Paclitaxel_--FDA指南
超药品说明书用药目录(详细)
泊沙康唑
混悬液
400mg
毛霉菌
200mg，每日4次
1.美国FDA未批准泊沙康唑用于毛霉菌
2.中华医学会结核和呼吸学会《抗菌药物超说明书用法专家共识》
Class Ⅱa
Class Ⅱb
Category B
32
布洛芬
胶囊
300mg
骨关节炎
1200-3200mg/日，分3-4次服用
，一般使用不超过10天
美国FDA已批准用于治疗13-17岁儿童/青少年的精神分裂症
Class ⅡaClass Ⅱb来自Category B12
阿司匹林
拜阿司匹灵
肠溶片
100mg
预防子痫前期
对存在子痫前期复发风险和子痫前期高危因素者，在妊娠早中期（妊娠12～16周）开始服用小剂量阿司匹林（50-100mg），可维持到孕28周。
埃索美拉唑钠
耐信
注射液
40mg
急性上消化道出血
首剂量80mg iv，续以8mg/h iv 维持3～6天
1.美国FDA未批准用于急性上消化道出血
2.中华医学会内科学会《急性非静脉曲张性上消化道出血诊治指南（2009）》
Class I
Class Ⅱb
Category B
14
艾司西酞普兰
来士普
片剂
10mg
Class Ⅱa
Class Ⅱb
Category B
21
奥沙利铂
草酸铂
粉针
50mg
结肠癌，辅助性II期，与5-氟尿嘧啶/亚叶酸组合
85mg/m2
1.FDA说明书-超适应症用法
2.结直肠癌NCCN指南2016 version2
Class Ⅱa
紫杉醇——现代天然药物研究开发的典范
1994年，中国医学科学院药物研究所有关专家会同中国 科学院的专家，在一次保护野生红豆杉资源专题会议上 向林业部建议我国亦应颁布保护这种野生资源的法令。 1995年野生红豆杉被列为国家一级保护植物，相当于 “植物中的大熊猫”，严禁砍伐。
•
•
•
内生真菌发酵生产紫杉醇的优势
(1) 生产的可重复性，在工业上可用发酵罐大规模进行 生产，内生真菌生长迅速，易于培养，易于缩短生 产周期，可满足市场的需求，降低紫杉醇的价格； (2) 微生物的发酵生产不需要特别的技术； (3) 微生物育种和选育速度会明显高于植物细胞株； (4) 在药厂利用微生物规模化发酵生产的技术比较成熟， 微生物发酵法生产紫杉醇的转产风险明显小于细胞 培养法与化学合成法； (5) 生物多样性丰富：到目前为止，人们已发现了20多 个属内生真菌可以产生紫杉醇，其寄主也不仅限于 红豆杉属植物，从而提供了丰富的研究对象。
O
O O OH
HO
A
B C
反应步骤多达数十步 大量使用手性试剂 反应条件极难控制 制备成本昂贵 具有重要的理论意义 不适合大规模工业生产
HO BzO
H
D
AcO O
2. 化学半合成
• 母核：红豆杉针叶中提取BaccatinIII（R=Ac）和 10-去乙酰基巴卡亭III（10-DAB，R=H） RO • 侧链：化学合成 18
英文名：Paclitaxel, Taxol® 分子式：C47H51NO4 二萜类化合物 M.C. Wani et al. The Isolation and Structure of Taxol, a Novel Antileukemic and Antitumor Agent from Taxus breoifolia. Journal of the American Chemical Society 1971, 93, 2325.
美国FDA《联邦规章典集》(CFR)第21篇目录中文版
美国FDA《联邦规章典集》（CFR）第21篇目录中文版发布时间：2010-5-11 13:44:12 发布方：奥咨达医疗器械咨询美国《联邦规章典集》（CFR）第21篇“食品与药品”总目概述：美国《联邦规章典集》（Code of Federal Regulations，CFR）第21篇“食品与药品”（Title 21―Food and Drugs）共有9卷（Volume）、3章（Chapter）、1499部（Parts）。
其中：第1―8卷第1章第1―1299部，为健康与人类服务部食品与药品管理局（Food and Drug Administration，Department of Health and Human Services）的规章；第9卷第2章第1300―1399部，为司法部毒品强制执行局（Drug Enforcement Administration，Department of Justice）的规章；第9卷第3章第1400―1499部，为毒品控制政策办公室（Office of National Drug Control Policy）的规章。
第21篇“食品与药品”（Tit le 21―Food and Drugs）的概况卷（Volume）章（Chapter）部（Parts）规制机关（Regulatory Entity）1 Ⅰ1-99 健康与人类服务部食品与药品管理局（FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES）2 100-1693 170-1994 200-2995 300-4996 500-5997 600-7998 800-12999 Ⅱ1300-1399 司法部毒品强制执行局（Drug Enforcement Administration，Department of Justice）Ⅲ1400-1499 毒品控制政策办公室（Office of National Drug Control Policy）第21篇“食品与药品”（Title 21―Food and Drugs）的章、部目录部(Part) 中译文原英文第Ⅰ章―健康与人类服务部食品与药品管理局（CHAPTER Ⅰ―FOOD AND DRUG ADMINIST RATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES）第A分章―总则（SUBCHAPTER A―GENERAL）1 一般强制执行规章GENERAL ENFORCEMENT REGULATIONS2 一般行政规则与决定GENERAL ADMINISTRATIVE RULINGS AND DECISIONS3 产品管辖权PRODUCT JURISDICTION5 组织ORGANIZATION7 强制执行政策ENFORCEMENT POLICY10 行政规范与程序ADMINISTRATIVE PRACTICES AND PROCEDURES11 电子化记录；电子化签名ELECTRONIC RECORDS; ELECTRONIC SIGNATURES12 正式证据的公众听证FORMAL EVIDENTIARY PUBLIC HEARING13 在公众质询委员会前的公众听证PUBLIC HEARING BEFORE A PUBLIC BOARD OF INQUIRY14 在公众咨询委员会前的公众听证PUBLIC HEARING BEFORE A PUBLIC ADVISORY COMMITTEE15 在FDA局长前的公众听证PUBLIC HEARING BEFORE THE COMMISSIONER16 在FDA前的规制性听证REGULATORY HEARING BEFORE THE FOOD AND DRUG ADMINISTRATION17 行政罚款听证CIVIL MONEY PENALTIES HEARINGS19 行为标准与利益冲突STANDARDS OF CONDUCT AND CONFLICTS OF INTEREST20 公共信息PUBLIC INFORMATION21 隐私保护PROTECTION OF PRIVACY25 环境影响考虑ENVIRONMENTAL IMPACT CONSIDERATIONS26 药品良好制造规范报告、医疗器械质量体系核查报告以及某些医疗器械产品评价报告的互认：美国与欧共体MUTUAL RECOGNITION OF PHARMACEUTICAL GOOD MANUFACTURING PRACTICE REPORTS, MEDICAL DEVICE QUALITY SYSTEM AUDIT REPORTS, AND CERTAIN MEDICAL DEVICE PRODUCT EVALUATION REPORTS: UNITED STATES AND THE EUROPEAN COMMUNITY50 人类受试者的保护PROTECTION OF HUMAN