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A SEMINOR ON
BIO PHARMACEUTICS
CLASSIFICATION SYSTEM
BY
P. HARI BABU
MPHARMACY
NALANDA COLLEGE OF
PHARMACEUTICAL SCINCE
Contents
• Introduction
• Overview of the Classification
system
• Applications
• Conclusion
• References
Introduction
Biopharmaceutics Classification
System (BCS)
♥Scientific framework for classifying drug
substances based on their aqueous solubility and
intestinal permeability
 What is the need for a classification
based on biopharmaceutics of the
drug?
• Ans. Its importance in determining
bioavailability
♠ Route of choice for the formulators
 Continues to dominate the area of drug delivery
technologies.
 LIMITATIONS
 Absorption and Bioavailability in the milieu of
gastrointestinal tract.
 Limitations more prominent
 with the advent of protein and peptide drugs
 compounds emerging as a result of combinatorial chemistry and
the technique of high throughput screening
ORAL ROUTE
drug
solubility
drug product
quality
attributes
API structure
salt form and
excipients
Bioavailability of drug
is determined by
extent of drug solubility
and
permeability
 Guidance provided by the U.S. Food and Drug
Administration for predicting the intestinal drug
absorption
The fundamental basis established by
Dr. Gordon Amidon
 Distinguished Science Award (Aug ’06 ,FIP)
 First introduced into regulatory decision-making process in the
guidance document on Immediate Release Solid Oral Dosage
Forms: Scale Up And Post Approval Changes
Biopharmaceutics Classification System
 Drug development tool that allows estimation of the
contributions of 3 major factors, that affect
oral drug absorption from immediate release
solid oral dosage forms
Dissolution
Solubility
Intestinal permeability.
The Biopharmaceutics Classification System (BCS)
(as defined by the FDA after Amidon)
SIMILAR IN VIVO
DISSOLUTION
SIMILAR IN VIVO ABSORPTION
SIMILAR SYSTEMIC
AVAILABILITY
Dissolution of drug in vivo
Drug Concentration in
the Membrane Domain
Intestinal Absorption
determines
proportional
Basis of BCS
(37±100
C in aqueous medium with pH range of 1-7.5.)
A sufficient number of pH conditions
 ionization characteristics of the test drug substance
A minimum of three replicate determinations of
solubility in each pH condition
 Standard buffer solutions described in pharmacopoeias
Methods other than shake flask method (with
Justification). e g. acid or base titration methods
SOLUBILITY DETERMINATION
♣ Not just based on lipophilicity (encompass in vivo effects
of efflux and uptake transporters)
A. Human studies
 Mass balance studies
 Absolute bioavailability studies
 Intestinal perfusion methods
B.In vivo or in situ intestinal perfusion in a suitable animal
model
C.In vitro permeability methods using excised intestinal
tissues
D. In vitro permeation studies across a monolayer of cultured
epithelial cells.e.g. Caco-2 cells or TC-7 cells
Determination
of permeability
DISSOLUTION DETERMINATION
 USP apparatus I (basket) at 100 rpm or USP apparatus
II (paddle) at 50 rpm.
 Dissolution media (900 ml): 0.1 N HCl or simulated
gastric fluid, pH 4.5 buffer, and pH 6.8 buffer or
simulated intestinal fluid.
 Compare dissolution profiles of test and reference
products using a similarity factor (f2).
0
CLASS BOUNDARIES
HIGHLY SOLUBLE the highest dose strength is
soluble in < 250 ml water over a pH range of 1 to 7.5.
The volume estimate-a glassful (8 ounce)
HIGHLY PERMEABLE when the extent of
absorption in humans is determined to be > 90% of
an administered dose
RAPIDLY DISSOLVING when > 85% of the
labeled amount of drug substance dissolves within 30
minutes using USP apparatus I or II in a volume of <
900 ml buffer solutions.
