The dog's blog no. 13 Drug names and mix-ups

Drug names and mix-ups

Several completely new drugs have recently been marketed as veterinary medicines for companion animals: grapiprant, lokivetmab and maropitant. How did they get these names?

Drug names and mix-ups

Several completely new drugs have recently been marketed as veterinary medicines for companion animals – grapiprant, lokivetmab and maropitant. How did they get these names?

Until the 1960s, the development of drug names was fairly random. For example, the anticoagulant warfarin was named after the Wisconsin Alumni Research Foundation, which funded research on coumarin derivatives leading to the discovery of the anticoagulant warfarin; and the antifungal nystatin was discovered by scientists at the New York State Department of Health. 

Later, a more consistent approach was developed. A pharmaceutical substance usually has three names – the chemical name, the generic (approved or official) name and the brand (or trade) name. 

  • The chemical name generally follows the rules of the International Union of Pure and Applied Chemistry. For example, the chemical name for meloxicam is 4-hydroxy-2-methyl-N-(5-methyl-2-thiazolyl)-2H-1,2-benzothiazine-3-carboxamide 1,1-dioxide.
  • The International Nonproprietary Name (INN) is usually used for the approved name. INNs have been coordinated by the World Health Organization since 1953. The INN is a unique pharmaceutical name that is recognised globally and is public property. It often consists of a stem (a group of letters used as a prefix, inflix or suffix), which defines the pharmacologically-related group to which the INN belongs. The WHO keeps a record of accepted stems and their definitions, for example:
    • –icam for anti-inflammatory, isoxicam derivatives, e.g. meloxicam
    • –pril for angiotensin-converting enzyme inhibitors, e.g. benazepril
    •  lokivetmab contains the stem –mab, which is used for monoclonal antibodies
    • maropitant contains the stem –tant, which is used for neurokinin (tachykinin) receptor antagonists. 
    • grapiprant contains the stem –piprant, which is used for prostaglandin-receptor antagonists. 

Stems can be a useful clue to the mode of action or use of a drug, but there are some exceptions. 

Pharmaceutical companies create brand names. It’s conventional to start generic names with a lower case letter and brand names with an uppercase letter. Confusion between similar-looking generic or brand names can lead to medication errors resulting in the wrong drug, wrong dose or wrong route of administration. In human medicine, wrong drug errors are known to be common and occasionally have fatal consequences.  For example propranolol is confused with prednisolone; atenolol with amlodipine (MHRA 2018). I wonder how much is known about medication errors in veterinary practice? Double checking at every stage (right medicine; right patient; right dose; right route; right time) is the way to avoid errors. 

Related blog: Why I love generic names.

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