SUBJECTS54 临床试验者的财务公开FINANCIAL DISCLOSURE BY CLINICAL INVESTIGATORS56 机构审查委员会INSTITUTIONAL REVIEW BOARDS58 对非临床实验室研究的良好实验室规范GOOD LABORATORY PRACTICE FOR NONCLINICAL LABORATORY STUDIES60 专利期恢复PATENT TERM RESTORATION70 色素添加剂COLOR ADDITIVES71 色素添加剂申请COLOR ADDITIVE PETITIONS73 免除认证的色素添加剂的列表LISTING OF COLOR ADDITIVES EXEMPT FROM CERTIFICATION74 适用认证的色素添加剂的列表LISTING OF COLOR ADDITIVES SUBJECT TO CERTIFICATION80 色素添加剂认证COLOR ADDITIVE CERTIFICATION81 用于食品、药品和化妆品的临时性色素添加剂的一般规范和一般限制GENERAL SPECIFICATIONS AND GENERAL RESTRICTIONS FOR PROVISIONAL COLOR ADDITIVES FOR USE IN FOODS, DRUGS, AND COSMETICS82 经认证的临时性列表的色素和规范的列表LISTING OF CERTIFIED PROVISIONALLY LISTED COLORS AND SPECIFICATIONS83-98 [预留的] [Reserved]99 已上市的药品、生物制品和器械的未经批准的/新的用途的信息的发布DISSEMINATION OF INFORMATION ON UNAPPROVED/NEW USES FOR MARKETED DRUGS, BIOLOGICS, AND DEVICES第B分章―用于人类消费的食品（SUBCHAPTER B―FOOD FOR HUMAN CONSUMPTION）100 总则GENERAL101 食品标识FOOD LABELING102 非标准化食品的普通的或者通常的名称COMMON OR USUAL NAME FOR NONSTANDARDIZED FOODS104 食品的营养质量指南NUTRITIONAL QUALITY GUIDELINES FOR FOODS105 特殊膳食用途的食品FOODS FOR SPECIAL DIETARY USE106 婴儿配方母乳替代食品质量控制程序INFANT FORMULA QUALITY CONTROL PROCEDURES107 婴儿配方母乳替代食品INFANT FORMULA108 紧急许可控制EMERGENCY PERMIT CONTROL109 在人类食品与食品-包装材料中的不可避免的污染物UNAVOIDABLE CONTAMINANTS IN FOOD FOR HUMAN CONSUMPTION AND FOOD-PACKAGING MATERIAL110 在制造、包装或者保存人类食品中的现行良好制造规范CURRENT GOOD MANUFACTURING PRACTICE IN MANUFACTURING, PACKING, OR HOLDING HUMAN FOOD113 装在密封容器中的热加工低酸食品THERMALLY PROCESSED LOW-ACID FOODS PACKAGED IN HERMETICALLY SEALED CONTAINERS114 酸化食品ACIDIFIED FOODS115 带壳蛋SHELL EGGS119 存在显著或者不合理风险的膳食补充剂DIETARY SUPPLEMENTS THAT PRESENT A SIGNIFICANT OR UNREASONABLE RISK120 危害分析与关键控制点（HACCP）体系HAZARD ANALYSIS AND CRITICAL CONTROL POINT (HACCP) SYSTEMS123 鱼与渔业产品FISH AND FISHERY PRODUCTS129 饮用水加工与装瓶PROCESSING AND BOTTLING OF BOTTLED DRINKING WATER130 食品标准：总则FOOD STANDARDS: GENERAL131 乳与奶油MILK AND CREAM133 乳酪与相关乳酪产品CHEESES AND RELATED CHEESE PRODUCTS135 冷冻点心FROZEN DESSERTS136 烘焙产品BAKERY PRODUCTS137 谷物粉与相关产品CEREAL FLOURS AND RELATED PRODUCTS139 通心粉与面条产品MACARONI AND NOODLE PRODUCTS145 罐装水果CANNED FRUITS146 罐装水果汁CANNED FRUIT JUICES150 水果黄油、果冻、防腐剂以及相关产品FRUIT BUTTERS, JELLIES, PRESERVES, AND RELATED PRODUCTS152 水果馅饼FRUIT PIES155 罐装蔬菜CANNED VEGETABLES156 蔬菜汁VEGETABLE JUICES158 冷冻蔬菜FROZEN VEGETABLES160 蛋与蛋制品EGGS AND EGG PRODUCTS161 鱼与有壳的水生动物FISH AND SHELLFISH163 可可制品CACAO PRODUCTS164 树坚果与花生制品TREE NUT AND PEANUT PRODUCTS165 饮料BEVERAGES166 人造黄油MARGARINE168 增甜剂与餐桌糖浆SWEETENERS AND TABLE SIRUPS169 食品敷料与调味料FOOD DRESSINGS AND FLAVORINGS170 食品添加剂FOOD ADDITIVES171 食品添加剂申请FOOD ADDITIVE PETITIONS172 允许直接加入用于人类消费食品的食品添加剂FOOD ADDITIVES PERMITTED FOR DIRECT ADDITION TO FOOD FOR HUMAN CONSUMPTION173 在用于人类消费的食品中允许的次直接的食品添加剂SECONDARY DIRECT FOOD ADDITIVES PERMITTED IN FOOD FOR HUMAN CONSUMPTION174 间接食品添加剂：总则INDIRECT FOOD ADDITIVES: GENERAL175 间接食品添加剂：胶粘剂与涂层的组分INDIRECT FOOD ADDITIVES: ADHESIVES AND COMPONENTS OF COATINGS176 间接食品添加剂：纸与纸板组分INDIRECT FOOD ADDITIVES: PAPER AND PAPERBOARD COMPONENTS177 间接食品添加剂：聚合体INDIRECT FOOD ADDITIVES: POLYMERS178 间接食品添加剂：辅剂、生产助剂和消毒剂INDIRECT FOOD ADDITIVES: ADJUVANTS, PRODUCTION AIDS, AND SANITIZERS 179 在食品生产、加工和处理中的辐照IRRADIATION IN THE PRODUCTION, PROCESSING AND HANDLING OF FOOD180 在额外试验期间临时在食品或者在与食品接触中被允许的食品添加剂FOOD ADDITIVES PERMITTED IN FOOD OR IN CONTACT WITH FOOD ON AN INTERIM BASIS PENDING ADDITIONAL STUDY181 先前核准的食品配料PRIOR-SANCTIONED FOOD INGREDIENTS182 一般认为安全的物质SUBSTANCES GENERALLY RECOGNIZED AS SAFE184 被确认为一般认为安全的直接食品物质DIRECT FOOD SUBSTANCES AFFIRMED AS GENERALLY RECOGNIZED AS SAFE 186 被确认为一般认为安全的间接食品物质INDIRECT FOOD SUBSTANCES AFFIRMED AS GENERALLY RECOGNIZED AS SAFE 189 禁止用于人类食品的物质SUBSTANCES