By Ginya Carnahan, APR, CPRC
“I want a new drug – One that won’t make me sick
One that won’t make me crash my car – Or make feel three feet thick.
I want a new drug – One that won’t hurt my head
One that won’t make my mouth too dry – Or make my eyes too red!”*
When 1980s pop icon Huey Lewis wrote those lyrics, I don’t think he was thinking about Otezla®or Vraylar®. Or Amovig®, Qbrexza®or Biktarvy®.
Have you ever wondered where these crazy names come from and what they mean, if anything? I did a little digging to satisfy my own curiosity.
A Popular Science article from 2013, authored by Rebecca Boyle, pretty much sets the stage for this investigation with this introduction: “Say it with me: Xeljanz. OK, at least try and say it with me. Shell-jance? Zell-johns? Ghel-yahns? Who knows. It is an arthritis drug, and I have no idea how to pronounce it, but one thing is definitely clear: It could be worth billions to its maker, Pfizer. (That name you probably know how to say).” It turns out that Xeljanz is a made-up word, made up to be more memorable (and marketable) than the drug’s generic name: tofacitinib citrate, or its totally unpronounceable chemical name, containing a long string of characters numbers and symbols.
As it turns out, drugs have three names. The chemical name comes first and many of those drugs never make it to market even after decades of research. Once a drug has passed all the tests to prove it is viable and useful, and not too dangerous, the Food and Drug Administration will give its stamp of approval. At that point naming the drug becomes the task of a very specialized marketing whiz.
This is serious business. According to the FDA, mis-prescribed drugs are the most common error in health care, and thousands of people die this way every year. New generic drug names must meet the standards set by the World Health Organization’s International Nonproprietary Names (INN) and the United States Adopted Names Council for Pharmaceuticals (ANC-P). All brand names must be approved by the FDA.
Here is an example of how this works. For instance, take the common drug Prozac®. It has a second generic name, fluoxetine, indicating the active ingredient in the drug. In addition to Prozac®, another manufacturer offers fluoxetine in a formula called Serafem®. Either of these registered trade names for fluoxetine is much easier to say than the drug’s chemical name (RS)-N-methyl-3-phenyl-3-[4-(trifluromethyl)phenoxy]propan-1-amine.
Drugs cannot be named just anything – such as “Cure-me” or “Ache-no-more.” Here are some of the stipulations in naming of drugs:
- Prefixes that imply better, newer or more effective; prefixes that evoke the name of the sponsor, dosage form, duration of action or rate of drug release should not be used.
- Prefixes that refer to an anatomical connotation or medical condition are not acceptable.
- Certain letters or sets of letters also are not allowed at the beginning of new generic names. These include me, str, x or z. (I would have to contest this rule – what about the aforementioned Xeljanz? And what about Zoloft?)
Every generic name will have two parts. The last half of the name is the same for all drugs in a particular class. Take, for instance, the family of cholesterol-lowering drugs. They all end in “vastatin.” Lipitor® (brand name), atorvastatin (generic name); Zocor® (brand name), simvastatin (generic name); Crestor® (brand) rosuvastatin (generic).
Other easily recognizable class suffixes include:
-oxetine – antidepressants, such as fluoxetine (Prozac®)
-sartan – blood pressure lowering, such as losartan (Cozaar®)
-afil – erectile dysfunction, such as sildenafil (Viagra®)
-coxib – anti-inflammatory, pain relievers such as celecoxib (Celebrex®)
-dronate – prevents calcium loss, such as alendronate (Fosamax®)
-formin – one class of diabetes drugs, such as metformin (Glucophage®)
-vir – for antivirals such as anti-flu drug zanamivir (Relenza®)
These suffixes usually come from the full chemical name, but sometimes they combine several syllables, such as: mab from monoclonal antibodies.
When it comes to the prefix part of the drug name, you can mostly use your imagination, as long as it conforms to the USANC’s rules. Branding the drug with a memorable name is, as I said, serious business. You will want the public to remember it and ask for it.
The next fun challenge is creating a television, radio and print advertising campaign to market the drug. Untold millions of dollars go into this work. Do you recall the grandfather who “huffs and puffs” because of his COPD (chronic obstructive pulmonary disease)? Or the poor, sad woman who sees itchy spores coming out of the sweater in the store window? And the happy-go-lucky guy who is mowing his grass in a circle with a spring in his step? If you do, those ads are memorable. But do you remember the specific product?
That is the question!
*Song lyrics by Christopher John Hayes; Huey Lewis