The Grammarphobia Blog

Virile Viagra vs. wimpy sildenafil

Q: The brand names of drugs are often memorable while the generics can be tongue twisters. Where do generic names come from?

A: Yes, the brand names of drugs can indeed be catchy, while the generics are usually forgettable. The proprietary name “Viagra,” for example, suggests vigor and virility, while the generic name, “sildenafil,” is wimpy and hard to pronounce.

The names of modern generic drugs are made up of fragments, called “stems,” that are generally based on Latin and denote the drug’s medical function.

The US National Library of Medicine, part of the National Institutes of Health, maintains a list of these stems, and every generic drug has to have one somewhere in its name.

The stem is usually at the end, as with “sildenafil.” The “afil” stem means the drug increases blood flow to the penis and enhances erectile function (technically, it’s a phosphodiesterase-5 inhibitor with vasodilator action).

At least nine other generic drugs have “afil” in their names, including “vardenafil” (Levitra) and “tadalafil” (Cialis). In Latin, the “a-” prefix can mean “off” or “away,” while “filum” is a “thread” or “filament.”

The more familiar stems “micin” and “mycin (as in generic names like “gentamicin” and “lincomycin”) are for antibiotic drugs; the different spellings mean they treat different strains of bacteria.

Those stems were created in the mid-20th century from –myces, a suffix in scientific Latin that’s used in genus names and that comes from the ancient Greek μύκης (mukēs, fungus), according to the Oxford English Dictionary.

And the stem “vastatin” (as in “simvastatin,” “lovastatin,” “pravastatin”) is for antihyperlipidemics—that is, drugs that help reduce lipid levels in the blood and thus treat high cholesterol.

The “vas” in such names, the OED says, is “perhaps” modeled on physiological terms that include “vaso-” (from the Latin vās for “vessel,” the source of “vascular”). And the “statin” part is modeled on scientific terms that include “stato-” (from ancient Greek στατός or statós, for a standing still).

To use a more recent example, generic names for so-called “medical marijuana” drugs include the stem “nab” (as in “nabazenil” and “dronabinol”). The stem means the drugs are derivatives of cannabinol, a substance found in cannabis, a word found in classical Latin (cannabis means hemp), from the ancient Greek κάνναβις (kánnabis).

The procedures for assigning names to new drugs are quite complicated. Every drug that comes to market must have a generic name as well as a brand name, and there are separate sets of agencies and regulations involved in the approval of each, but we’ll concern ourselves only with generics.

In the US, manufacturers suggest possible generic names (each including the appropriate stem) to the United States Adopted Names Council. The council then submits its top three choices to the World Health Organization’s International Nonproprietary Names program, which chooses a single generic name by which that drug will be known worldwide.

The rules for all this are stringent. Because generic names are used in many different languages, for example, the letters “h,” “j,” “k,” and “w” are ruled out since they might create confusion. And names are carefully vetted to make sure they don’t have obscene or profane connotations in any of the World Health Organization’s member countries.

For more detail, there are interesting articles on the websites of the American Medical Association and Chemical & Engineering News.

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