PROHIBITED FROM USE IN HUMAN FOOD190 膳食补充剂DIETARY SUPPLEMENTS191-199 [预留的] [Reserved]第C分章―药品：总则（SUBCHAPTER C―DRUGS: GENERAL）200 总则GENERAL201 标识LABELING202 处方药广告PRESCRIPTION DRUG ADVERTISING203 处方药销售PRESCRIPTION DRUG MARKETING205 对批发处方药销售商颁发州执照的指南GUIDELINES FOR STATE LICENSING OF WHOLESALE PRESCRIPTION DRUG DISTRIBUTORS206 人用固体口服剂型药品的印码IMPRINTING OF SOLID ORAL DOSAGE FORM DRUG PRODUCTS FOR HUMAN USE207 药品生产者的登记与商业销售的药品的列表REGISTRATION OF PRODUCERS OF DRUGS AND LISTING OF DRUGS IN COMMERCIAL DISTRIBUTION208 处方药的药物治疗指导MEDICATION GUIDES FOR PRESCRIPTION DRUG PRODUCTS210 制造、加工、包装或者保存药品的现行良好制造规范；总则CURRENT GOOD MANUFACTURING PRACTICE IN MANUFACTURING, PROCESSING, PACKING, OR HOLDING OF DRUGS; GENERAL211 对完成的药品的现行良好制造规范CURRENT GOOD MANUFACTURING PRACTICE FOR FINISHED PHARMACEUTICALS216 药房配药PHARMACY COMPOUNDING225 对含药饲料的现行良好制造规范CURRENT GOOD MANUFACTURING PRACTICE FOR MEDICATED FEEDS226 对A型含药物品的现行良好制造规范CURRENT GOOD MANUFACTURING PRACTICE FOR TYPE A MEDICATED ARTICLES 250 对特殊人用药品的特殊要求SPECIAL REQUIREMENTS FOR SPECIFIC HUMAN DRUGS290 管制的药品CONTROLLED DRUGS299 药品；正式名称与已确定的名称DRUGS; OFFICIAL NAMES AND ESTABLISHED NAMES第D分章―人用药品（SUBCHAPTER D―DRUGS FOR HUMAN USE）300 总则GENERAL310 新药NEW DRUGS312 试验用新药申请INVESTIGATIONAL NEW DRUG APPLICATION314 为FDA批准上市新药的申请APPLICATIONS FOR FDA APPROVAL TO MARKET A NEW DRUG315 诊断用放射性药品DIAGNOSTIC RADIOPHARMACEUTICALS316 罕见病药ORPHAN DRUGS320 生物利用度与生物等效性要求BIOAVAILABILITY AND BIOEQUIVALENCE REQUIREMENTS328 含有酒精的预期用于口部摄入的非处方药品OVER-THE-COUNTER DRUG PRODUCTS INTENDED FOR ORAL INGESTION THAT CONTAIN ALCOHOL330 一般认为安全与有效以及不错误标识的非处方人用药品OVER-THE-COUNTER (OTC) HUMAN DRUGS WHICH ARE GENERALLY RECOGNIZED AS SAFE AND EFFECTIVE AND NOT MISBRANDED331 用于非处方的人类使用的抗酸产品ANTACID PRODUCTS FOR OVER-THE-COUNTER (OTC) HUMAN USE332 用于非处方的人类使用的抗胃肠气胀产品ANTIFLATULENT PRODUCTS FOR OVER-THE-COUNTER HUMAN USE333 用于非处方的人类使用的局部抗菌药品TOPICAL ANTIMICROBIAL DRUG PRODUCTS FOR OVER-THE-COUNTER HUMAN USE335 用于非处方的人类使用的止泻药品ANTIDIARRHEAL DRUG PRODUCTS FOR OVER-THE-COUNTER HUMAN USE336 用于非处方的人类使用的止吐药品ANTIEMETIC DRUG PRODUCTS FOR OVER-THE-COUNTER HUMAN USE338 用于非处方的人类使用的帮助夜间睡眠的药品NIGHTTIME SLEEP-AID DRUG PRODUCTS FOR OVER-THE-COUNTER HUMAN USE340 用于非处方的人类使用的兴奋药品STIMULANT DRUG PRODUCTS FOR OVER-THE-COUNTER HUMAN USE341 用于非处方的人类使用的感冒、咳嗽、过敏症药、支气管扩张以及平喘药品COLD, COUGH, ALLERGY, BRONCHODILATOR, AND ANTIASTHMATIC DRUG PRODUCTS FOR OVER-THE-COUNTER HUMAN USE343 用于非处方的人类使用的内服的止痛、退热以及抗风湿药品INTERNAL ANALGESIC, ANTIPYRETIC, AND ANTIRHEUMATIC DRUG PRODUCTS FOR OVER-THE-COUNTER HUMAN USE344 用于非处方的人类使用的局部的耳部药品TOPICAL OTIC DRUG PRODUCTS FOR OVER-THE-COUNTER HUMAN USE346 用于非处方的人类使用的肛肠药品ANORECTAL DRUG PRODUCTS FOR OVER-THE-COUNTER HUMAN USE347 用于非处方的人类使用的皮肤保护药品SKIN PROTECTANT DRUG PRODUCTS FOR OVER-THE-COUNTER HUMAN USE348 用于非处方的人类使用的外部的止痛药品EXTERNAL ANALGESIC DRUG PRODUCTS FOR OVER-THE-COUNTER HUMAN USE349 用于非处方的人类使用的眼科药品OPHTHALMIC DRUG PRODUCTS FOR OVER-THE-COUNTER HUMAN USE350 用于非处方的人类使用的止汗药品ANTIPERSPIRANT DRUG PRODUCTS FOR OVER-THE-COUNTER HUMAN USE352 用于非处方的人类使用的遮光药品SUNSCREEN DRUG PRODUCTS FOR OVER-THE-COUNTER HUMAN USE [STAYED INDEFINITELY]355 用于非处方的人类使用的防龋药品ANTICARIES DRUG PRODUCTS FOR OVER-THE-COUNTER HUMAN USE357 用于非处方的人类使用的其他内服药品MISCELLANEOUS INTERNAL DRUG PRODUCTS FOR OVER-THE-COUNTER HUMAN USE358 用于非处方的人类使用的其他外用药品MISCELLANEOUS EXTERNAL DRUG PRODUCTS FOR OVER-THE-COUNTER HUMAN USE361 一般认为安全与有效以及不错误标识的处方人用药品：用于研究的药品PRESCRIPTION DRUGS FOR HUMAN USE GENERALLYRECOGNIZED AS SAFE AND EFFECTIVE AND NOT MISBRANDED: DRUGS USED IN RESEARCH369 在用于非处方销售的药品与器械上关于警告的解释性声明INTERPRETATIVE STATEMENTS RE WARNINGS ON DRUGS AND DEVICES FOR OVER-THE-COUNTER SALE370-499 [预留的] [Reserved]第E分章―动物药品、饮料和相关产品（SUB