Why are drug names so long and complicated? A pharmacist explains the logic of nomenclature

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(The Conversation is an independent, nonprofit source of news, analysis, and commentary from academic experts.)

(THE CONVERSATION) At some point in your life, you will probably find yourself with a prescription from your doctor to fill. While it’s important to keep track of all the medications you take, it can be difficult to do when the names of so many of these medications are hard to pronounce and even harder to remember.

In my role as a pharmacist, I have helped countless patients determine exactly what medications they were taking for what illness. Some wonder why they were prescribed the drug in the first place, or need help differentiating between drugs whose names seem like complete gibberish.

But there is a rhyme and a reason to drug names. All prescribed medications follow a standard nomenclature that describes what the drug is made of and how it works.


Who names the drugs?

Drugs are given both a brand or proprietary name and a non-proprietary generic name. Each is awarded in a slightly different process.

Until a drug compound is patented, pharmaceutical companies decide on a proprietary brand name for the drugs they sell. Usually the brand name relates to the conditions the drug is intended to treat and is easy for providers and patients to remember, but does not follow a standardized naming guideline. For example, the drug Lopressor helps lower blood pressure.

On the other hand, generic drug names all follow a standard nomenclature that helps medical providers and researchers recognize and classify the drug more easily. Lopressor, for example, has a generic name of metoprolol tartrate. The US Adopted Names Council, made up of representatives from the Food and Drug Administration, American Medical Association, US Pharmacopeia, and American Pharmacists Association, works with the World Health Organization to assign international nonproprietary names , or INN, to drug compounds. Similar organizations exist internationally.

A globally recognized naming process makes an otherwise confusing naming scheme more manageable. It helps the medical community easily learn and categorize newly approved drugs and reduce prescription errors by providing a unique standard name that reflects each active ingredient in the drug.

For example, several drugs for type 2 diabetes belong to a class called glucagon-1-like peptide (GLP-1) receptor agonists. Although all drugs in this class have different brand names, each of the generic versions ends with the suffix “-tide”. This helps health care providers identify all drugs that belong to this drug class. Some examples include Byetta (exenatide), Trulicity (dulaglutide), and Victoza (liraglutide).

How are generic drug names assigned?

The naming process begins when a pharmaceutical company submits an application to the US Adopted Names Council with a proposed generic name. USAN considers a number of factors when evaluating a name, such as whether it is related to how the drug works, whether it is translatable into other languages, and whether it is easy to pronounce. In general, the name should be simple – less than four syllables – and should not be easily confused with other existing generic drugs.

Once a name is agreed upon between USAN and the pharmaceutical company, it is then proposed to the DCI panel. Sponsored by the World Health Organization, the DCI Expert Panel is made up of global experts representing the pharmaceutical, chemical, pharmacological and biochemical sciences. They can either accept the proposed name or suggest an alternative. Once the pharmaceutical company, USAN, and the INN Expert Panel reach agreement on a name, it is placed in the WHO Drug Information journal for four months for public comment or objection before publication. final adoption.

What’s in a generic drug name?

Generic names follow a prefix-infix-stem system. The prefix helps distinguish a drug from other drugs in the same class. The infix, used more occasionally, further subclasses the drug. The root at the very end of the name indicates the drug’s function and marks its place in the name game.

Roots are made up of one or two syllables that describe a drug’s biological effects as well as its physical and chemical qualities and structure. Drugs with the same strain share characteristics such as the conditions they treat and how they work in the body. The WHO publishes a regularly updated stalk book to keep everything in line.

For example, the root “-prazole” indicates that the drug is chemically related to a class of compounds called benzimidazoles which have similar functions. As a result, drugs such as lansoprazole (Prevacid), esomeprazole (Nexium), and omeprazole (Prilosec) all treat acid reflux, ulcers, and heartburn. The “e” prefix of esomeprazole differentiates it from omeprazole, which has a slightly different chemical structure.

Another common example is drugs that use the radical “stat”, which stands for enzyme inhibitors. Atorvastatin (Lipitor), rosuvastatin (Crestor), and simvastatin (Zocor) all belong to the same class of inhibitors that block a key enzyme in the body’s cholesterol-producing process. Therefore, these cholesterol-lowering “statins” are used to prevent cardiovascular diseases such as heart attacks and strokes.

Are there exceptions to the name game?

Although generic names remain consistent, many changes have been made to brand names over the past two decades after an increase in prescribing and dispensing errors. Some examples include the acid reflux and stomach ulcer drug omeprazole, which was renamed from Losec to Prilosec because it was frequently confused with the diuretic Lasix. Another example is when the antidepressant Brintellix was replaced by Trintellix because it was often confused with the blood thinner Brilinta.

Some generic drugs can act on multiple targets in the body and be used for multiple conditions. For example, drugs with the root “-afil,” such as tadalafil (Cialis), sidenafil (Viagra), and vardenafil (Levitra), belong to a class of drugs that relax smooth muscles and widen blood vessels. Although commonly prescribed for erectile dysfunction, they can also be used to treat pulmonary hypertension, a specific type of high blood pressure that affects the arteries of the heart and lungs.

Additionally, nomenclature guidelines are not set in stone, and the US Adopted Names Council anticipates that they will continue to change as new, more complex substances are discovered, developed, and marketed.

For example, an increase in the number of drugs developed with different salts and esters has led to the use of a modified naming process to incorporate the inactive parts of the compound.

As you might guess, it takes healthcare providers countless months and years to learn and understand this naming process. We are taught the science behind each chemical structure and how it works, making it easy to know the rules of the name game. But for those without a background in chemistry and biology, it can be like reading a foreign language.

However, there are several resources that can help you navigate the drug name game. Ask your healthcare provider or pharmacist if you have any questions about how your medicine works or what it is used for. They are usually a phone call or a remote visit.

This article is republished from The Conversation under a Creative Commons license. Read the original article here: https://theconversation.com/why-are-drug-names-so-long-and-complicated-a-pharmacist-explains-the-logic-behind-the-nomenclature-164148.

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