Medicine name or sci-fi planet: the science behind how drugs are named

With names like Zoloft, Prozac, Alderaan and Nexium it’s hard to tell the difference between what’s a medicine name and what’s a planet from a sci-fi movie. (Hint: Alderaan is from Star Wars).  So, why are medication names so complicated? Are medication manufactures trying to confuse consumers or are they just sci-fi geeks?

It turns out there is a lot more science than science fiction behind medicine names. There is the obvious chemical makeup of the medication, but there is also some science and maybe a little bit of art behind the battle between FDA regulations the manufacture’s marketing tactics.

Medication Safety

One of the biggest worries for medication regulators is that consumers, doctors and pharmacists will confuse medications, because the medicine name looks and or sounds too similar. Imagine this, you go to a pharmacy to pick up your prescription of Celebrex, an anti-inflammatory medication, but instead you are given Celexa, an antidepressant, because the doctor’s handwriting was hard for the pharmacist to read. This honest, but incredibly serious, mistake could have serious side effects. It’s the reason the FDA scrutinizes and rejects about 20 to 35 percent of proposed medication names.

Here’s what the FDA examines for medicine names:

  • How the medicine name looks handwritten
  • How the medication name sounds when pronounced by a variety of people each with different accents
  • If the medication name contains an illegal stem
  • If there is any similarity between the proposed medication name and the name of a discontinued medication
  • If there are any common medical or coined abbreviations tucked within the name
  • If there are any promotional claims or references to active or inert ingredients within the sound of the proposed name

The extensive review and regulation process, surrounding medication names, exists to reduce the Institute of Medicine’s estimate that more than 1.5 million Americans are sickened, injured or killed each year by errors in prescribing, dispensing and taking medications.

Medication Identifier

Prescription errors aren’t just caused by medicine name confusion, often it’s the actual pill itself that’s the problem. I mean, how do you tell the difference between the big white round one and the small white round one? Well, the best way to avoid those mistakes is to use LowestMed’s Medication Identifier. This tool can help you learn exactly what your medication looks like, or help you identify a bottle of forgotten pills.

Chemical Name

When you see a medication, such as Prozac, you are only seeing one of its names. Each medication has at least three different names – a chemical name, a generic name and a brand name. This is the first name given to the medication based on the chemical formula of its active substances. Prozac’s chemical name is N-methyl-3-phenyl-3-[4-(trifluoromethyl) phenoxy]propan-1-amine. Scary, right? But don’t worry, the chemical name of a medication isn’t something we should worry about, since it is only used by chemists.

Generic Medicine Name

The generic name is used most often by pharmacists, doctors and nurses, but savvy consumers should familiarize themselves with generics as well, since they are often more affordable than brand medications.

Use LowestMed’s price comparison tool if you don’t believe me. The generic name stems from the active ingredient in the medication. Every medication name has two main parts, the prefix and the suffix. The suffix of the name is the same for all medications in that specific class of medications. For instance, there are many cholesterol-lowering medications whose generic names all end in –vastatin: Atorvastatin (Lipitor), Fluvastatin (Lescol), Rosuvastatin (Crestor), Simvastatin (Zocor). The suffixes used to be based off the full chemical name, but now they are either based on descriptive terms of what the medication does or even just made up.

The other part of the generic medication name, the prefix, can be just about whatever the medication company wants, as long as it doesn’t violate certain rules such as:

  • Implying that medication is better, newer or more effective
  • Evoking the name of the sponsor
  • Referring to an anatomical connotation or medical condition
  • Beginning the name with the letters or letter combinations of me, str, x and z.

Once the generic name is decided it must be reviewed and approved by the World Health Organization and the United States Adopted Names council (USAN).

Brand Medicine Name

A medication’s brand name is one that consumers most often recognize. Nexium, Prozac and Viagra are all brand names. It is also the hardest name to come up with, since it must be both marketable and still fit within the regulations set by the FDA. Most naming agencies begin this process by playing a numbers game. The agencies will start with anywhere from 2,000 to 5,000 names and, using the same examination they know the FDA will use, whittle the list down until they have around ten.

At this point the agencies engage in creation engineering, a process based on evolutionary science, as well as art history. During this process, agencies will focus on four distinct dimensions:

  • Visual Distinctiveness
  • Melodic Contrast
  • Verbal Velocity (how the name sounds when spoken within a sentence)
  • Language Neutrality (how well the name can work across different languages)

Even with the strict regulations, many medicine names still manage to slip in a subtle hint or sign of what the medication does. The medication Concerta for ADHA sounds a lot like concentrate. Lipitor is used to lower cholesterol and cholesterol is a type of lipid. Tamiflu sounds an awful lot like “tame the flu.” Other times the hints are better hidden. The agency charged with creating the name for Viagra, ran a focus group with urologist who treated erectile dysfunction and asked one of the doctors what it felt like for men when the condition went away. The doctor’s answer was that it felt like a “strong stream.” The agency melded the words “vigorous” and “Niagara,” to come up with Viagra.

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Memorability

The science and art behind medication names comes down to memorability. Agencies will try anything that helps the medication stick in consumers’ minds – from shorter medication names that sound punchier when pronounced, to including specific letters to help them stand out, such as “x’s, z’s, k’s and j’s” (think Scrabble points here).

Memorability is key. So, in the end, we have safety regulations and marketing tactics to thank for our struggles in trying to pronounce the name of a medication that is spelled like someone fell asleep on the keyboard.

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