CHAPTER E―ANIMAL DRUGS, FEEDS, AND RELATED PRODUCTS）500 总则GENERAL501 动物食品标识ANIMAL FOOD LABELING502 非标准化的动物食品的普通的或通常的名称COMMON OR USUAL NAMES FOR NONSTANDARDIZED ANIMAL FOODS509 在动物食品与食品-包装材料中的不可避免的污染物UNAVOIDABLE CONTAMINANTS IN ANIMAL FOOD AND FOOD-PACKAGING MATERIAL510 新动物药NEW ANIMAL DRUGS511 作为试验用途的新动物药NEW ANIMAL DRUGS FOR INVESTIGATIONAL USE514 新动物药申请NEW ANIMAL DRUG APPLICATIONS515 含药饲料厂执照MEDICATED FEED MILL LICENSE520 口服剂型的新动物药ORAL DOSAGE FORM NEW ANIMAL DRUGS522 植入或者注射剂型的新动物药IMPLANTATION OR INJECTABLE DOSAGE FORM NEW ANIMAL DRUGS524 眼科和局部剂型的新动物药OPHTHALMIC AND TOPICAL DOSAGE FORM NEW ANIMAL DRUGS526 乳房内的剂型INTRAMAMMARY DOSAGE FORMS529 某些其他剂型的新动物药CERTAIN OTHER DOSAGE FORM NEW ANIMAL DRUGS530 在动物中的特别标签药品使用EXTRALABEL DRUG USE IN ANIMALS556 在食品中新动物药残留的容许量TOLERANCES FOR RESIDUES OF NEW ANIMAL DRUGS IN FOOD558 用于动物饲料的新动物药NEW ANIMAL DRUGS FOR USE IN ANIMAL FEEDS564 [预留的] [Reserved]570 食品添加剂FOOD ADDITIVES571 食品添加剂申请FOOD ADDITIVE PETITIONS573 在动物饲料与饮用水中允许的食品添加剂FOOD ADDITIVES PERMITTED IN FEED AND DRINKING WATER OF ANIMALS579 在动物饲料和宠物食品的生产、加工和处理中的辐照IRRADIATION IN THE PRODUCTION, PROCESSING, AND HANDLING OF ANIMAL FEED AND PET FOOD582 一般认为安全的物质SUBSTANCES GENERALLY RECOGNIZED AS SAFE584 在动物饲料与饮用水中被确认为一般认为安全的食品物质FOOD SUBSTANCES AFFIRMED AS GENERALLY RECOGNIZED AS SAFE IN FEED AND DRINKING WATER OF ANIMALS589 禁止用于动物食品或者饲料的物质SUBSTANCES PROHIBITED FROM USE IN ANIMAL FOOD OR FEED590-599 [预留的] [Reserved]第F分章―生物制品（SUB CHAPTER F―BIOLOGICS）600 生物制品：总则BIOLOGICAL PRODUCTS: GENERAL601 颁发执照LICENSING606 对血液与血液组分的现行良好制造规范CURRENT GOOD MANUFACTURING PRACTICE FOR BLOOD AND BLOOD COMPONENTS607 对人类血液与血液制品的制造者的机构登记与产品列表ESTABLISHMENT REGISTRATION AND PRODUCT LISTING FOR MANUFACTURERS OF HUMAN BLOOD AND BLOOD PRODUCTS610 普通生物制品标准GENERAL BIOLOGICAL PRODUCTS STANDARDS630 对血液、血液组分和血液衍生物的一般要求GENERAL REQUIREMENTS FOR BLOOD, BLOOD COMPONENTS, AND BLOOD DERIVATIVES640 对人类血液和血液制品的附加标准ADDITIONAL STANDARDS FOR HUMAN BLOOD AND BLOOD PRODUCTS660 对用于实验室检测的诊断物质的附加标准ADDITIONAL STANDARDS FOR DIAGNOSTIC SUBSTANCES FOR LABORATORY TESTS680 对其他产品的附加标准ADDITIONAL STANDARDS FOR MISCELLANEOUS PRODUCTS第G分章―化妆品（SUBCHAPTER G―COSMETICS）700 总则GENERAL701 化妆品标识COSMETIC LABELING710 化妆品机构的自愿登记VOLUNTARY REGISTRATION OF COSMETIC PRODUCT ESTABLISHMENTS720 化妆品配料构成声明的自愿存档VOLUNTARY FILING OF COSMETIC PRODUCT INGREDIENT COMPOSITION STATEMENTS740 化妆品警告声明COSMETIC PRODUCT WARNING STATEMENTS741-799 [预留的] [Reserved]第H分章―医疗器械（SUBCHAPTER H―MEDICAL DEVICES）800 总则GENERAL801 标识LABELING803 医疗器械报告MEDICAL DEVICE REPORTING806 医疗器械；改正与移动的报告MEDICAL DEVICES; REPORTS OF CORRECTIONS AND REMOVALS807 对器械的制造者与首次进口者的机构登记与器械列表ESTABLISHMENT REGISTRATION AND DEVICE LISTING FOR MANUFACTURERS AND INITIAL IMPORTERS OF DEVICES808 对州和地方医疗器械要求的联邦优先权的豁免EXEMPTIONS FROM FEDERAL PREEMPTION OF STATE AND LOCAL MEDICAL DEVICE REQUIREMENTS809 人用体外诊断产品IN VITRO DIAGNOSTIC PRODUCTS FOR HUMAN USE810 医疗器械召回权MEDICAL DEVICE RECALL AUTHORITY812 试验用器械豁免INVESTIGATIONAL DEVICE EXEMPTIONS813 [预留的] [Reserved]814 医疗器械的上市前批准PREMARKET APPROVAL OF MEDICAL DEVICES820 质量体系规章QUALITY SYSTEM REGULATION821 医疗器械跟踪要求MEDICAL DEVICE TRACKING REQUIREMENTS822 上市后监视POSTMARKET SURVEILLANCE860 医疗器械分类程序MEDICAL DEVICE CLASSIFICATION PROCEDURES861 性能标准制定程序PROCEDURES FOR PERFORMANCE STANDARDS DEVELOPMENT862 临床化学与临床毒理学器械CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES864 血液学与病理学器械HEMATOLOGY AND PATHOLOGY DEVICES866 免疫学与微生物学器械IMMUNOLOGY AND MICROBIOLOGY DEVICES868 麻醉学器械ANESTHESIOLOGY DEVICES870 心血管器械CARDIOVASCULAR DEVICES872 牙科器械DENTAL DEVICES874 耳、鼻和咽器械EAR, NOSE, AND THROAT DEVICES876 胃肠病学-泌尿学器械GASTROENTEROLOGY-UROLOGY DEVICES878 普通与整形外科器械GENERAL AND PLASTIC SURGERY DEVICES880 普通医院与个人使用器械GENERAL