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The Division does not recommend further amendments at this point. Pertinent labeling sections include the following: 1) Clinical Pharmacokinetics; 2) CLINICAL EFFICACY TRIALS; hydrocodone online without rx 3) Interdose Symptoms; 4) ADVERSE-REACTIONS; and 5) DOSAGE AND ADMINISTRATION.

' Of note, in contrast to previous versions of proposed labeling, here; the sponsor does not seek labeling for the use - -- C.Switching Treatment from XANAX IR to XANAX XR Essentially, the sponsor recommends that in switching a patient from XANAX IR to XANAX XR, hydrocodone online without rx the physician should initiate the change by substituting the total daily XANAX IR dose with a single daily dose of XANAX XR. The sponsor suggests that: "If the therapeutic response after switching is inadequate, the dosage may be titrated as outlined above [in cost oxycontin the DOSAGE AND ADMINISTRATION section] ." Proposed labeling is reasonable, based on hydrocodone sniff the finding from Study 271 that the dose-response relationships of XANAX IR and XANAX IR appear to be approximately equivalent.

As above, there are limits on the degree to which one can interpret the type of dose-response data provided. In any case, the sponsor's recommended switching strategy appears to be the safest and most rational approach in guiding prescribers who choose to change a patient's treatment from XANAX IR to XANAX XR. D.Regulatory Status Update Since the submission of NDA 21,hydrocodone online without rx 434 on December 26, 2001, there has been one additional approval for registration (Kazakhstan, May 24, 2002). XANAX XR has•never been refused approval for safety reasons. - E.World Literature Update Since the last submission, there have been no additional publications pertaining to XANAX XR.

F.Safety Update The sponsor's spontaneous adverse event database was reviewed for the period of April 16, 2002 through October 31, 2002 for serious adverse events that were reported in association with use of alprazolam XR. There were no serious adverse events reported for this time period. G.Biopharmacesutic and CMC Issues These items will be addressed by reviewers in the respective disciplines. Conclusions and Recommendations The sponsor has adequately addressed all of the items that the Division specified in the Approvable Letter. I recommend that the Division accept the proposed labeling changes and take an approvable action for NDA 21,434. Robert hydrocodone online without rx Levin, This NDA can be approved once the remaining CMC and biopnarm issues are resolved; see memo to file for more detailed comments-TPL APPEARS THIS WAY ON ORIGINAL MEMORANDUM: DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC HEALTH SERVICE FOOD AND DRUG ADMINISTRATION CENTER FOR DRUG EVALUATION AND RESEARCH Team Leader, Psychiatric Drug Products Division of Neuropharmacological Drug Products HFD-120 Recommendation for Approvable Action for Xanax XR (alprazolam extended release) for the treatment of panic disorder, with or without agoraphobia Alprazolam is a hydrocodone online without rx triazolobenzodiazepine that is currently approved and marketed as Xanax, an immediate release form for the treatment of generalized anxiety disorder and also for panic disorder, with or without agoraphobia.

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