The FDA has requested labeling updates for all generic drugs referencing Accutane (isotretinoin) capsules as their reference listed drug (RLD). These updates are necessary because new scientific evidence exists that is not reflected in current labeling, and the approved labeling does not follow the current format that better serves healthcare providers.
About Isotretinoin
Isotretinoin is indicated for treating severe recalcitrant nodular acne in patients unresponsive to conventional therapy, including systemic antibiotics. The drug carries known serious risks and clinically significant adverse reactions. Due to the risk of embryo-fetal toxicity, isotretinoin products are subject to a Risk Evaluation and Mitigation Strategy (REMS) with requirements for prescribers, pharmacies, wholesalers, distributors, and patients.
Benefits of Updated Labeling
FDA determined that updating this labeling will benefit public health by improving clarity and supporting safer, more effective use. With improved labeling, healthcare providers will be better equipped to reduce, mitigate, monitor, and manage isotretinoin's known serious risks.
Key Updates Include:
- Conversion to Physician Labeling Rule (PLR) format to meet current legal and regulatory requirements
- Consistency with labeling for other drugs containing the same active ingredient or drug class
- Enhanced clarity in sections including WARNINGS AND PRECAUTIONS and DRUG INTERACTIONS
- Updates to adverse reaction descriptions (in combination with MODERN)
FDA's Authority Under MODERN
This is the first time FDA has used its authority under section 324 of the Consolidated Appropriations Act, 2021—"Modernizing the Labeling of Certain Generic Drugs" (referred to as MODERN). This provision added section 503D to the Federal Food, Drug, and Cosmetic Act and established a process for FDA to order labeling updates for generic drugs when their RLD application has been withdrawn for reasons other than safety or effectiveness.
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