Why drug names are so increasingly weird

By Ellen Jean Hirst, ehirst@tribpub.com Chicago Tribune and edited by Pharmanaming.com

Naming a brand drug is a lot harder than it used to be.

With thousands of drugs on the market, the No. 1 reason drug names are rejected by the Food and Drug Administration is that the agency doesn't want names to be too similar when prescriptions are filled.

Bottles of antidepressant pills (L to R) Wellbutrin, Paxil, Lexapro, Effexor, Zoloft and Fluoxetine are shown March 23, 2004 photographed in Miami, Florida. (Joe Raedle, Getty Images)

The concern is that the prescribed drug will be confused with another, which could cause serious medical problems or even death. Letters get transposed, letters get confused, The pharmacist is often scrolling down an alphabetized list. Proposed drug names also can't elicit an air of superiority. Superbeststatin, for instance, would be a no-go with the FDA.

And names should avoid eliciting any cultural confusion or sensitivity around the world. Drug names have to be memorable, too, yet easy (enough) for doctors to spell. Can you remember and spell Avycaz, Farydak, and Prezcobix?

Appeal

If possible, names should have a certain appeal too. Take Zarxio, a drug that helps prevent infection during cancer treatments: The name has a very positive, fast, strong sound,

Zarxio became the first biosimilar drug to gain approval in the U.S. As a result, a lot was riding on the name, Biosimilars are copycats of high-tech biologic drugs.

For biosimilars, one of the biggest issues they're facing is are you actually similar, or are you the same?" If the name would have been soft or obtuse or difficult, especially as the first approved, it would not have been something that people would have latched on to. This name has this sort of invitation where people are like 'Wow.'" Zarxio also illustrates how a drug can wear a different name elsewhere. Zarxio is marketed as Zarzio outside the U.S. And North Chicago-based AbbVie's recently FDA-approved Parkinson's drug named Duopa is named Duodopa outside the U.S.

Frustrating process

It's increasingly difficult to get a global drug name approved.

Sometimes it's one letter that can make a name legally not viable or risky. They may approve a name in Europe, but then by the time it's approved by the FDA, there's an issue. It might be a conflict with a product only marketed in the U.S. and isn't an issue in Europe.

Before drugs get their brand names, they receive more syllable-heavy generic names. There are more than 10,000 generic drug names on the books. Names selected are based on stems that allude to their scientific roots — drugs that end in statin, for instance, are used to lower cholesterol.

There could be several trade names (brand names) for one particular drug, but there's only one nonpropriety name. That's why we live in a world with Avycaz instead of ceftazidime-avibactam.