BCS Class Boundaries: Objectives
Dissolution
(Product)
Solubility
(Drug)
Permeabilit
y
(Drug)
Rapid dissolution - ensure that in vivo
dissolution is not likely to be the
“rate determining” step
High solubility- ensure that solubility
is not likely to limit dissolution and,
therefore, absorption
High permeability - ensure that drug
is completely absorbed during the limited
transit time through the small intestine
BCS -Implications for drug
developmentЖApplication in early drug development and then in
the management of product change through its life
cycle
ЖAids fundamental understanding of the
biopharmaceutical and physical properties of the drug
ЖAids discriminatory dissolution method development
ЖCan help guide the development of in-vitro/in-vivo
correlations
ЖCan be used to obtain a biowaiver
ЖDevelopment of poorly soluble drugs
This classification is associated with drug
dissolution and absorption model, which
identifies the key parameters controlling
drug absorption as a set of dimensionless
numbers viz
BCS defines 3 numbers (no units)
An ~ absorption number
Do ~ dose number
Dn ~ dissolution number
( )
ABS
GI
GI
eff
T
T
T
R
P
An =





=
Effective permeability
Radius of GI
Residence time in GI
Time required for
complete absorption
Absorption Number
A function of GI Permeability to Drug Substance










=
S
Water
C
V
D
Do
Highest Dose Unit
250 mL
Solubility
Dose Number
A function of solubility of drug substance
Solubility
mg/mL
( ) 





=










=
DISS
GI
GI
S
T
T
T
C
r
D
Dn
ρ2
3
Diffusivity
5x10-6
cm2
/s
Density
1.2 mg/cm3
Particle Radius
25 µm
Residence time in GI
180 min
Time required for
complete dissolution
Dissolution Number
A function of drug release from formulation
IVIVC expectations for immediate release products based on
BCS
Class Solubility Permeability Absorption
rate
control
IVIVC expectations for
Immediate release product
I High High Gastric
emptying
IVIVC expected, if dissolution rate is
slower than gastric emptying rate,
otherwise limited or no
correlations
II Low High Dissolution IVIVC expected, if in vitro
dissolution rate is similar to in
vivo dissolution rate, unless
dose is very high.
III High Low Permeability Absorption (permeability) is rate
determining and limited or no
IVIVC with dissolution.
IV Low Low Case by
case
Limited or no IVIVC is expected.
High Solubility Low SolubilityHighPermeability
Class 1
Abacavir
Acetaminophen
Acyclovirb
AmilorideS,I
Amitryptyline S,I
Antipyrine
Atropine
Buspironec
Caffeine
Captopril
ChloroquineS,I
Chlorpheniramine
Cyclophosphamide
Desipramine
Diazepam
Diltiazem S,I
Diphenhydramine
Disopyramide
Doxepin
Doxycycline
Enalapril
Ephedrine
Ergonovine
Ethambutol
Ethinyl Estradiol
FluoxetineI
Glucose
ImipramineI
Ketorolac
Ketoprofen
Labetolol
LevodopaS
Levofloxacin S
LidocaineI
Lomefloxacin
Meperidine
Metoprolol
Metronidazole
MidazolamS,I
Minocycline
Misoprostol
Nifedipine S
Phenobarbital
Phenylalanine
Prednisolone
PrimaquineS
Promazine
Propranolol I
Quinidine
S,I
Rosiglitazone
Salicylic acid
Theophylline
Valproic acid
Verapamil I
Zidovudine
Class 2
Amiodarone I
AtorvastatinS, I
AzithromycinS ,I
Carbamazepine S,I
Carvedilol
Chlorpromazine I
CisaprideS
Ciprofloxacin S
Cyclosporine
S, I
Danazol
Dapsone
Diclofenac
Diflunisal
Digoxin S
Erythromycin S,I
Flurbiprofen
Glipizide
GlyburideS,I
Griseofulvin
Ibuprofen
Indinavir S
Indomethacin
Itraconazole S,I
Ketoconazole I
LansoprazoleI
Lovastatin S,I
Mebendazole
Naproxen
Nelfinavir S,I
Ofloxacin
Oxaprozin
Phenazopyridine
PhenytoinS
Piroxicam
Raloxifene S
Ritonavir S,I
Saquinavir S,I
Sirolimus S
Spironolactone I
Tacrolimus S,I
TalinololS
Tamoxifen I
Terfenadine I
Warfarin
High Solubility Low SolubilityLowPermeability
Class 3
Acyclovir
AmilorideS,I
AmoxicillinS,I
Atenolol
Atropine
Bisphosphonates
Bidisomide
Captopril
Cefazolin
Cetirizine
Cimetidine S
CiprofloxacinS
Cloxacillin
DicloxacillinS
ErythromycinS,I
Famotidine
FexofenadineS
Folinic acid
Furosemide
Ganciclovir
Hydrochlorothiazide
Lisinopril
Metformin
Methotrexate
Nadolol
PravastatinS
Penicillins
RanitidineS
Tetracycline
TrimethoprimS
Valsartan
Zalcitabine
Class 4
Amphotericin B
Chlorthalidone
Chlorothiazide
Colistin
CiprofloxacinS
Furosemide
Hydrochlorothiazide
Mebendazole
Methotrexate
Neomycin
Applications of BCS in oral drug
delivery technology
 Achieve a target release profile associated with a
particular pharmacokinetic and/or pharmacodynamic
profile.
