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DBL%20Hendrix%20small.png College chemistry, 1983

Derek Lowe The 2002 Model

Dbl%20new%20portrait%20B%26W.png After 10 years of blogging. . .

Derek Lowe, an Arkansan by birth, got his BA from Hendrix College and his PhD in organic chemistry from Duke before spending time in Germany on a Humboldt Fellowship on his post-doc. He's worked for several major pharmaceutical companies since 1989 on drug discovery projects against schizophrenia, Alzheimer's, diabetes, osteoporosis and other diseases. To contact Derek email him directly: Twitter: Dereklowe

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January 28, 2013

Time to Refill Your Prescription For Zxygjfb

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Posted by Derek

The brand names of drugs are famously odd. But they seem to be getting odder. That's the conclusion of a longtime reader, who sent this along:

I was recently perusing through the recent drug approval list and was struck by how strange the trade names have become. Perhaps it is a request from the FDA so that there are fewer prescription errors, but some of these are really bizarre and don't quite roll off the tongue. USAN names I can understand, but trade names, to me anyway, used to be much more polished (Viagra, Lipitor etc). Could it have to do with the fact that most of these are for cancer? I have a list below comparing trade names from 2004 to those from the past year or so.

2004:    Vidaza;   Avastin;  Sensipar;  Cymbalta;   Tarceva;   Certican;   Factive;   Sinseron;   Alimta;  Lyrica;  Exanta

2012:   Fulyzaq;  Bosulif;  Xeljanz;  Myrbetriq;  Juxtapid;  Iclusig;  Fycompa;  Zelboraf;   Xalkori;  Jakafi;  Pixuvri

He's got a point; some of those look like someone rested an elbow on the keyboard when they were filling out the form. I'd be willing to bet that the oncology connection is a real one - those drugs don't get mass-market advertising at all, so they don't have to be catchy. This Reuters article also notes the trend in cancer drugs, and brings up the need for novelty. Not only is it good to have a name that stands out in the memory, it's a legal requirement to have one that can't be easily confused with another drug. That goes for handwriting as well:

"Regulators want a lot of pen strokes up and down that provide a much more unique-looking name. It is more readable or interpretable if it has a lot of (Zs and Xs)," said Brannon Cashion, Addison Whitney's president.

Whether anyone can actually pronounce the name is of less concern.

That's for sure, when you're talking about things like Xgeva (edit: fixed this name to eliminate the extra "r" I put into it. Can anyone blame me for getting it wrong?). But that one's a good case in point: the generic name is denosumab. That's a good ol' USAN name, with the "-mab" suffix telling you that it's a monoclonal antibody. It's sold in the oncology market as Xgreva for bone-related cancer complications, but it's also prescribed for postmenopausal women to halt loss of bone tissue. There, the same drug goes under the much more consumer-friendly name of Prolia. Now, that's a blandly uplifting name if I've ever heard one, whereas Xgeva sounds like the name of an alien race in a cheap science fiction epic ("An Xgeva ship has been detected in the quadrant, Captain!").

Or, like its recent peers, it also sounds like an excellent Scrabble word, were it to be allowed, which it wouldn't. Me, my proudest moment was playing "axolotl" one time for seven letters. Come to think of it, Axolotl would make a perfectly good drug name under the current conditions. . .

Update: I notice that the comments are filling up with alternative definitions of some of these names, many of which (not all!) sound more sensible.

Comments (31) + TrackBacks (0) | Category: Business and Markets | Cancer


1. imarx on January 28, 2013 9:01 AM writes...

FYI, it's "Xgeva," not "Xgreva".

Also, I wonder if the naming of drugs has changed due to the widening focus on non-US markets. I don't know if drugs are still sold under different names in different countries, but one can imagine going to more obscure sounding names as a necessity to avoid negative connotations across multiple languages.

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2. Anthony on January 28, 2013 9:08 AM writes...

Here's an idea.

We just stick to USANs, the rest is just marketing fluff

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3. exGlaxoid on January 28, 2013 9:12 AM writes...

