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How are drugs named?

Posted by Dr. Suzanne Koven  July 14, 2012 06:35 AM

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determining_drug_names.jpgOne summer in college, when I couldn't think of what else to do, I lived near campus in a punishingly hot walk up apartment, held down three boring jobs, and took intensive Latin. Every morning we met in a blissfully air-conditioned classroom--that was the upside!-- to conjugate and decline: a whole year of Latin in 6 weeks. I remember nothing I learned, of course. I'm reminded of the great Woody Allen line: "I took a speed-reading course and read War and Peace in twenty minutes. It involves Russia."

I do remember one thing I learned, though, which is that manufacturers often turn to the classics when naming products--including medications.

My Latin teacher was a young instructor who mentioned that he was supplementing his meager academic income by moonlighting with a marketing firm. His job was to use his knowledge of Latin and Greek to think up names for medications and other goods. "We want something like 'Xerox'!" he told us the marketing firm told him. "Like 'Xerox'!" (Xero is the Greek root meaning "dry"--xerostomia is the medical term for dry mouth--and so "Xerox" emphasized that this particular photocopy method didn't involve wet ink--as anyone old enough to remember those sticky purple mimeographed sheets they used to hand out in school will appreciate...)

But I digress.

Every drug has at least three names. First, there's the chemical name, then there's the generic name, and then there is a brand name (sometimes more than one, if it's produced by more than one company). For example, a commonly used diuretic's chemical name is 4-chloro-N-furfuryl-5-sulfamoylanthranilic acid, its generic name is furosemide and its brand name is Lasix.

Brand names and, to a lesser extent, generic names, are chosen with great care and often at great expense. Often, as I mentioned, Latin (or, less frequently, Greek) roots are chosen to enforce, even if only subliminally, our association with the drug. Some examples:

Paxil: an antidepressant and anti-anxiety drug (Pax=peace in Latin)

Lunesta: a sleeping medication (Luna=moon in Latin)

Viagra: a medication for erectile dysfunction (Vi[r]= man in Latin and Agra=field, usually farmed or fertile in Latin and Greek)

Fosamax: a drug for osteoporosis, or bone thinning (Os=bone Max=great in Latin)

Sometimes, drug names are chosen because of the meaning their sounds imply.

For example, several drugs that regulate heart rhythm end in the suffix -olol (propranolol, atenolol, nadolol)--those two echoed syllables mimicking the beating heart.

The letters "X," "Z," "N," "Q," and "K" connote cutting edge science, which the makers of Zantac, Nexium, and Protonix (all medicines for acid reflux) wish to convey.

"S." "M," "V," "L" and "R" are "soft" letters, which the names of drugs for women are likely to include. Examples are Sarafem (for pre-menstrual syndrome) and Provera and Vivelle (hormone replacements). Many birth control pills employ these letters and sort of sound like women's first names: Junel, Alesse, Apri, Mircette, Yasmin, etc.

Medications marketed to men are more likely to contain a "hard" sound like "T," "G," "K" or "X"--like Flomax for enlarged prostate or Levitra, for erectile dysfunction. An exception is Cialis, also for ED and with only soft syllables but with a meaningful classical root (cael=sky in Latin, also connoting "up" or "above," as in "ceiling.")

Even when drugs have randomly chosen names, the companies that make them seek assistance. There's actually a website with a program, Drug-o-Matic , that generates names for pharmaceuticals.

But the frequent use of certain classical roots ("Pro," "Uni," "Vi," etc.) and of certain high tech sounding letters ("X" and "Z," especially) has led to the problem of drugs that sound alike and can be easily confused. Up to 15% of errors in drug administration are estimated to be caused by the similarity of drug names such as Celebrex (for arthritis) and Celexa (for depression) or Zocor (for high cholesterol) and Zoloft (for depression or anxiety) or Lamisil (an anti fungal) and Lamictal (an anticonvulsant and mood stabilizer). Many hospitals have initiated systems to flag such drugs. At MGH the system is called SALAD ("sound alike/look alike drugs).

Here's an interesting article from MIT with more information about the linguistics of drug naming.

So, it turns out that some of the effects drugs have on us occur even before we open the bottle--or so pharmaceutical companies would have it.

This blog is not written or edited by Boston.com or the Boston Globe.
The author is solely responsible for the content.

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About the author

Suzanne Koven, M.D. practices internal medicine at Massachusetts General Hospital in Boston. She writes a monthly column for the Globe's G Health section and her essays have appeared in the More »

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