HOSPITAL AND PERSONAL USE DEVICES882 神经学器械NEUROLOGICAL DEVICES884 产科与妇科学器械OBSTETRICAL AND GYNECOLOGICAL DEVICES886 眼科器械OPHTHALMIC DEVICES888 矫形外科器械ORTHOPEDIC DEVICES890 内科学器械PHYSICAL MEDICINE DEVICES892 放射学器械RADIOLOGY DEVICES895 禁止的器械BANNED DEVICES898 电极铅线与患者电缆的性能标准PERFORMANCE STANDARD FOR ELECTRODE LEAD WIRES AND PATIENT CABLES第I分章―乳房造影质量标准法（SUBCHAPTER I―MAMMOGRAPHY QUALITY STANDA RDS ACT）900 乳房造影法MAMMOGRAPHY第J分章―放射学的健康（SUBCHAPTER J―RADIOLOGICAL HEALTH）1000 总则GENERAL1002 记录与报告RECORDS AND REPORTS1003 缺陷与未能守法的通报NOTIFICATION OF DEFECTS OR FAILURE TO COMPLY1004 电子产品的回购、修理或者置换REPURCHASE, REPAIRS, OR REPLACEMENT OF ELECTRONIC PRODUCTS1005 电子产品的进口IMPORTATION OF ELECTRONIC PRODUCTS1010 电子产品的性能标准：总则PERFORMANCE STANDARDS FOR ELECTRONIC PRODUCTS: GENERAL1020 电离辐射发生产品的性能标准PERFORMANCE STANDARDS FOR IONIZING RADIATION EMITTING PRODUCTS1030 微波与射电频率发生产品的性能标准PERFORMANCE STANDARDS FOR MICROWAVE AND RADIO FREQUENCY EMITTING PRODUCTS1040 发光产品的性能标准PERFORMANCE STANDARDS FOR LIGHT-EMITTING PRODUCTS1050 声波、次声波和超声波发生产品的性能标准PERFORMANCE STANDARDS FOR SONIC, INFRASONIC, AND ULTRASONIC RADIATION-EMITTING PRODUCTS第K分章―[预留的]（SUBCHAPTER K―[RESERVED]）第L分章―根据由食品与药品管理局行政执行的某些其他法的规章（SUBCHAPTER L―REGULATIONS UNDER CERTAIN OTHER ACTS ADMINISTERED BY THE FOOD AND DRUG ADMINISTRATION）1210 根据《联邦进口乳法》的规章REGULATIONS UNDER THE FEDERAL IMPORT MILK ACT1230 根据《联邦腐蚀性毒物法》的规章REGULATIONS UNDER THE FEDERAL CAUSTIC POISON ACT1240 传染病的控制CONTROL OF COMMUNICABLE DISEASES1250 州际运输卫生INTERSTATE CONVEYANCE SANITATION1251-1269 [预留的] [Reserved]1270 预期用于移植的人体组织HUMAN TISSUE INTENDED FOR TRANSPLANTATION1271 人体细胞、组织以及细胞的和基于组织的产品HUMAN CELLS, TISSUES, AND CELLULAR AND TISSUE-BASED PRODUCTS 1272-1299 [预留的] [Reserved]第Ⅱ章―司法部毒品强制执行局（CHAPTER Ⅱ―DRUG ENFORCEMENT ADMINISTRATION, DEPARTMENT OF JUSTICE）1300 定义DEFINITIONS1301 管制物质的制造者、分销者和调剂者的登记REGISTRATION OF MANUFACTURERS, DISTRIBUTORS, AND DISPENSERS OF CONTROLLED SUBSTANCES1302 对管制物质的标识与包装要求LABELING AND PACKAGING REQUIREMENTS FOR CONTROLLED SUBSTANCES1303 定额QUOTAS1304 登记者的记录与报告RECORDS AND REPORTS OF REGISTRANTS1305 令的格式ORDER FORMS1306 处方PRESCRIPTIONS1307 杂项MISCELLANEOUS1308 管制物质的表SCHEDULES OF CONTROLLED SUBSTANCES1309 表I化学品的制造者、分销者、进口者和出口者的登记REGISTRATION OF MANUFACTURERS, DISTRIBUTORS, IMPORTERS AND EXPORTERS OF LIST I CHEMICALS1310 列入表的化学品和某些机器的记录与报告RECORDS AND REPORTS OF LISTED CHEMICALS AND CERTAIN MACHINES 1311 [预留的] [Reserved]1312 管制物质的进口与出口IMPORTATION AND EXPORTATION OF CONTROLLED SUBSTANCES1313 前体与必要化学品的进口与出口IMPORTATION AND EXPORTATION OF PRECURSORS AND ESSENTIAL CHEMICALS1314-1315 [预留的] [Reserved]1316 行政职能、规范和程序ADMINISTRATIVE FUNCTIONS, PRACTICES, AND PROCEDURES第Ⅲ章―毒品控制政策办公室（CHAPTER Ⅲ―Office of National Drug Control Policy）1400 [预留的] [Reserved]1401 信息的公众可及性PUBLIC AVAILABILITY OF INFORMATION1402 强制性解密审查MANDATORY DECLASSIFICATION REVIEW1403 对给予州和地方政府资金和合作协议的统一行政要求UNIFORM ADMINISTRATIVE REQUIREMENTS FOR GRANTS AND COOPERATIVE AGREEMENTS TO STATE AND LOCAL GOVERNMENTS1404 政府范围的排除与暂停（非获得）GOVERNMENTWIDE DEBARMENT AND SUSPENSION (NONPROCUREMENT)1405 对无毒品工作场所的政府范围的要求（财政援助）GOVERNMENTWIDE REQUIREMENTS FOR DRUG-FREE WORKPLACE (FINANCIAL ASSISTANCE)1406-1499 [预留的] [Reserved]。
紫杉类抗肿瘤药物特点及临床合理应用
在多西他赛用药后平均8天，中性粒细胞计数降到最低 点(400/mm3)
可对逆于及中性非粒蓄细胞积的性下降的，可以采取G-CSF预防性用药
很少并发感染及发热
非血液学不良反响
紫杉醇
多西他赛
过敏反响
过敏反响
心血管毒性
皮肤及皮下组织异常
紫杉类药物药理作用机制
星状体微管束
3’位与 β-tubulin N末端的1-31氨基酸残基结合 2位与β-tubulin 217-233氨基酸结合 7位与β-tubulin Arg282结合
He LF, Orr GA, Horwitz SB drug Discovery Today 2001 :1153
紫杉醇研发过程
年代
进
展
1958
NCI开始大规模植物药研发筛选
1967
发现紫杉醇抗癌活性
1968
从红豆杉中分离出紫杉醇
1971
完成结构鉴定
1979
发表作用机制
1983
临床Ⅰ试验
1985
临床II期
1991
临床III期
1992
FDA批准上市
national cancer institute 〔NCI〕〕
应
、心动过缓等，但通
常不用治疗）
