The dog's blog no.5 - Why I love generic names

Why I love generic names

I was having a check up with my optician the other day. We were talking about maculopathy, which I had had in one eye a few years ago (related to my extreme myopia rather than my age). Were you treated with Lucentis she asked? No, the cheaper one - bevacizumab, I replied. I can tell you’re a pharmacist, she said, remarking on my fluent pronunciation.

Most drugs have at least two names (the proprietary or brand name, and the international non-proprietary (INN) or generic name). A drug’s generic name is approved by the World Health Organization under the International Non-Proprietary Name (INN) scheme. There are a few rules affecting the construction of a generic name: it must be distinctive in sound and spelling, not inconveniently long and not liable to confusion with names in common use. Where possible the names of drugs belonging to a group of pharmacologically-related substances show their relationship by use of a common stem.  For example, -caine for local anaesthetics ; pril(at) for  angiotensin-converting enzyme inhibitors;  -olol for beta-adrenoreceptor antagonists; -mab for monoclonal antibodies.  Generic names are recognised throughout the world and are public property. 

A drug’s brand name is chosen by the pharmaceutical company and approved by the regulatory authority. Brand names are designed for marketing purposes, to be easily remembered with the aim of increasing sales. 

Some drugs have several different brand names created by different companies. There are some rules: brands for use in humans are not allowed to include the generic stem in the name and not allowed to imply benefits. Brand names are often simpler, more euphonious and more easily pronounced, spelled and remembered than generic names. They are aimed at connecting with customers on an emotional level. Apparently Viagra, the brand name for sildenafil (for treating erectile dysfunction) came from a combination of the words vigorous and Niagra that were associated with the concept of a strong flow, an image conjured up when a group of urologists were asked to describe what it was like when the condition went away. 

Brand names are usually short and easier to remember, pronounce and spell: Apoquel or Cytopoint are clearly easier than oclacitinib and lokivetmab for example. Prescribers often remain loyal to the brand names when patents expire. But their multiplicity compels vets and vet nurses to learn needlessly many names. Generic names have many more advantages: they usually indicate the chemical class to which the drug belongs and so give a 'shorthand' account of a drug's pharmacology and clues about the drug’s adverse effect profile.  Generic names are standard throughout the world whereas brand names often differ from country to country. Generic names are crucial for communication between scientists worldwide. They aid communication and help veterinary professionals recognise a treatment’s role and avoid duplicate therapy. The most important advantage of generic names is that they help prescribers to think more clearly about drugs. For instance, it’s impossible to make sense of the vast range of parasiticides without sorting them by generic name.

Learning to understand common stems and using generic names when thinking about, talking about, and prescribing drugs is far more useful than memorising brand names. It’s a good habit to get into, and you might even impress your friends by getting your tongue around complicated drug names.