[Federal Register Volume 90, Number 237 (Friday, December 12, 2025)]
[Notices]
[Pages 57766-57767]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2025-22676]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Food and Drug Administration

[Docket No. FDA-2025-N-4732]


Determination That ZANTAC (Ranitidine Hydrochloride) Injection, 
Equivalent to 25 Milligrams Base/Milliliter, Has Not Been Withdrawn 
From Sale for Reasons of Safety or Effectiveness

AGENCY: Food and Drug Administration, HHS.

ACTION: Notice.

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SUMMARY: The Food and Drug Administration (FDA or Agency) has 
determined that ZANTAC (ranitidine hydrochloride (HCl)) injection, 
equivalent to (EQ) 25 milligram (mg) base/milliliter (mL), has not been 
withdrawn from sale for reasons of safety or effectiveness to the 
extent that the drug can be manufactured or formulated in a manner that 
satisfies any applicable acceptable intake limit for nitrosamine 
impurities. This determination means that FDA will not begin procedures 
to withdraw approval of abbreviated new drug applications (ANDAs) that 
refer to this drug product, and it will allow FDA to continue to 
approve ANDAs that refer to the product as long as they meet relevant 
legal and regulatory requirements, including satisfying any applicable 
acceptable intake limit for nitrosamine impurities.

FOR FURTHER INFORMATION CONTACT: Robin Fastenau, Center for Drug 
Evaluation and Research, Food and Drug Administration, 10903 New 
Hampshire Ave., Bldg. 51, Rm. 6236, Silver Spring, MD 20993-0002, 240-
893-4962, [email protected].

SUPPLEMENTARY INFORMATION: Section 505(j) of the Federal Food, Drug, 
and Cosmetic Act (FD&C Act) (21 U.S.C. 355(j)) allows the submission of 
an ANDA to market a generic version of a previously approved drug 
product. To obtain approval, the ANDA applicant must show, among other 
things, that the generic drug product: (1) has the same active 
ingredient(s), dosage form, route of administration, strength, 
conditions of use, and (with certain exceptions) labeling as the listed 
drug, which is a version of the drug that was previously approved, and 
(2) is bioequivalent to the listed drug. ANDA applicants do not have to 
repeat the extensive clinical testing otherwise necessary to gain 
approval of a new drug application (NDA).
    Section 505(j)(7) of the FD&C Act requires FDA to publish a list of 
all approved drugs. FDA publishes this list as part of the ``Approved 
Drug Products With Therapeutic Equivalence Evaluations,'' which is 
known generally as the ``Orange Book.'' Under FDA regulations, drugs 
are removed from the list if the Agency withdraws or suspends approval 
of the drug's NDA or ANDA for reasons of safety or effectiveness or if 
FDA determines that the listed drug was withdrawn from sale for reasons 
of safety or effectiveness (21 CFR 314.162).
    A person may petition the Agency to determine, or the Agency may 
determine on its own initiative, whether a listed drug was withdrawn 
from sale for reasons of safety or effectiveness. This determination 
may be made at any time after the drug has been withdrawn from sale, 
but must be made prior to approving an ANDA that refers to the listed 
drug (Sec.  314.161 (21 CFR 314.161)). FDA may not approve an ANDA that 
does not refer to a listed drug.
    ZANTAC (ranitidine HCl) injection, EQ 25 mg base/mL, is the subject 
of NDA 019090, held by Pharmaceutical Associates, Inc. (PAI) Pharma, 
and initially approved on October 19, 1984. ZANTAC (ranitidine HCl) 
injection, EQ 25 mg base/mL is indicated in some hospitalized patients 
with pathological hypersecretory conditions or intractable duodenal 
ulcers, or as an alternative to the oral dosage form for short-term use 
in patients who are unable to take oral medication.
    On March 31, 2020, FDA requested that all manufacturers voluntarily 
withdraw their ranitidine products from the market because accumulated 
data showed levels of N-Nitrosodimethylamine (NDMA) above the 
acceptable daily intake limit in many ranitidine-containing 
products.\1\ This request applied to all ranitidine applicants, 
including the applicant for ZANTAC (ranitidine HCl) injection, EQ 25 mg 
base/mL, NDA 019090. ZANTAC (ranitidine HCl) injection, EQ 25 mg base/
mL, NDA 019090, was withdrawn from sale prior to March 31, 2020. ZANTAC 
(ranitidine HCl) injection, EQ 25 mg base/mL, is currently listed in 
the ``Discontinued Drug Product List'' section of the Orange Book.
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    \1\ Nitrosamine impurities in the drug supply are an important 
public health concern. As explained in the guidance for industry 
entitled ``Control of Nitrosamine Impurities in Human Drugs'' 
published September 2024 (available at https://www.fda.gov/media/141720/download) (at 4-5), ``Nitrosamine compounds are potent 
genotoxic agents in several animal species and some are classified 
as probable or possible human carcinogens by the International 
Agency for Research on Cancer. They are referred to as cohort of 
concern compounds in the International Council for Harmonisation of 
Technical Requirements for . . . Human Use (ICH) guidance for 
industry M7(R2) Assessment and Control of DNA Reactive (Mutagenic) 
Impurities in Pharmaceuticals to Limit Potential Carcinogenic Risk 
(July 2023).'' Many drug products have been found to contain levels 
of nitrosamines that are unacceptable or require further evaluation. 
FDA's current understanding is that nitrosamine levels in affected 
drug products have different causes and may be controlled using 
different strategies, including formulation design (i.e., adding 
antioxidants or adding pH adjusters that modify the microenvironment 
to base or neutral pH) and supplier qualification programs.
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    After reviewing Agency records and based on the information we have 
at this time, FDA has determined under Sec.  314.161 that ZANTAC 
(ranitidine HCl) injection, EQ 25 mg base/mL, has not been withdrawn 
for reasons of safety or effectiveness to the extent that the drug can 
be manufactured or formulated in a manner that satisfies any applicable 
acceptable intake limit for nitrosamine impurities.
    Accordingly, the Agency will continue to list ZANTAC (ranitidine 
HCl) injection, EQ 25 mg base/mL, in the ``Discontinued Drug Product 
List'' section of the Orange Book. The ``Discontinued Drug Product 
List'' delineates, among other items, drug products that have been 
discontinued from marketing for reasons other than safety or 
effectiveness. FDA will not begin procedures to withdraw approval of 
approved ANDAs that refer to this drug product. Additional ANDAs for 
this drug product may be approved by the Agency as long as they meet 
all other legal and regulatory requirements for the approval of ANDAs, 
including satisfying any applicable acceptable intake limit for 
nitrosamine impurities.

[[Page 57767]]

If FDA determines that labeling for this drug product should be revised 
to meet current standards, the Agency will advise ANDA applicants to 
submit such labeling.

Lowell M. Zeta,
Acting Deputy Commissioner for Policy, Legislation, and International 
Affairs.
[FR Doc. 2025-22676 Filed 12-11-25; 8:45 am]
BILLING CODE 4164-01-P