Why drug names are so increasingly weird

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, said Brannon Cashion, global president of branding firm Addison Whitney.

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," Cashion said. "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. Remember the Chevy Nova? Didn't do so well in Latin America ("no va" in Spanish means "no go").

Drug names have to be memorable, too, yet easy enough for doctors to spell, Cashion said.

Can you remember and spell Avycaz, Farydak, and Prezcobix?

And the names have to "punch."

Take Zarxio, a drug that helps prevent infection during cancer treatments: "The name has a very positive, fast, strong sound," Cashion said. "It's punchy."

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

"If you think about biosimilars, one of the biggest issues they're facing is are you actually similar, are you the same?" Cashion said. "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 AbbVie's recently FDA-approved Parkinson's drug named Duopa is named Duodopa outside the U.S.

Cashion said 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," Cashion said. "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 - or "sexy" names, as Stephanie Shubat, director of the United States Adopted Names council calls them - they receive more syllable-heavy generic names.

Shubat said 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," Shubat said, "but there's only one nonpropriety name." That's why we live in a world with Avycaz instead of ceftazidime-avibactam.

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