order in Sec. 201.66(c)(5)(ii) is not consistent with another FDA 
labeling provision.
    Under Sec. 201.314(h)(2), the Reye's syndrome warning must be the 
first warning listed under the ``Warnings'' heading. To conform 
Sec. 201.66(c)(5)(ii) to Sec. 201.314(h)(2), the agency is 
redesignating paragraph (c)(5)(ii)(A) as paragraph (c)(5)(ii)(B) and 
paragraph (c)(5)(ii)(B) as paragraph (c)(5)(ii)(A). In addition, the 
agency is correcting the word ``Reye'' to read ``Reye's'' in 
Sec. 201.314(h)(1).
     2. Section 201.66(c)(5)(iii) requires the use of the subheading 
``Do not use.'' Section 330.1(i)(38) (21 CFR 330.1(i)(38)) allows the 
phrases ``give to'' and ``use in'' to be used interchangeably. However, 
Sec. 201.66(f) does not allow the use of interchangeable terms in 
subheadings. This limitation on the use of interchangeable terms may 
cause some confusion when applied to certain monoamine oxidase 
inhibitor warnings.
    Specifically, the monoamine oxidase inhibitor (MAOI) warning in 
Secs. 341.74(c)(4)(vi) (21 CFR 341.74(c)(4)(vi)) and 
341.80(c)(1)(ii)(D) (21 CFR 341.80(c)(1)(ii)(D)) provides slightly 
different language for products labeled only for children under 12 
years of age. The warning states: ``Do not give to a child who * * *''. 
Similarly, the warning under the entry ``SODIUM GENTISATE'' in 
Sec. 369.21 (21 CFR 369.21) contains a warning that states ``Do not 
give to children * * *''. To allow these warnings to conform to the 
required subheadings in the new labeling format, the agency is revising 
these warnings to replace the words ``give to'' with the words ``use 
in.''
     3. Section 201.66(d)(3) of the final rule provides, in relevant 
part, that the title, headings, subheadings, and information in 
paragraphs (c)(1) through (c)(9) must not appear in reverse type, and 
that the required labeling must be all black or one dark color, printed 
on a white or other light, neutral color, contrasting background. 
Section 201.66(d)(3) also provides for the use of a single, 
alternative, contrasting dark color to highlight the Drug Facts title 
and headings.
    Section 201.66(d)(3) is based on the finding that color contrast 
between text and background is a significant factor affecting the 
legibility of OTC drug product labeling. Generally, high contrast 
between the color of the text and the color of the background can 
significantly improve legibility. If, however, the text blends into the 
background, consumers may have difficulty focusing on and reading the 
information.
    The final rule recognizes that black text on a white background is 
the most common way to achieve high contrast. However, to emphasize the 
importance of contrast and to provide more options than black on white 
labeling, the agency included the terms ``dark'' text and ``light'' 
background in Sec. 201.66(d)(3). After receiving several inquiries from 
manufacturers about the meaning of these terms, the agency has decided 
that the rule would be less confusing if the terms ``dark,'' ``light,'' 
and ``reverse type'' (i.e., ``light'' type on a ``dark'' background) 
were deleted.
    Section 201.66(d)(3) is intended to ensure adequate contrast 
between text and background. The terms ``dark'' and ``light'' may have 
added an unnecessary element of complexity to the rule. Aside from the 
difficulty in assigning a fixed meaning to these terms, the agency 
acknowledges that there may be combinations of light text on a dark 
background that, assuming high contrast, would be consistent with 
achieving readable OTC drug product labeling. (See, e.g., Ref. 2 at 62 
FR 9024 at 9049 (February 27, 1997), noting that in OTC drug labeling 
white text on a brown background may provide good, readable contrast.)
    To eliminate possible confusion, while keeping the emphasis in the 
final rule on achieving high contrast, the agency is removing the words 
``dark'' and ``light'' and the phrase ``shall not appear in reverse 
type'' from Sec. 201.66(d)(3). Thus, the amended version of the rule 
requires black on white text or, any other combination of a single 
color of text on a contrasting background. Generally, the agency 
expects the color contrast used in the Drug Facts labeling to be at 
least as high as that used in a product's principal display panel or 
other promotional labeling.
    These amendments institute minor changes and corrections to the 
rule and may provide greater flexibility in the implementation of the 
new OTC drug labeling requirements. Also, with respect to the third 
technical amendment, the agency notes that only few comments submitted 
during the rulemaking process addressed the issue of color contrast. Of 
these, most supported the need for using good contrast but did not take 
a substantive position on whether to require only dark on light 
labeling. As discussed above, the agency is retaining the contrast 
requirement. Therefore, the agency believes this amendment does not