 Formulation approaches include both control of release
rate and certain physicochemical properties of drugs
like pH-solubility profile of drug.
Class I - High Permeability,
High Solubility
Class II - High Permeability,
Low Solubility
Micronisation,
Addition of surfactants,
Formulation as emulsions and microemulsions
systems,
Use of complexing agents like cyclodextrins
 Require the technologies that address to
fundamental limitations of absolute or
regional permeability.
 Peptides and proteins constitute the part of
class III and the technologies handling such
materials are on rise now days
Class III - Low Permeability,
High Solubility
Class IV - Low Permeability,
Low Solubility
♫Major challenge for development of drug
delivery system and the route of choice
for administering such drugs is parenteral
(solubility enhancers.)
♫Fortunately, extreme examples are the
exception rather than the rule and are
rarely developed and reach the market
Biowaiver
 A biowaiver is an exemption from conducting
human bioequivalence studies when the active
ingredient(s) meet certain solubility and
permeability criteria in vitro and when the
dissolution profile of the dosage form meets the
requirements for an "immediate" release dosage
form.
Waiver of In Vivo Bioequivalence Study
based on
Pharmaceutical Dosage Form (Solutions)
Biopharmaceutics Classification
System
Dose. (Highest Strength should be tested)
BCS BIOWAIVER
 Biowaiver for
 Rapid and similar dissolution.
 High solubility &High permeability.
 Wide therapeutic window.
 Excipients used in dosage form used
previously in approved IR solid dosage
forms.
REQUEST FOR BIOWAIVERS
Data Supporting :-
Rapid and Similar Dissolution
High Permeability
High Solubility
Limitations of BCS as a Predictor
of Drug Disposition
Ω Permeability (90% absorption) is difficult to
determine, and difficult to convince the regulatory
agency .
Ω There is little predictability for BCS classification
drugs beyond Class 1 primarily due to the difficulty of
determining and proving 90% absorption.
 many drugs are misclassified (e.g. HIV protease inhibitors
as Class 4 compounds)).
Conclusion
 BCS aims to provide a regulatory tool for
replacing certain BE studies by accurate in-
vitro dissolution tests..
 This increased awareness of a proper
biopharmaceutical characterization of new
drugs may in the future result in drug
molecules with a sufficiently high
permeability, solubility and dissolution rate,
and that will automatically increase the
importance of the BCS as a regulatory tool
over time
References:
 Draft guidance for industry, waiver of in vivo bioavailability
and bioequivalence studies for immediate release solid oral
dosage forms containing certain active moieties/ active
ingredients based on a biopharmaceutic classification system,
february 1999, CDER/FDA.
 Amidon G.L., Lennernas H., Shah V.P., Crison J.R.A., A
theoretical basis for a biopharmaceutic drug classification:
the correlation of in vitro drug product dissolution and in
vivo bioavailability. Pharm. Res. 12: 413-420 (1995).
 Guidance for industry, immediate release solid oral dosage
forms: scale up and post approval changes, november 1995,
CDER/FDA.
 Medicamento generico from website
http://www.Anvisa.Go/.
 Devane J., Oral drug delivery technology: addressing the solubility/
permeability paradigm, pharm. Technol. 68-74, november 1998
 Amidon, G. L.,Lennernäs H., Shah V. P., And crisonj. R., A theoretical
basis for a biopharmaceutics drug classification: the correlation of in
vitro drug product dissolution and in vivo bioavailability,
Pharmaceutical research, 12: 413-420 (1995)
 Guidance for Industry: Dissolution Testing of Immediate Release Solid
Oral Dosage Forms, FDA CDER, 1997
􀀛http://www.fda.gov/cder/guidance/1713bp1.pdf
 Guidance for Industry: Waiver of In Vivo Bioavailability and
Bioequivalence Studies for Immediate Release Solid Oral Dosage Forms
Based on a Biopharmaceutics Classification System, FDA CDER,
August 2000 http://www.fda.gov/cder/guidance/3618fnl.htm
Thank you..

