The Science and Art of Naming Drugs: How Do Medicines Come Up with Their Names?

Every approved medication has at least three names: a chemical name, a generic name, and a brand name [1.2.3]. The answer to 'How do medicines come up with their names?' reveals a meticulous process balancing science, marketing, and, most importantly, patient safety [1.2.1].

Quick Summary

Medicines acquire their names through two distinct paths. Generic names follow a scientific formula set by global bodies, while brand names are developed by companies for market appeal, with both types facing strict regulatory approval.

Key Points

• Two-Name System: Every drug has a scientific generic name and a marketable brand name, each created through different processes [1.2.3].

• Generic Naming is Scientific: Generic names use a 'stem' system (e.g., -statin) to classify the drug's function for healthcare providers worldwide [1.2.1].

• Brand Naming is Marketing: Brand names are created by companies to be memorable and often suggest the drug's benefit, like 'Lasix' for a diuretic that 'lasts six' hours [1.6.2].

• FDA is the Final Approver: In the U.S., the FDA must approve all proprietary (brand) names, with patient safety being the primary concern [1.3.1].

• Safety First: Regulators reject names that are too similar to others (LASA errors), overstate efficacy, or are otherwise misleading to prevent medication errors [1.5.1, 1.7.2].

• International Cooperation: The USAN Council and WHO work together to ensure generic names are standardized globally [1.3.3].

• Complex Process: The entire naming process can take several years and involves scientists, marketers, and multiple regulatory bodies [1.2.7].

A Tale of Two Names: Generic vs. Brand

Every medication begins its journey with an exceptionally long and complex chemical name based on its molecular structure, defined by the International Union of Pure and Applied Chemistry (IUPAC) [1.2.3]. For example, the chemical name for omeprazole is 5-methoxy-2-[[(4-methoxy-3,5-dimethyl-2-pyridinyl)methyl]sulfinyl]-1H-benzimidazole [1.2.3]. Since this is impractical for daily use, two more user-friendly names are created: the generic (nonproprietary) name and the brand (proprietary) name [1.2.3]. These names serve different purposes and are created through entirely different processes, involving a mix of international committees, regulatory bodies like the U.S. Food and Drug Administration (FDA), and pharmaceutical company marketing teams [1.2.1, 1.3.1].

The Science of the Generic Name: A Global Language for Clinicians

The generic name is a drug's official, globally recognized active ingredient name [1.3.3]. The process for creating it has been in place since the 1960s and is systematic, not creative [1.2.1, 1.3.3]. In the United States, a drug company submits proposals to the United States Adopted Names (USAN) Council, which consists of representatives from the American Medical Association (AMA), the American Pharmacists Association (APhA), the U.S. Pharmacopeia (USP), and the FDA [1.2.1, 1.4.7]. The USAN Council works closely with the World Health Organization's (WHO) International Nonproprietary Name (INN) Programme to ensure names are consistent worldwide, a crucial step for preventing medication errors for travelers and global health initiatives [1.3.3, 1.3.4].

The core of the generic naming system is the stem. A stem is a syllable or set of syllables that identifies a drug's class and mechanism of action [1.2.1]. For example:

• -statin: Used for cholesterol-lowering drugs (e.g., atorvastatin, simvastatin) [1.4.7].
• -olol: Indicates a beta blocker for heart conditions (e.g., metoprolol, atenolol) [1.2.3].
• -vir: Denotes an antiviral drug (e.g., oselamifvir) [1.2.7].
• -cillin: Signifies a penicillin-class antibiotic.
• -prazole: Identifies a proton pump inhibitor for acid reflux (e.g., omeprazole) [1.3.3].
• -mab: Stands for monoclonal antibody, a type of biologic therapy (e.g., ritumab) [1.2.3].

A unique, often two-syllable prefix is added to the stem to differentiate the drug from others in its class [1.2.2]. This prefix should be simple, easy to pronounce, and not easily confused with other drug names [1.3.3].

The Art of the Brand Name: Marketing and Memorability

While generic names are for scientific clarity, brand names are created by pharmaceutical companies for market appeal [1.3.1]. The goal is to craft a name that is catchy, memorable, and easy for doctors and patients to say and spell [1.6.4]. Companies often hire specialized branding agencies, which can generate hundreds of potential names [1.2.7].

These names often try to convey a benefit or a positive concept [1.6.4]. For example:

• Viagra: A combination of "vigor" and "Niagara," suggesting strength and force [1.6.3].
• Lunesta: Derived from "lunar" and "siesta," implying a restful night's sleep [1.6.4].
• Lasix: So named because its diuretic effect "lasts six" hours [1.6.2].
• Lipitor: Suggests it targets lipids (cholesterol).

