What's in a Nonproprietary Drug (Generic) Name?
New medications coming on the market since the 90s have some very interesting nonproprietary or generic pharmaceutical names with lots of z's and x's. Have you ever wondered from where these strange-sounding, tongue-twisting names come? There really is a method to this madness. When broken apart (much like the Latin we use in medical terminology), they assist medical professionals in identifying what class of medications a drug is in, and from where it may come.
Depending on when you attended pharmacy school, the list of stems or pre-stems (syllables) in a nonproprietary or generic pharmaceutical name was relatively short such as -olol (beta blockers), -pril (antiotensin-converting-enzyme or ace inhibitors), -statin (anticholesterol), -vir (antiretrovirals), -azole (antifungals), -illin (penicillins), etc.
Today we have words like abciximab, lenalidomide, sunitinib, natalizumab, tirozanib, ibrutinib, certolizumab, imatinib, rituximab, ponatinib, and dasatinib for disease states from cancer and diabetes to arthritis. The names can be broken down into their "stems" and/or "pre-stems" such as -bac- (bacterial), -lim- (immunomodulator), -mel- (melanoma), -pr(o)- (prostate tumor), -ci(r)- (cardiovascular), -vir- (viral), -mar- (mammary tumor), -u- (human), -o- (mouse),-c- (hamster), -a- (rat), -xi- (chimeric).
Can you imagine the task of International Nonproprietary Names (INN) for Pharmaceutical Substances Experts who work with the World Health Organization (WHO) to develop names that satisfy all the languages and ethical/cultural barriers around the globe? Since 1953 when the INN system became active, it has facilitated the identification of pharmaceutical substances or active pharmaceutical ingredients for thousands of medications throughout the globe. These unique names used globally are public property. I am thankful that there is a group who is keeping this all straight!
In the U.S., the WHO and INN work with the U.S. Adopted Names (USAN) Council, and the Nomenclature, Safety and Labeling (NSL) Expert Committee of the United States Pharmacopeia (USP). If you would like to be a part of the USP NSL Committee, or any of the other committees that set the standards for pharmaceuticals used in the U.S. for the 2015-2020 cycle, you can apply at http://www.usp.org/council-experts-expert-committees-overview/call-candidates.
The next time you are looking at the name of a new medication and feel like you are singing "supercalifragilisticexpialidocious" when trying to pronounce it...look at any of the resources below to help you and your patients understand from where these medications and their names were derived.
World Health Organization and International Nonproprietary Names (INN) Programmes and Projects. www.who.int/medicines/services/inn/en/. Accessed December 4, 2013.
The use of stems in the selection of International Nonproprietary Names (INN) for pharmaceutical substances 2013. www.who.int/medicines/services/inn/StemBook_2013_Final.pdf. Accessed December 4, 2013.
Pre-stems*: Suffixes used in the selection of INN. October 2013. Programme of International Nonproprietary Names (INN), Technologies Standards and Norms (TSN). World Health Organization, Geneva, Switzerland. www.who.int/medicines/services/inn/Prestem_Suffixes_201310.pdf. Accessed December 4, 2013.
United States Pharmacopeia Chapter <1121> Nomenclature. Available at: www.usp.org. Accessed December 4, 2013.
Lisa D. Ashworth, BS Pharm, RPh, FACA
Vice-Chair, USP Compounding Expert Committee 2010-2015
Children's Medical Center of Dallas