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Bcs classification system

  • 1. A SEMINOR ON BIO PHARMACEUTICS CLASSIFICATION SYSTEM BY P. HARI BABU MPHARMACY NALANDA COLLEGE OF PHARMACEUTICAL SCINCE
  • 2. Contents • Introduction • Overview of the Classification system • Applications • Conclusion • References
  • 3. Introduction Biopharmaceutics Classification System (BCS) ♥Scientific framework for classifying drug substances based on their aqueous solubility and intestinal permeability  What is the need for a classification based on biopharmaceutics of the drug? • Ans. Its importance in determining bioavailability
  • 4. ♠ Route of choice for the formulators  Continues to dominate the area of drug delivery technologies.  LIMITATIONS  Absorption and Bioavailability in the milieu of gastrointestinal tract.  Limitations more prominent  with the advent of protein and peptide drugs  compounds emerging as a result of combinatorial chemistry and the technique of high throughput screening ORAL ROUTE
  • 5. drug solubility drug product quality attributes API structure salt form and excipients Bioavailability of drug is determined by extent of drug solubility and permeability
  • 6.  Guidance provided by the U.S. Food and Drug Administration for predicting the intestinal drug absorption The fundamental basis established by Dr. Gordon Amidon  Distinguished Science Award (Aug ’06 ,FIP)  First introduced into regulatory decision-making process in the guidance document on Immediate Release Solid Oral Dosage Forms: Scale Up And Post Approval Changes Biopharmaceutics Classification System
  • 7.  Drug development tool that allows estimation of the contributions of 3 major factors, that affect oral drug absorption from immediate release solid oral dosage forms Dissolution Solubility Intestinal permeability.
  • 8. The Biopharmaceutics Classification System (BCS) (as defined by the FDA after Amidon)
  • 9. SIMILAR IN VIVO DISSOLUTION SIMILAR IN VIVO ABSORPTION SIMILAR SYSTEMIC AVAILABILITY Dissolution of drug in vivo Drug Concentration in the Membrane Domain Intestinal Absorption determines proportional Basis of BCS
  • 10. (37±100 C in aqueous medium with pH range of 1-7.5.) A sufficient number of pH conditions  ionization characteristics of the test drug substance A minimum of three replicate determinations of solubility in each pH condition  Standard buffer solutions described in pharmacopoeias Methods other than shake flask method (with Justification). e g. acid or base titration methods SOLUBILITY DETERMINATION
  • 11. ♣ Not just based on lipophilicity (encompass in vivo effects of efflux and uptake transporters) A. Human studies  Mass balance studies  Absolute bioavailability studies  Intestinal perfusion methods B.In vivo or in situ intestinal perfusion in a suitable animal model C.In vitro permeability methods using excised intestinal tissues D. In vitro permeation studies across a monolayer of cultured epithelial cells.e.g. Caco-2 cells or TC-7 cells Determination of permeability
  • 12. DISSOLUTION DETERMINATION  USP apparatus I (basket) at 100 rpm or USP apparatus II (paddle) at 50 rpm.  Dissolution media (900 ml): 0.1 N HCl or simulated gastric fluid, pH 4.5 buffer, and pH 6.8 buffer or simulated intestinal fluid.  Compare dissolution profiles of test and reference products using a similarity factor (f2). 0
  • 13. CLASS BOUNDARIES HIGHLY SOLUBLE the highest dose strength is soluble in < 250 ml water over a pH range of 1 to 7.5. The volume estimate-a glassful (8 ounce) HIGHLY PERMEABLE when the extent of absorption in humans is determined to be > 90% of an administered dose RAPIDLY DISSOLVING when > 85% of the labeled amount of drug substance dissolves within 30 minutes using USP apparatus I or II in a volume of < 900 ml buffer solutions.