Marketers may also use high-value Scrabble letters like X, Y, and Z to create a modern, high-tech feel (e.g., Xanax, Xeljanz) [1.3.5, 1.6.4]. The entire branding process, from creation to final approval, can take several years [1.2.7].

The Guardian at the Gate: FDA Approval and Patient Safety

Ultimately, both generic and brand names must be approved. The USAN Council and WHO handle the generic name, while the FDA has the final say on proprietary (brand) names in the U.S [1.3.1]. The FDA's primary concern is preventing medication errors that can arise from name confusion [1.5.1].

The FDA's Center for Drug Evaluation and Research (CDER) meticulously reviews proposed brand names to reject any that:

• Are Look-Alike, Sound-Alike (LASA): Names that look or sound too similar to existing drug names are a major cause of medication errors [1.7.2]. For example, the antidepressant Brintellix had its name changed to Trintellix to avoid confusion with the blood thinner Brilinta [1.4.7]. The FDA uses tools like the Phonetic and Orthographic Computer Analysis (POCA) to screen for similarities [1.5.1].
• Overstate Efficacy or Minimize Risk: A name cannot be promotional or make unsubstantiated claims, such as implying it's a "cure" or has no side effects [1.5.1, 1.5.3].
• Are Otherwise Misleading: This includes names that incorporate a generic stem, reference an inactive ingredient, or use terms like "Max" or "Ultra" that imply superior strength without evidence [1.3.1, 1.5.4].

If the FDA rejects a name, the company must go back to the drawing board. This rigorous safety review is why drug names, both generic and brand, undergo such a long and complex development process.

Comparison: Generic vs. Brand Names

Feature	Generic Name (Nonproprietary)	Brand Name (Proprietary)
Purpose	To identify the active ingredient for healthcare professionals globally [1.3.3].	To create a memorable and marketable identity for the product [1.3.1].
Naming Authority	USAN Council and WHO's INN Programme [1.4.7].	Pharmaceutical company, with final approval from the FDA [1.3.1].
Key Convention	Uses a scientific stem system to classify the drug by its action or structure [1.2.1].	Creative, often intended to be catchy or suggest a benefit [1.6.4].
Example	Sildenafil Citrate [1.4.5]	Viagra [1.4.5]
Exclusivity	Public property, can be used by any manufacturer after patent expires [1.2.4].	Trademarked, exclusive to the original manufacturer [1.2.4].
Primary Goal	Scientific clarity and patient safety [1.2.2].	Brand recognition and market success [1.3.5].

Conclusion

How medicines come up with their names is a story of two distinct philosophies united by a common regulatory framework. The generic name is born from a global, scientific consensus designed for clarity and safety among medical professionals. In contrast, the brand name is a product of market strategy, creativity, and psychology, aimed at doctors and consumers. Both paths, however, must pass through the stringent review of regulatory bodies like the FDA, whose ultimate goal is to ensure that a name, whether scientific or catchy, never becomes a source of harm to a patient.

For more information on medication safety from the World Health Organization, you can visit their website: https://www.who.int/initiatives/medication-without-harm

Frequently Asked Questions

What is the difference between a generic name and a brand name?

A generic name is the official, scientific name of a drug's active ingredient (e.g., atorvastatin), and it follows a global standard. A brand name is the trademarked name given by the manufacturer for marketing (e.g., Lipitor) [1.2.3, 1.4.7].

Who decides on the generic name for a drug?

Generic names are decided through a collaborative process involving the drug manufacturer, the United States Adopted Names (USAN) Council, and the World Health Organization's (WHO) INN Programme to ensure a single, global name [1.2.3, 1.3.3].

Why are brand names for drugs often catchy or unusual?

Pharmaceutical companies design brand names to be memorable, easy to pronounce, and appealing to doctors and patients. They often use creative spellings or letters like X and Z to create a unique, high-tech identity [1.3.5, 1.6.4].

Can the FDA reject a proposed drug name?

Yes, the FDA frequently rejects proposed brand names. The most common reasons are if the name is too similar to an existing drug (a 'look-alike, sound-alike' or LASA issue), if it makes misleading claims about the drug's effectiveness, or if it could otherwise cause confusion and lead to medication errors [1.5.1].

What is a drug name 'stem'?

A stem is a common syllable or word part in a generic drug name that identifies the drug's class or how it works. For example, the stem '-olol' signifies a beta blocker, and '-prazole' identifies a proton pump inhibitor [1.2.1, 1.2.3].

Why are some generic drug names so hard to pronounce?

Generic names must be unique to avoid confusion and often incorporate scientific stems to classify them, which can lead to complex combinations. As more drugs are created, it becomes harder to devise simple, unique names [1.2.3].

Do all drugs have two names?

Marketed drugs typically have at least two names used in practice: a generic (nonproprietary) name and a brand (proprietary) name. They also have a much longer, formal chemical name that is rarely used outside of a laboratory setting [1.2.3].