5. 肌痛、关节痛胃肠道反 应，口腔皮肤质 体
1.骨髓抑制:严重粒缺达47%
2.外周神经毒：62%，严重 达6%
3.过敏反应：潮红、皮疹、 呼吸困难、低血压、心 动过速。曾发生过敏禁 用。
4.心血管毒：低血压、心动 过缓肌肉关节疼痛。， 呈剂量依赖型。
溶剂型紫杉醇促使循环中胶束的形成
紫杉醇知识培训
Literature abstract of Paclitaxel
简介： 简介：
紫杉醇是从红豆杉树皮中提取分离出的一种天然产物。 紫杉醇是从红豆杉树皮中提取分离出的一种天然产物。 1992年12月29日，美国FDA批准紫杉醇上市，美国 1992年12月29日 美国FDA批准紫杉醇上市， FDA批准紫杉醇上市
BMS公司，商品名Taxol，用于治疗卵巢癌。 BMS公司，商品名Taxol，用于治疗卵巢癌。 公司 Taxol
除了卵巢癌，对转移性乳腺癌、肺癌、头部和颈部肿 除了卵巢癌，对转移性乳腺癌、肺癌、
瘤、恶心黑色素癌和淋巴肉瘤同样有效。 恶心黑色素癌和淋巴肉瘤同样有效。
史清文 天然药物紫杉醇的研究与开发综述 天然产物研究与发展 1997 Vol. 9 No. 3
临床研究表明，紫杉醇不仅对乳腺癌、 临床研究表明，紫杉醇不仅对乳腺癌、 卵巢癌（包括对有抗药性的乳腺癌、卵巢癌） 卵巢癌（包括对有抗药性的乳腺癌、卵巢癌） 有效， 有效，而且对人体其它部位的实体瘤和白血 病也有明显的疗效。因此认为它是一种广谱 病也有明显的疗效。 抗癌药物。 抗癌药物。临床运用紫杉醇的剂量一般在 135135-210mg/m2。
药动学： 药动学：
紫杉醇由于其独特的作用机制使之成为继环磷 酰胺、阿霉素、顺铂后又一重要抗胂瘤药物。 酰胺、阿霉素、顺铂后又一重要抗胂瘤药物。单药 应用对晚期乳腺癌、肺癌、头颈部癌、食管癌、淋 应用对晚期乳腺癌、肺癌、头颈部癌、食管癌、 巴瘤均有一定疗效，被认为是一种广谱抗癌药物， 巴瘤均有一定疗效，被认为是一种广谱抗癌药物， 联合其它常用抗肿瘤药物，疗效可进一步提高。 联合其它常用抗肿瘤药物，疗效可进一步提高。成 为最最有效的抗肿瘤药之一。 为最最有效的抗肿瘤药之一。
FDA draft Guidance-Abraxane(1)
Contains Nonbinding RecommendationsDraft Guidance on PaclitaxelThis draft guidance, once finalized, will represent the Food and Drug Administration's (FDA's) current thinking on this topic. It does not create or confer any rights for or on any person and does not operate to bind FDA or the public. You can use an alternative approach if the approach satisfies the requirements of the applicable statutes and regulations. If you want to discuss an alternative approach, contact the Office of Generic Drugs.Active Ingredient: PaclitaxelForm/Route: Suspension/InjectableRecommended Studies: 2 studies1. Type of study: Bioequivalence study with pharmacokinetic (PK) endpointsDesign: Single-dose, two-way crossover, fasting, in vivoStrength: 100 mg/vial (260 mg/m2 dose administered in 30 minutes)Subjects: Breast cancer patients after failure of combination chemotherapy formetastatic disease or relapse within 6 months of adjuvant chemotherapyAdditional comments:a.Submission of a Bio Investigational New Drug Application (Bio-IND) isrequired prior to the conduct of a bioequivalence in vivo study for a cytotoxicdrug product such as paclitaxel (see 21 CFR § 320.31).b.The pivotal bioequivalence study should be conducted using test productmanufactured on the proposed commercial scale.c.If the patient’s health status prevents fasting, the sponsor may provide a non-high-fat diet during the proposed study provided that both study periods areconducted under same conditions.d.If the patient’s health status necessitates a dose reduction or any change in therecommended 260 mg/m2 dose administered in 30 minutes, they are to bewithdrawn from the study.e.Patients must have baseline neutrophil counts ≥ 1500 cells/mm3; Patients whoexperience a severe hypersensitivity reaction to ABRAXANE should not berechallenged with the drug; Frequent peripheral blood counts are to beperformed; Prior therapy should have included an anthracycline unlessclinically contraindicated; Female patients should be nonpregnant and non-lactating; Women of childbearing potential should be advised to avoidbecoming pregnant while receiving paclitaxel injectable suspension, and menshould be advised not to father a child while receiving paclitaxel injectablesuspension.f.The use of antiemetic prophylaxis is acceptable provided that the patientreceives the same prophylaxis in both periods of the study.Analytes to measure: unbound and total paclitaxel in plasmaBioequivalence based on (90% CI): AUC and Cmax for unbound and total paclitaxel________________________________________________________________________ Recommended Sep 201212.Type of study: In Vitro Particle Size DistributionDesign: In vitro