PART 216—HUMAN DRUG COMPOUNDING Authority: 21 U.S.C. 351, 352, 353a, 353b, 355, and 371. Source: 64 FR 10944, Mar. 8, 1999, unless otherwise noted. Subpart A—General Provisions [Reserved] Subpart B—Compounded Drug Products § 216.23 Bulk drug substances that can be used to compound drug products in accordance with section 503A of the Federal Food, Drug, and Cosmetic Act. (a) The following bulk drug substances can be used in compounding under section 503A(b)(1)(A)(i)(III) of the Federal Food, Drug, and Cosmetic Act. (1) Brilliant Blue G, also known as Coomassie Brilliant Blue G-250. (2) Cantharidin (for topical use only). (3) Diphenylcyclopropenone (for topical use only). (4) N-acetyl-D-glucosamine (for topical use only). (5) Squaric acid dibutyl ester (for topical use only). (6) Thymol iodide (for topical use only). (b) After balancing the criteria set forth in paragraph (c) of this section, FDA has determined that the following bulk drug substances will not be included on the list of substances that can be used in compounding set forth in paragraph (a) of this section: (1) Oxitriptan. (2) Piracetam. (3) Silver Protein Mild. (4) Tranilast. (c) FDA will use the following criteria in evaluating substances considered for inclusion on the list set forth in paragraph (a) of this section: (1) The physical and chemical characterization of the substance; (2) Any safety issues raised by the use of the substance in compounded drug products; (3) The available evidence of the effectiveness or lack of effectiveness of a drug product compounded with the substance, if any such evidence exists; and (4) Historical use of the substance in compounded drug products, including information about the medical condition(s) the substance has been used to treat and any references in peer-reviewed medical literature. (d) Based on evidence currently available, there are inadequate data to demonstrate the safety or efficacy of any drug product compounded using any of the drug substances listed in paragraph (a) of this section, or to establish general recognition of the safety or effectiveness of any such drug product. Any person who represents that a compounded drug made with a bulk drug substance that appears on this list is FDA approved, or otherwise endorsed by FDA generally or for a particular indication, will cause the drug to be misbranded under section 502(a) and/or 502(bb) of the Federal Food, Drug, and Cosmetic Act. [84 FR 4710, Feb. 19, 2019] § 216.24 Drug products withdrawn or removed from the market for reasons of safety or effectiveness. The following drug products were withdrawn or removed from the market because such drug products or components of such drug products have been found to be unsafe or not effective. The following drug products may not be compounded under the exemptions provided by section 503A(a) or section 503B(a) of the Federal Food, Drug, and Cosmetic Act: Adenosine phosphate: Adrenal cortex: Alatrofloxacin mesylate: Aminopyrine: Astemizole: Azaribine: Benoxaprofen: Bithionol: Bromfenac sodium: Bromocriptine mesylate: Butamben: Camphorated oil: Carbetapentane citrate: Casein, iodinated: Cerivastatin sodium: Chloramphenicol: Chlorhexidine gluconate: Chlormadinone acetate: Chloroform: Cisapride: Cobalt: Dexfenfluramine hydrochloride: Diamthazole dihydrochloride: Dibromsalan: Diethylstilbestrol: Dihydrostreptomycin sulfate: Dipyrone: Encainide hydrochloride: Esmolol hydrochloride: Etretinate: Fenfluramine hydrochloride: Flosequinan: Gatifloxacin: Gelatin: Glycerol, iodinated: Gonadotropin, chorionic: Grepafloxacin: Mepazine: Metabromsalan: Methamphetamine hydrochloride: Methapyrilene: Methopholine: Methoxyflurane: Mibefradil dihydrochloride: Nitrofurazone: Nomifensine maleate: Novobiocin sodium: Ondansetron hydrochloride: Oxyphenisatin: Oxyphenisatin acetate: Pemoline: Pergolide mesylate: Phenacetin: Phenformin hydrochloride: Phenylpropanolamine: Pipamazine: Polyethylene glycol 3350, sodium chloride, sodium bicarbonate, potassium chloride, and bisacodyl: Potassium arsenite: Potassium chloride: Povidone: Propoxyphene: Rapacuronium bromide: Reserpine: Rofecoxib: Sibutramine hydrochloride: Sparteine sulfate: Sulfadimethoxine: Sulfathiazole: Suprofen: Sweet spirits of nitre: Tegaserod maleate: Temafloxacin hydrochloride: Terfenadine: 3,3′,4′,5-tetrachlorosalicylanilide: Tetracycline: Ticrynafen: Tribromsalan: Trichloroethane: Troglitazone: Trovafloxacin mesylate: Urethane: Valdecoxib: Vinyl chloride: Zirconium: Zomepirac sodium: [81 FR 69676, Oct. 7, 2016, as amended at 83 FR 63573, Dec. 11, 2018]