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present a significant or controversial issue that warrants further 
opportunity for notice and comment rulemaking.
    For these reasons, the agency finds for good cause that notice and 
comment procedures are unnecessary in this instance and that these 
changes may go into effect immediately (5 U.S.C. 553(b) and (d) and 21 
CFR 10.40(c) and (e)). However, in accordance with 21 CFR 10.40(e)(1), 
the agency will accept comments on these amendments to determine 
whether they should be modified or revoked.

III. The Paperwork Reduction Act of 1995

    FDA analyzed all relevant information collections associated with 
this rule in the original final rule document (64 FR 13254 at 13274 to 
13276). These amendments do not impose any new requirements and, 
therefore, do not require any further analysis and are not subject to 
review by the Office of Management and Budget.

IV. Analysis of Impacts

     FDA provided a detailed analysis of impacts in the original final 
rule document (64 FR 13254 at 13276 through 13285). This technical 
amendment provides several clarifications and allows additional 
flexibility in the labeling requirements. Thus, no further analysis of 
impacts is necessary.

V. Environmental Impact

     The agency has determined under 21 CFR 25.30(h) that this action 
is of a type that does not individually or cumulatively have a 
significant effect on the human environment. Therefore, neither an 
environmental assessment nor an environmental impact statement is 
required.

List of Subjects

21 CFR Part 201

     Drugs, Labeling, Reporting and recordkeeping requirements.

21 CFR Part 341

     Labeling, Over-the-counter drugs.

21 CFR Part 369

     Labeling, Medical devices, Over-the-counter drugs.
    Therefore, under the Federal Food, Drug, and Cosmetic Act, the 
Public Health Service Act, and under authority delegated to the 
Commissioner of Food and Drugs, 21 CFR parts 201, 341, and 369 are 
amended as follows:

PART 201--LABELING

     1. The authority citation for 21 CFR part 201 continues to read as 
follows:

    Authority: 21 U.S.C. 321, 331, 351, 352, 353, 355, 358, 360, 
360b, 360gg-360ss, 371, 374, 379e; 42 U.S.C. 216, 241, 262, 264.

     2. Section 201.66 is amended by redesignating paragraphs 
(c)(5)(ii)(A) and (c)(5)(ii)(B) as paragraphs (c)(5)(ii)(B) and 
(c)(5)(ii)(A), respectively, and revising paragraph (d)(3) to read as 
follows:


Sec. 201.66  Format and content requirements for over-the-counter (OTC) 
drug product labeling.

* * * * *
     (d) * * *
     (3) The title, heading, subheadings, and information in paragraphs 
(c)(1) through (c)(9) of this section shall be legible and clearly 
presented, shall have at least 0.5-point leading (i.e., space between 
two lines of text), and shall not have letters that touch. The type 
style for the title, headings, subheadings, and all other required 
information described in paragraphs (c)(2) through (c)(9) of this 
section shall be any single, clear, easy-to-read type style, with no 
more than 39 characters per inch. The title and headings shall be in 
bold italic, and the subheadings shall be in bold type, except that the 
word ``(continued)'' in the title ``Drug Facts (continued)'' shall be 
regular type. The type shall be all black or one color printed on a 
white or other contrasting background, except that the title and the 
headings may be presented in a single, alternative, contrasting color 
unless otherwise provided in an approved drug application, OTC drug 
monograph (e.g., current requirements for bold print in Secs. 341.76 
and 341.80 of this chapter), or other OTC drug regulation (e.g., the 
requirement for a box and red letters in Sec. 201.308(c)(1)).
* * * * *
     3. Section 201.314 is amended by revising paragraph (h)(1) to read 
as follows:


Sec. 201.314  Labeling of drug preparations containing salicylates.

