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How Rx drugs get their crazy names - (3/13/2018)

By Dr. Ron Gasbarro

Joe came into the pharmacy and handed a prescription to the pharmacist. “Can you read this, doc? I never saw a word like that!” The pharmacist agreed that drug names are getting crazier. Some of them look like they were picked from a pile of Scrabble® tiles. First off, all drugs have at least 2 names: the brand name, such as Tylenol® and its generic name, which is acetaminophen. There is also a chemical name, which only chemistry scholars would embrace. In Tylenol’s case, the chemical name is N-acetyl-p-aminophenol – notice the -tyl and -ol in there to create the word “Tylenol." In any event, most people ask for Tylenol even though they want acetaminophen because Tylenol is easier to say. 

From a medical standpoint, there is a method to the madness of selecting generic drug names. Example: the popular class of cholesterol-lowering drugs called “statins.” Every generic drug in that class ends with the suffix “-vastatin,” as in simvastatin (Zocor®), atorvastatin (Lipitor®), and lovastatin (Mevacor®). The same goes for beta-blockers, which lower your heart rate to control blood pressure. Beta-blockers end in “-lol,” such as metoprolol (Lopressor®), carvedilol (Coreg®), and bisoprolol (Zebeta®).  

However, brand names of drugs are indeed getting weirder. Drugs ending in the letter “Q” are now becoming more common, such as Belviq® (weight-reduction drug), Myrbetriq® (bladder control drug), and Siliq® (used for psoriasis). Then there are drugs that start with the letter “Q” – but guess what? The second letter is not a “u” as in quiet, quiz, and quack. These drug names are Qsymia® (weight-reduction drug), Qtern® (for diabetes), and Qroxim® (for muscle and joint pain). The letter “X” is famously used as both the first letter and the last letter of the drug Xanax®. But now there is Xeljanz® (for rheumatoid arthritis), Xgeva® (used in bone cancer), and Xepi® (used for impetigo). Run out of Q and X ideas for names? Just repeat a letter for no reason whatsoever: Viibryd® (for depression), Xiidra® (for dry eye), and Krystexxa® (for gout). Has the pharmaceutical world gone insane?        
There is a reason so many drug names look so, um, unusual. Certainly, it is every manufacturer’s dream to hit the nail on the head with a memorable, society-quaking brand name like Viagra®. Besides the challenge of creating a household name, there are legal and regulatory barriers for pharma companies. Lawyers for the drug companies watch carefully to make sure no one is infringing on any of their thousands of brand trademarks. This is to make sure nobody can ride the coattails of a consumer hit like Viagra and call their new product a bastardized version of that drug, such as Ziagra or Viagro. 

Once a name can be shown to be truly unique from a marketing perspective, the road to the pharmacy shelf remains long and winding. Companies can easily spend a year or two getting through the creative process, the trademark process, and then the FDA approval process. The FDA is getting particularly tough, rejecting about 4 out of every 10 name proposals, because it wants to avoid medication mix-ups that can lead to dangerous—and sometimes deadly—adverse reactions. Even then, some drug names need to be changed after the drug has been introduced to the market. In 1990, soundalikes Losec® (heartburn drug) and Lasix® (diuretic) blasted into the marketplace. Soon after, a series of prescribing mistakes occurred. Ultimately, Losec was changed to Prilosec® and the problem was solved.   

Meanwhile, the pharmacist told Joe, expect to see more wild names for drugs, whether the public can pronounce them or not. At least, you can say they are imaginative.  

Ron Gasbarro, PharmD is a registered pharmacist, medical writer, and principal at Rx-Press.com. Read more at www.rx-press.com     


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