bioequivalence study on at least three lots of both test andreference productsStrength: 100 mg/vialAdditional comments: NoneParameters to measure: D10, D50, and D90Bioequivalence based on (95% CI): Population bioequivalence based on D50 and span(D90-D10)/D50 or polydispersity index________________________________________________________________________As per 21 CFR § 314.94(a)(9)(iii), the proposed parenteral drug product should bequalitatively (Q1) and quantitatively (Q2) the same as the corresponding reference listeddrug product. In addition, firms are recommended to obtain assurance from OGD that thetest product has the same in-vitro characteristics as those of reference listed drug productprior to conducting any bioequivalence study for submission. Additional in vitrocharacterization are recommended to demonstrate the sameness between the test andreference products in terms of particle morphology, particle size, surface potential,paclitaxel crystallinity, fraction of free and bound paclitaxel or albumin in reconstitutedsuspension, nature of bond between paclitaxel and albumin, and in vitro release kinetics.In addition, albumin, the only excipient in the final product, is critical to the formulation.The characterization of the oligomeric status of albumin in both the albumin excipientand the final drug product is also recommended. The in vitro characterization tests arerecommended to be conducted on three batches of the ANDA and RLD products (at leastone ANDA batch should be produced by the commercial scale process).________________________________________________________________________Waiver request of in vivo testing: Not applicableIn Vitro Release Testing Method: The applicants are encouraged to explore methods tocharacterize in vitro release.Recommended Sep 2012 2。
天然抗癌药物紫杉醇的研究进展
天然抗癌药物紫杉醇的研究进展吴秀兰;贾艳;朱波;周杰【摘要】紫杉醇是一种二萜类化合物,具有独特的抗癌活性.近年来围绕紫杉醇所进行的高水平研究越来越多.综述了紫杉醇来源的研究进展,主要涉及化学合成和生物合成方法,并对其发展前景进行展望.【期刊名称】《中国野生植物资源》【年(卷),期】2014(033)005【总页数】5页(P42-45,60)【关键词】紫杉醇;来源;生物合成【作者】吴秀兰;贾艳;朱波;周杰【作者单位】正大天晴药业集团股份有限公司,江苏南京210023;正大天晴药业集团股份有限公司,江苏南京210023;正大天晴药业集团股份有限公司,江苏南京210023;正大天晴药业集团股份有限公司,江苏南京210023【正文语种】中文【中图分类】R2841 紫杉醇介绍紫杉醇(Paclitaxel，商品名Taxol) 被用于治疗卵巢癌、乳腺癌、肺癌以及Kaposi’s 肉瘤的治疗，同时也在研究与其他抗癌药物联用的治疗方法，是获得FDA批准的第一个来自天然植物的化学药物[1]。
最初，紫杉醇是从短叶紫杉(Taxus brevifolia)的树皮中分离获得，这种紫杉主要分布在北美西北太平洋区域从北加拿大到阿拉斯加的原生森林中。
短叶紫杉生长极其缓慢且不易繁殖，一棵直径22 cm、高度9 m的树大约有125年树龄，其树皮极薄，只有大约0.3～0.6 cm厚，这样的一棵树可以得到大约2kg树皮。
紫杉醇必须从新鲜砍伐剥取的树皮中提取。
从砍伐树木，收集紫杉树皮到分离萃取出紫杉醇，消耗极大的人力物力财力。
30吨干树皮可以得到大约100 g紫杉醇，花费大约150万美元。
因为紫杉醇极难得到，所以在研究初期对紫杉醇的研究进度也极其缓慢。
因此从植物中提取紫杉醇代价太高，而且会对生态环境造成破坏。
迄今为止已经探索出化学半合成法、化学全合成法、植物细胞培养或内生菌培养等多种方法获得紫杉醇[1-3]。
2 紫杉醇的理化性质紫杉醇为白色结晶性粉末，不溶于水，易溶于氯仿、丙酮等有机溶剂。
Abraxane 白蛋白紫杉醇-FDA说明书
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Contains Nonbinding RecommendationsDraft Guidance on PaclitaxelThis draft guidance, once finalized, will represent the Food and Drug Administration's (FDA's) current thinking on this topic. It does not create or confer any rights for or on any person and does not operate to bind FDA or the public. You can use an alternative approach if the approach satisfies the requirements of the applicable statutes and regulations. If you want to discuss an alternative approach, contact the Office of Generic Drugs.Active Ingredient: PaclitaxelForm/Route: Suspension/InjectableRecommended Studies: 2 studies1. Type of study: Bioequivalence study with pharmacokinetic (PK) endpointsDesign: Single-dose, two-way crossover, fasting, in vivoStrength: 100 mg/vial (260 mg/m2 dose administered in 30 minutes)Subjects: Breast cancer patients after failure of combination chemotherapy