  • 14. BCS Class Boundaries: Objectives Dissolution (Product) Solubility (Drug) Permeabilit y (Drug) Rapid dissolution - ensure that in vivo dissolution is not likely to be the “rate determining” step High solubility- ensure that solubility is not likely to limit dissolution and, therefore, absorption High permeability - ensure that drug is completely absorbed during the limited transit time through the small intestine
  • 15.
  • 16. BCS -Implications for drug developmentЖApplication in early drug development and then in the management of product change through its life cycle ЖAids fundamental understanding of the biopharmaceutical and physical properties of the drug ЖAids discriminatory dissolution method development ЖCan help guide the development of in-vitro/in-vivo correlations ЖCan be used to obtain a biowaiver ЖDevelopment of poorly soluble drugs
  • 17. This classification is associated with drug dissolution and absorption model, which identifies the key parameters controlling drug absorption as a set of dimensionless numbers viz BCS defines 3 numbers (no units) An ~ absorption number Do ~ dose number Dn ~ dissolution number
  • 18. ( ) ABS GI GI eff T T T R P An =      = Effective permeability Radius of GI Residence time in GI Time required for complete absorption Absorption Number A function of GI Permeability to Drug Substance
  • 19.           = S Water C V D Do Highest Dose Unit 250 mL Solubility Dose Number A function of solubility of drug substance
  • 20. Solubility mg/mL ( )       =           = DISS GI GI S T T T C r D Dn ρ2 3 Diffusivity 5x10-6 cm2 /s Density 1.2 mg/cm3 Particle Radius 25 µm Residence time in GI 180 min Time required for complete dissolution Dissolution Number A function of drug release from formulation
  • 21.
  • 22. IVIVC expectations for immediate release products based on BCS Class Solubility Permeability Absorption rate control IVIVC expectations for Immediate release product I High High Gastric emptying IVIVC expected, if dissolution rate is slower than gastric emptying rate, otherwise limited or no correlations II Low High Dissolution IVIVC expected, if in vitro dissolution rate is similar to in vivo dissolution rate, unless dose is very high. III High Low Permeability Absorption (permeability) is rate determining and limited or no IVIVC with dissolution. IV Low Low Case by case Limited or no IVIVC is expected.
  • 23. High Solubility Low SolubilityHighPermeability Class 1 Abacavir Acetaminophen Acyclovirb AmilorideS,I Amitryptyline S,I Antipyrine Atropine Buspironec Caffeine Captopril ChloroquineS,I Chlorpheniramine Cyclophosphamide Desipramine Diazepam Diltiazem S,I Diphenhydramine Disopyramide Doxepin Doxycycline Enalapril Ephedrine Ergonovine Ethambutol Ethinyl Estradiol FluoxetineI Glucose ImipramineI Ketorolac Ketoprofen Labetolol LevodopaS Levofloxacin S LidocaineI Lomefloxacin Meperidine Metoprolol Metronidazole MidazolamS,I Minocycline Misoprostol Nifedipine S Phenobarbital Phenylalanine Prednisolone PrimaquineS Promazine Propranolol I Quinidine S,I Rosiglitazone Salicylic acid Theophylline Valproic acid Verapamil I Zidovudine Class 2 Amiodarone I AtorvastatinS, I AzithromycinS ,I Carbamazepine S,I Carvedilol Chlorpromazine I CisaprideS Ciprofloxacin S Cyclosporine S, I Danazol Dapsone Diclofenac Diflunisal Digoxin S Erythromycin S,I Flurbiprofen Glipizide GlyburideS,I Griseofulvin Ibuprofen Indinavir S Indomethacin Itraconazole S,I Ketoconazole I LansoprazoleI Lovastatin S,I Mebendazole Naproxen Nelfinavir S,I Ofloxacin Oxaprozin Phenazopyridine PhenytoinS Piroxicam Raloxifene S Ritonavir S,I Saquinavir S,I Sirolimus S Spironolactone I Tacrolimus S,I TalinololS Tamoxifen I Terfenadine I Warfarin
  • 24. High Solubility Low SolubilityLowPermeability Class 3 Acyclovir AmilorideS,I AmoxicillinS,I Atenolol Atropine Bisphosphonates Bidisomide Captopril Cefazolin Cetirizine Cimetidine S CiprofloxacinS Cloxacillin DicloxacillinS ErythromycinS,I Famotidine FexofenadineS Folinic acid Furosemide Ganciclovir Hydrochlorothiazide Lisinopril Metformin Methotrexate Nadolol PravastatinS Penicillins RanitidineS Tetracycline TrimethoprimS Valsartan Zalcitabine Class 4 Amphotericin B Chlorthalidone Chlorothiazide Colistin CiprofloxacinS Furosemide Hydrochlorothiazide Mebendazole Methotrexate Neomycin
