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An Rx for the name
Imagine: You’re off to a foreign nation on your first vacation in years, but suddenly you fall ill. It dawns on you that you forgot your prescription at home. Maybe that wouldn’t be so terrifying now, but what if there was no standard drug-naming system around the world? And the pharmacist or doctor in the town you’re staying at halfway across the world gives you a blank stare when you ask for lisinopril, the blood pressure medication.
That was reality until around the 1950s, when people started traveling abroad more often, and it became necessary for patients to safely get their prescription drugs in other countries without confusion.
Now, generic drug names are the same everywhere around the world. But why do they all sound straight out of a sci-fi novel? Here’s your prescription to find out below.
Explain it to me like I’m 5!
The drug-naming process starts when a new compound is discovered. Scientists assign it a chemical name based on its structure and rules set by the International Union of Pure and Applied Chemistry.
These chemical names can be very long and inconvenient to use day-to-day. For example, the chemical name for Tylenol is n-(4-hydroxyphenyl)acetamide.
So, when new drugs move on to clinical trials, drug companies in the U.S. work with the United States Adopted Name Council to assign the new medication a non-proprietary generic name. These names are meant to be short and distinctive. A generic name is made up of at least two parts, a stem which tells medical professionals how the drug functions and a prefix that differentiates drugs in the same class.
For example, the generic names of GLP-1 drugs all have the same stem, but different prefixes. Semaglutide is the generic name for Ozempic, while tirzepatide is the generic name for Zepbound.
Once the USAN approves of a generic name, it clears it with the World Health Organization to ensure the drug is known by the same generic name globally. And then pharmaceutical companies shift their focus to finding a strong brand name.
Brief history
2800 B.C.: Cannabis is one of the first drugs documented. It’s included in Chinese Emperor Shen Nung’s pharmacopoeia, where it’s referred to as “ma.”
1804: German pharmacist Friedrich Wilhelm Adam Sertürner discovers morphine and names it after the Greek god of dreams Morpheus.
1878: American chemist Harmon Northrop Morse becomes the first person to synthesize the fever and pain reliever acetaminophen — also known as paracetamol in other countries. However, it didn’t launch commercially in the U.S. until 1955 as the brand Tylenol Children’s Elixir.
1919: The first commercial international flight departs from Paris to London.
1950: The WHO establishes its nonproprietary names program to help prevent drug name confusion and medication errors around the world.
2024: The FDA approves over 1,400 new drugs, not including generics, since 1980.
Playing the name game
The amount of people involved in deciding new drug names in the U.S. is actually quite small.
USAN director Stephanie Shubat and senior scientist Gail Karet review about 200 drug applications a year and present their name recommendations to a five-person council for approval.
They consider things like whether a generic name sounds too similar to the name of the manufacturer or the planned brand name, which would give the drug maker an unfair market advantage. They also avoid names with the letters W, K, H, J, and Y because they are uncommon in some non-English languages.
Shubat told the Los Angeles Times that it has been increasingly more difficult to come up with new prefixes. She said she sometimes looks at license plates and pet names for inspiration.
Listen up!
Stelara, Comirnaty, Sronyx — why are drug names often so strange? It’s actually primarily due to safety. Settling on a name can take a drug manufacturer up to four years and involves several regulatory agencies.
In the season premier of the Quartz Obsession podcast —Drug Names: The machinations behind the monikers — Quartz reporter Bruce Gil tells host Rocio Fabbro all about the art and science of drug naming.
🎧 Listen now on Spotify | Apple | Pandora
👓 Or, read the transcript
A branding hang 10
Pharma companies will often work with an agency like Branding Institute to come up with a list of hundreds, sometimes thousands, of names. Teams made of copywriters, linguists, and even poets look for inspiration everywhere including cowboy and surfer dictionaries.
Ideally, a good brand name represents a drug in some way or evokes a positive association. Some classic examples include the insomnia medication Lunesta, which begins with the French word for moon. Another example is the erectile dysfunction medication Viagra, which is a melding of the words vigor and Niagara.
Quotable
“Prior to Viagra, impotence was a psychological disorder that went to the core of how men defined themselves. By creating a brand that is named in a way that allows people to discuss it, and creating language or using language to describe the condition in a way that makes it easier for people to engage in conversation, you had more people seeking treatment and also improving sexual health and relationships around the world.” — The Development’s head of brand innovation and commercial impact R. John Fidelino on CNN
Pop quiz
How many novel drugs has the FDA approved this year so far?
A. 211
B. 47
C. 104
D. 18
We recommend you read until the end to find out, no side effects included.
By the digits
20,000: Prescription drug products on the market in the U.S.
7,000: Annual deaths in the U.S. due to medication errors, including mixed up prescriptions
$22 billion: Prozac’s worldwide sales from its launch in 1988 to 2001, when its patent expired
24%: The rejection rate for new brand names by the FDA’s Center for Drug Evaluation and Research
Watch this!
A 2017 Saturday Night Live sketch starring Octavia Spencer satirizes where drug makers look to for inspiration when naming their medications.
Poll
What is your favorite new drug name from recent years?
- Ozempic — Novo Nordisk’s diabetes medication
- Spikevax — Moderna’s COVID-19 vaccine
- Leqembi — Biogen and Eisai’s Alzheimer’s treatment
- Skyrizi — the plaque psoriasis treatment by AbbVie
💬 Let’s talk!
In last week’s poll on business class, 39% of you said you don’t care where you sit on a plane as long as you get to where you are going. But 35% said comfort is your middle name and you’ll pick a seat as such, and 26% of you said you’d ditch expensive lattes for a month if it meant avoiding economy.
🐤 X this!
🤔 What did you think of today’s email?
💡 What should we obsess over next?
Today’s email was written by Bruce Gil (would name new drugs after his favorite drag queens) and edited and produced by Morgan Haefner (would look for drug name inspiration in the health foods aisle).
The answer to the quiz is D.,18. The FDA has approved 18 new novel drugs this year, including Iqirvo, Xolremdi, and Winrevair.