* * * * *
     (h)(1) The labeling of orally or rectally administered over-the-
counter aspirin and aspirin-containing drug products subject to this 
paragraph is required to prominently bear a warning. The warning shall 
be as follows: ``Children and teenagers should not use this medicine 
for chicken pox or flu symptoms before a doctor is consulted about 
Reye's syndrome, a rare but serious illness reported to be associated 
with aspirin.''
* * * * *

PART 341--COLD, COUGH, ALLERGY, BRONCHODILATOR, AND ANTIASTHMATIC 
DRUG PRODUCTS FOR OVER-THE-COUNTER HUMAN USE

     4. The authority citation for 21 CFR part 341 continues to read as 
follows:

    Authority: 21 U.S.C. 321, 351, 352, 353, 355, 360, 371.

    5. Section 341.74 is amended by revising paragraph (c)(4)(vi) to 
read as follows:


Sec. 341.74  Labeling of antitussive drug products.

* * * * *
     (c) * * *
     (4) * * *
     (vi) For products containing dextromethorphan or dextromethorphan 
hydrobromide as identified in Sec. 341.14(a)(3) and (a)(4) when labeled 
only for children under 12 years of age. Drug interaction precaution. 
``Do not use in a child who is taking a prescription monoamine oxidase 
inhibitor (MAOI) (certain drugs for depression, psychiatric, or 
emotional conditions, or Parkinson's disease), or for 2 weeks after 
stopping the MAOI drug. If you do not know if your child's prescription 
drug contains an MAOI, ask a doctor or pharmacist before giving this 
product.''
* * * * *
     6. Section 341.80 is amended by revising paragraph (c)(1)(ii)(D) 
to read as follows:


Sec. 341.80  Labeling of nasal decongestant drug products.

* * * * *
     (c) * * *
     (1) * * *
     (ii) * * *
     (D) Drug interaction precaution. ``Do not use in a child who is 
taking a prescription monoamine oxidase inhibitor (MAOI) (certain drugs 
for depression, psychiatric, or emotional conditions, or Parkinson's 
disease), or for 2 weeks after stopping the MAOI drug. If you do not 
know if your child's prescription drug contains an MAOI, ask a doctor 
or pharmacist before giving this product.''
* * * * *

PART 369--INTERPRETATIVE STATEMENTS RE WARNINGS ON DRUGS AND 
DEVICES FOR OVER-THE-COUNTER SALE

     7. The authority citation for 21 CFR part 369 continues to read as 
follows:


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    Authority: 21 U.S.C. 321, 331, 351, 352, 353, 355, 371.

     8. Section 369.21 is amended by revising the entry for ``SODIUM 
GENTISATE.'' to read as follows:


Sec. 369.21  Drugs; warning and caution statements required by 
regulations.

* * * * *
SODIUM GENTISATE. (See Secs. 201.314 and 310.301(a)(2) of this 
chapter.)
     Warning--Do not use in children under 6 years of age or use for 
prolonged period unless directed by physician.
    ``Keep out of reach of children. In case of overdose, get medical 
help or contact a Poison Control Center right away.''
    If offered for use in arthritis or rheumatism, in juxtaposition 
therewith, the statement:
    Caution--If pain persists for more than 10 days, or redness is 
present, or in conditions affecting children under 12 years of age, 
consult a physician immediately.
* * * * *

    Dated: December 22, 1999.
 Margaret M. Dotzel,
 Acting Associate Commissioner for Policy.
[FR Doc. 99-34040 Filed 12-30-99; 8:45 am]
BILLING CODE 4160-01-F