I think the real issue is that every reasonable sounding name has already be trademarked. Just like car model names and other products, the growth of business in the US has created a shortage of useful names left that are not already claimed by someone else. No different than the shortage of phone numbers by everyone over the age of 3 having a cell phone now. So drug names will have to either get longer or use unusual letters to be able to be "unique" enough to no infringe on someone else's name.

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4. cirby on January 28, 2013 9:17 AM writes...

The music industry has the same problem. It's getting to be really hard to come up with a good name for a new band - all the good ones are taken.

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5. Paul on January 28, 2013 9:34 AM writes...

Axolotl would be made with eye of newt, right?

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6. Alex W. on January 28, 2013 9:47 AM writes...

Juxtapid: a creature with juxtaposed limbs.

Zelboraf: ointment for dry elbow skin. ("Z' elbo raff")

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7. James on January 28, 2013 10:12 AM writes...

Iclusig: something for everyone

Bosulif: Famous Ottoman general

Pixuvri: or it didn't happen

Fycompa: Who cares if it's covered by your insurance or not?

Xeljanz: country & western band from Betelgeuse 5

Fulyzaq: No non-zaq! contaminants in this one

Yeah, they're a bit weird.

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8. Charlie Abrams on January 28, 2013 10:15 AM writes...

Maybe it's time to give drugs a first and last name, like we do with people. The last name would correlate with the drug classification.

Perhaps it isn't long before someone starts naming their child using one of these drug names anyway. Would that be crazier than what is already happening?

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9. Anon on January 28, 2013 10:43 AM writes...

Clearly a sign that Poles and Czechs are taking over the industry.

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10. The Iron Chemist on January 28, 2013 10:44 AM writes...

Am I the only one who thought of Mr. Mxyzptlk from Superman after reading some of these names?

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11. James on January 28, 2013 10:49 AM writes...

Apart from Xel-janz and Fac-tive, all the ones listed here are trisyllables too. Is that based on a market research finding?

I don't know exactly how they're all pronounced by everyone, but I'd guess they split roughly half and half between dactyls (stressed syllable - unstressed - unstressed) e.g. SEN-si-par, JUX-ta-pid and amphibrachs (unstressed - stressed- unstressed) e.g. a-VAS-tin, a-LIM-ta.

Maybe it's time for some major ionic names, then?

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12. James on January 28, 2013 10:51 AM writes...

Oops. Real-time corrections there.

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13. robert on January 28, 2013 11:54 AM writes...

explains why my pharmacist is always destroying me in Scrabble ...

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14. Ed on January 28, 2013 11:55 AM writes...

You also have to factor in the desire for there to be multiple rhyming words for marketing purposes.

After all, Beanz meanz Heinz. Fulyzaq - it's cack...hmm maybe not.

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15. FrdB on January 28, 2013 12:20 PM writes...

It occurs to me that "All the Good Ones Are Taken" is a great name for a band.

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16. Poul-Henning Kamp on January 28, 2013 12:25 PM writes...

Don't overlook the influence of a marketing department which nixes any name which google finds even one hit for or for which the domain-name is already registered by some domain-shark.

A similar pattern of increasingly unreadable names have been evident in other contexts for the same reasons as well.

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17. Derek Lowe on January 28, 2013 12:29 PM writes...

#15 FrdB: it's the name of an album by Ian Hunter, with a title song that I haven't heard in many years now.

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18. myma on January 28, 2013 12:41 PM writes...

I think they are using the Klingon dictionary now.

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19. Anonymous on January 28, 2013 12:46 PM writes...

Few of them reflects their MoA:
ZelboRAF: RAF inhibitor
XelJANz: Janus kinase (JAK)inhibitor
XALKori: ALK inhibitor
JAKafi: JAK inhibitor

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20. Drug Developer on January 28, 2013 1:36 PM writes...

Note also that the FDA won't approve names any more that contain some implied efficacy or safety, like "Omniflox" (a quinolone) or "Prevacid" (a PPI).