formetastatic disease or relapse within 6 months of adjuvant chemotherapyAdditional comments:a.Submission of a Bio Investigational New Drug Application (Bio-IND) isrequired prior to the conduct of a bioequivalence in vivo study for a cytotoxicdrug product such as paclitaxel (see 21 CFR § 320.31).b.The pivotal bioequivalence study should be conducted using test productmanufactured on the proposed commercial scale.c.If the patient’s health status prevents fasting, the sponsor may provide a non-high-fat diet during the proposed study provided that both study periods areconducted under same conditions.d.If the patient’s health status necessitates a dose reduction or any change in therecommended 260 mg/m2 dose administered in 30 minutes, they are to bewithdrawn from the study.e.Patients must have baseline neutrophil counts ≥ 1500 cells/mm3; Patients whoexperience a severe hypersensitivity reaction to ABRAXANE should not berechallenged with the drug; Frequent peripheral blood counts are to beperformed; Prior therapy should have included an anthracycline unlessclinically contraindicated; Female patients should be nonpregnant and non-lactating; Women of childbearing potential should be advised to avoidbecoming pregnant while receiving paclitaxel injectable suspension, and menshould be advised not to father a child while receiving paclitaxel injectablesuspension.f.The use of antiemetic prophylaxis is acceptable provided that the patientreceives the same prophylaxis in both periods of the study.Analytes to measure: unbound and total paclitaxel in plasmaBioequivalence based on (90% CI): AUC and Cmax for unbound and total paclitaxel________________________________________________________________________ Recommended Sep 201212.Type of study: In Vitro Particle Size DistributionDesign: In vitro bioequivalence study on at least three lots of both test andreference productsStrength: 100 mg/vialAdditional comments: NoneParameters to measure: D10, D50, and D90Bioequivalence based on (95% CI): Population bioequivalence based on D50 and span(D90-D10)/D50 or polydispersity index________________________________________________________________________As per 21 CFR § 314.94(a)(9)(iii), the proposed parenteral drug product should bequalitatively (Q1) and quantitatively (Q2) the same as the corresponding reference listeddrug product. In addition, firms are recommended to obtain assurance from OGD that thetest product has the same in-vitro characteristics as those of reference listed drug productprior to conducting any bioequivalence study for submission. Additional in vitrocharacterization are recommended to demonstrate the sameness between the test andreference products in terms of particle morphology, particle size, surface potential,paclitaxel crystallinity, fraction of free and bound paclitaxel or albumin in reconstitutedsuspension, nature of bond between paclitaxel and albumin, and in vitro release kinetics.In addition, albumin, the only excipient in the final product, is critical to the formulation.The characterization of the oligomeric status of albumin in both the albumin excipientand the final drug product is also recommended. The in vitro characterization tests arerecommended to be conducted on three batches of the ANDA and RLD products (at leastone ANDA batch should be produced by the commercial scale process).________________________________________________________________________Waiver request of in vivo testing: Not applicableIn Vitro Release Testing Method: The applicants are encouraged to explore methods tocharacterize in vitro release.Recommended Sep 2012 2。