  • 25. Applications of BCS in oral drug delivery technology  Achieve a target release profile associated with a particular pharmacokinetic and/or pharmacodynamic profile.  Formulation approaches include both control of release rate and certain physicochemical properties of drugs like pH-solubility profile of drug. Class I - High Permeability, High Solubility
  • 26. Class II - High Permeability, Low Solubility Micronisation, Addition of surfactants, Formulation as emulsions and microemulsions systems, Use of complexing agents like cyclodextrins
  • 27.  Require the technologies that address to fundamental limitations of absolute or regional permeability.  Peptides and proteins constitute the part of class III and the technologies handling such materials are on rise now days Class III - Low Permeability, High Solubility
  • 28. Class IV - Low Permeability, Low Solubility ♫Major challenge for development of drug delivery system and the route of choice for administering such drugs is parenteral (solubility enhancers.) ♫Fortunately, extreme examples are the exception rather than the rule and are rarely developed and reach the market
  • 29. Biowaiver  A biowaiver is an exemption from conducting human bioequivalence studies when the active ingredient(s) meet certain solubility and permeability criteria in vitro and when the dissolution profile of the dosage form meets the requirements for an "immediate" release dosage form.
  • 30. Waiver of In Vivo Bioequivalence Study based on Pharmaceutical Dosage Form (Solutions) Biopharmaceutics Classification System Dose. (Highest Strength should be tested)
  • 31. BCS BIOWAIVER  Biowaiver for  Rapid and similar dissolution.  High solubility &High permeability.  Wide therapeutic window.  Excipients used in dosage form used previously in approved IR solid dosage forms.
  • 32. REQUEST FOR BIOWAIVERS Data Supporting :- Rapid and Similar Dissolution High Permeability High Solubility
  • 33. Limitations of BCS as a Predictor of Drug Disposition Ω Permeability (90% absorption) is difficult to determine, and difficult to convince the regulatory agency . Ω There is little predictability for BCS classification drugs beyond Class 1 primarily due to the difficulty of determining and proving 90% absorption.  many drugs are misclassified (e.g. HIV protease inhibitors as Class 4 compounds)).
  • 34. Conclusion  BCS aims to provide a regulatory tool for replacing certain BE studies by accurate in- vitro dissolution tests..  This increased awareness of a proper biopharmaceutical characterization of new drugs may in the future result in drug molecules with a sufficiently high permeability, solubility and dissolution rate, and that will automatically increase the importance of the BCS as a regulatory tool over time
  • 35. References:  Draft guidance for industry, waiver of in vivo bioavailability and bioequivalence studies for immediate release solid oral dosage forms containing certain active moieties/ active ingredients based on a biopharmaceutic classification system, february 1999, CDER/FDA.  Amidon G.L., Lennernas H., Shah V.P., Crison J.R.A., A theoretical basis for a biopharmaceutic drug classification: the correlation of in vitro drug product dissolution and in vivo bioavailability. Pharm. Res. 12: 413-420 (1995).  Guidance for industry, immediate release solid oral dosage forms: scale up and post approval changes, november 1995, CDER/FDA.  Medicamento generico from website http://www.Anvisa.Go/.
  • 36.  Devane J., Oral drug delivery technology: addressing the solubility/ permeability paradigm, pharm. Technol. 68-74, november 1998  Amidon, G. L.,Lennernäs H., Shah V. P., And crisonj. R., A theoretical basis for a biopharmaceutics drug classification: the correlation of in vitro drug product dissolution and in vivo bioavailability, Pharmaceutical research, 12: 413-420 (1995)  Guidance for Industry: Dissolution Testing of Immediate Release Solid Oral Dosage Forms, FDA CDER, 1997 􀀛http://www.fda.gov/cder/guidance/1713bp1.pdf  Guidance for Industry: Waiver of In Vivo Bioavailability and Bioequivalence Studies for Immediate Release Solid Oral Dosage Forms Based on a Biopharmaceutics Classification System, FDA CDER, August 2000 http://www.fda.gov/cder/guidance/3618fnl.htm