Q: What kind of drugs are the people who name new drugs on? I constantly see TV ads for things like Cosentyx (sekukinubab), the COPD drug Symbicort (budesonide/formoterol) and the hepatitis C drug Harvoni (ledipusvir/sofosbuvir).
Are there any scientific clues to what the drug does in any of these names? Seems like it would make sense to have all drugs for, say, arthritis, to start with “arth” or something like that. Is anybody watching to make sure these names make sense? I figure Harvoni might be made from the blood of big white rabbits.
Hard to Swallow, of O’Fallon
A: At first glance, I’m sure millions might agree with you, myself included.
I mean, I have trouble just pronouncing Xeljanz, much less remembering it treats arthritis. So how should I remember that Xarelto blocks blood clot formation? Or Cialis for, well, you know?
Indeed, as you suggest, it would seem far more logical and memorable to begin all drugs for achy joints with arth-, much like Pepsi, Coca and RC all end in Cola. Just one problem. Can you imagine the massive confusion that would occur if three or four drug companies came out with a drug starting with Arth-? How would one company ever differentiate its product from the others in the minds of consumers?
And that’s not even the biggest headache. According to studies, up to 15 percent of errors in administering drugs are caused by the similarity of drug names — prescribing Celexa (depression) instead of Celebrex (for arthritis) or Zocor (for high cholesterol) for Zoloft (depression). Having several Arth- drugs might get patients an arthritis drug but maybe not always the one their doctors intended.
Instead, we have a naming system that frequently has consumers like you saying, “What were they thinking?!” But although drug companies guard their naming process as a proprietary secret, there often is a method to their madness if you closely study each name. Here’s a peek:
Remember in the musical “Cats” how felines are said to have three different names — a name used by humans, a name known by other cats and then a name that only the cat itself will ever know? Well, as it turns out, drugs do, too — a chemical name, a generic name and a brand name.
The first is just a bunch of chemicals strung together, so the name sounds like gobbledygook. For example, one of the most popular antidepressants has a chemical name of N-methyl-3-phenyl-3-[4-(trifluoromethyl)phenoxy]propan-1-amine.
If you were a doctor, how would you like to read or write that for a pharmacist every time you prescribed it? Instead, a drug company comes up with a simpler generic name. Generally, this generic name consists of two parts. The front part often contains a bit of the chemical name, although drug makers can pretty much call it anything they want, subject to approval by the United States Adopted Names Council. And one of the USANC’s rules specifically is, “Prefixes that refer to an anatomical connotation or medical condition are not acceptable.”
The “suffix” or back half of a generic name is the same for all drugs in a particular class. In fact, I’m sure you will recognize some of them because they’re used so often. For example, “-afil” is used for erectile dysfunction drugs, e.g., sildenafil (Viagra). Here are a few more: -prazole for stomach acid reducers (esomeprazole/Prilosec); -lukast for certain asthma drugs (montelukast/Singulair); and -dronate for osteoporosis (alendronate/Fosamax).
In my original example, they took “flu” from the “trifluoromethyl” chemical name and added -oxetine for certain antidepressants to produce the generic name fluoxetine. Still not familiar? Well, you probably know it better by its third name — the brand name Prozac.
Of course, the question remains: Just how do they come up with some of those odd-sounding brand names? Again, this is generally kept secret, but knowing some general rules and doing a little guessing, you can start to understand the thought processes involved, says Dr. Suzanne Koven, an internal medicine specialist in Boston who writes a blog called InPractice.
She stresses that names are always chosen with great care and often at great expense. She says drugs often will start with X, Z, N, Q and K because they seem to imply cutting-edge science. Hence, Zantac, Nexium (Nex for next?), etc. Drugs for women often include a “feminine” soft sound like S or M. Using this rule, we see Sarafem for premenstrual syndrome and Vivelle for hormone replacement. The birth-control pills Alesse, Apri, etc., not only take advantage of this rule, but they also sound like women’s names.
Conversely, male drugs usually contain a hard sound such as T, K or X. Thus, drug companies hope men will remember to ask their doctors about Flomax for their prostate problems (maximum flow, get it?) or Levitra for E.D. Cialis seems an exception to the rule until you realize it contains the Latin root “cael” for sky, which, of course, connotes “up.” Guess I don’t have to say any more about that.
In fact, when it comes to naming drugs, drug companies often find inspiration in Latin and Greek roots. If you see a doctor for anxiety, you want a drug that will give your mind a little peace. Ergo, you may be prescribed Paxil, “pax” meaning peace in Latin. If you associate sleeping with night, you may want Lunesta, because Luna is “moon” in Latin. And how about Viagra? Vi(r) is man in Latin while “agra” is field, which denotes fertility. So it’s not much of a stretch to go from Viagra to virility.
Again, if you think about it, this name game yields all kinds of treasures, Koven says. For example, drugs that regulate heart rhythm often end in -olol (propranolol/Inderal), which may bring to mind the lub-dub sound of a beating heart. So, far from being one toke over the line, the creative geniuses at drug companies seem to be crazy like a fox in coming up with names intended to affect your mind before you even open the bottle.
Do you remember the name of the “M*A*S*H” spinoff that ran only one episode — and was shown to just half the country?
Answer to Sunday’s trivia: In 1976, electronics engineer and inventor Ralph Baer was visiting a trade show, where he stopped to play an Atari arcade game that forced him to remember and then play back a series of musical tones. While the concept was interesting, he found the graphics boring and the sounds “miserable.” So he developed a flying saucer-shaped toy that mixed four colored buttons with the more harmonious sounds of a trumpet. Milton Bradley loved it, but what was Baer going to call it? After rejecting Follow Me, Tap Me and Feedback, the toy company launched Simon (as in Simon says) on May 15, 1978, at the glitzy Club 54 in New York. In just four years, 10 million Simons had been sold.