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21. RM on January 28, 2013 2:36 PM writes...

I briefly misread "Iclusig" as Iceland and immediately thought of Eyjafjallajökull. Maybe we should have Icelanders in charge of drug naming. "Is Mýrdalsjökull right for you? Ask your doctor how to pronounce it."

Drug Developer@20 - My favorite example of is "Abilify" (antidepressant). Every time a commercial comes on for it I think how horrible the name is. It's misleading and dopey all at the same time.

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22. Henning Makholm on January 28, 2013 4:49 PM writes...

What's the point of having separate trade names for drugs anyway?

Either the producer has exclusivity, in which case the two names are truly interchangeable and there appears to be point at all, -- or the drug has gone generic, in which case everybody (prescribing doctors, patients, pharmacists) are going to call it by its generic name anyway.

When I go to the pharmacy and show my prescription, I get a choice between "Simvastatin Sandoz", "Simvastatim Orion", "Simvastatin KRKA", "Simvastatin Bluefish", and "Simvastatin Actavis". Nice and easy to deal with. Then there's a single manufacturer who insist on calling the same stuff "Zocor" which looks rather fishy to me. (It's 30 times as expensive as the ones that display the usual name in big type, too). Who benefits from that?

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23. milkshaken on January 28, 2013 6:30 PM writes...

@9 anon: apparently they have must have taken over a long time ago. Two leading US laxative brands are "Serutan" and "Perdiem" - which makes Czechs and Slovak giggle ("Shittorun" and "Fartingham" would be an approximate rendering back to English)

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24. Xplodyncow on January 28, 2013 6:48 PM writes...

Marketers use weird trade names to make their products sound unique.

Just like everyone else.

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25. Eric Jablow on January 28, 2013 8:08 PM writes...

Perhaps they are using a computer program to design their names. Something like the one on this page, perhaps:

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26. Kerry on January 28, 2013 8:59 PM writes...

In the '90s I received an email from the marketing firm that was naming our PDE5 inhibitor. There were 9 names, but I only remember Tivvix, Jovent, Luxar, Xurance, and, of course, Cialis. I replied that I didn't like any of the names and that I preferred the name of their company: "Wood Worldwide". True story.

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27. Anon on January 28, 2013 10:33 PM writes...

These names are in Klingon.

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28. bcpmoon on January 29, 2013 1:26 AM writes...

Thats the Pokemon generation taking over the naming departments...

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29. Secondaire on January 29, 2013 9:23 AM writes...

It looks like the drug industry is following the current trend for naming children - excess Y's and clusters of consonants everywhere.

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30. mad dog on January 29, 2013 3:09 PM writes...

I was "fortunate" enough to see this from the other side when a program I worked progressed favorably. This was for the UCAN name, and the whole process is a complete farce. A few of the names that were reasonable did not come from the consulting agency so were thrown out for spurious reasons. Eventually the "agreed" name was a string of random letters that the consulting agency tried to sell it off as being derived from some random words they thought were related to the program. I think it was:


In addition, there is a way too much energy wasted on coming up with catchy clinical trial names. Hey who cares what the trial is called ROSEBUD.

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31. Jonadab on February 8, 2013 11:41 AM writes...

> every reasonable sounding name
> has already be trademarked

Only the really obvious ones are taken. English phonotactics are sufficiently flexible that it's still possible to come up with reasonable-sounding *syllables* that are not already in use for anything significant, let alone polysyllabic names.

If your trademark had to be pronounceable and unambiguous in Japanese, then you might have a problem.

The problem car makers have is that they want names that are already familiar to the public and carry a positive image. If those are already taken, tough beans. I have no sympathy. Come up with your own *original* name and do your own marketing.

As for band names, were you born yesterday? There are several thousand things that "would be a good names for a band" mentioned on the internet every second. (Today it's the internet, but the phenomenon of course is much older.) A good portion of them would actually be a better name than most actual band names.

It's like an aspiring author complaining because somebody already used the title they wanted, which was something like "The Bridesmaid" or "Alien Invasion!"

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