Rylaz? Montelukast? Blame smart FDA rule for weird drug names

Turns out that drug-makers aren't idiots with a fetish for weird names. They may be ruthless monsters who charge exorbitant amounts for life-saving drugs that cost a small fraction of that amount to create, but they're not crazy when it comes to drug names.

There's a reason that the drug your doctor prescribed for your cholesterol or high blood pressure has a bizarre name: It's due to a rule of the Food and Drug Administration.

Yeah, the FDA is to blame for crazy names. Or maybe the FDA should receive credit for the crazy names because it's for a good reason. It all comes from the desire to save confusion at the pharmacy.

Actually, that's not the full story, because we often get confused by the weird names (do you remember the names of your prescriptions? I don't).

But the unusual names – for instance, among the 25 most popular drugs are the hard-to-remember and hard-to-pronounce Levothyroxine, Montelukast, Furosemide and Trazodone – come from an effort to prevent mix-ups among drugs with similar names. Anyone who has brought home Pepsi instead of Pepsid or pesto instead of pasta can understand this: What if you ask for something and the pharmacist accidentally gives you a drug with a name that sounds the same?

It could be like when Mr. Gower in "It's a Wonderful Life" nearly gave deadly drugs to someone during George Bailey's vision of an alternate future (the focus of another column).

But enough about that.

The FDA's standard is that a drug name must be 70% dissimilar from all other names in its database. That database has 36,000 drug names, so it's a challenge, one that is met when drug companies produce such products as Amlodipine and Meloxicam. Or consider the official names of drugs you've probably taken in the past year: Comirnaty and Spikevax. Those are the official names of the Pfizer and Moderna vaccines for COVID-19. (If  I was Moderna, I would have leaned into the official name. Spikevax is an elite vaccine name!)

Anyway, drug names must be unique. According to an article in the Wall Street Journal, there are companies that earn big paydays from drug companies to compare proposed new drug names with existing ones and either attest that they're significantly different or (presumably) present an alternative.

Here's the looming problem. Will we get to a point where there are so many drugs that drug companies will run out of names? Is it possible that sometime in the future, drug names will become like passwords? If they keep coming up with these new drug names (Voxzogo, Tivdak and Rylaz were all approved by the FDA in 2021), there's a limit, right? How far away are we from a world where our drug name must have one capital letter, one lower-case letter, one letter and one symbol?

Are we headed to a future, where we call or stop in our local pharmacy and tell them we need a refill of F8jkLd$5!t?

I guess that will work, unless they have it close to their supply of F8jkLd$6!t, which could cause a mixup (although I guess F8jkLd$6!t isn't 70% different).

Just the idea makes me anxious and when that happens, I turn to ancient wisdom from Readers Digest: Laughter is the best medicine.

But according to my unofficial internet research, that isn't necessarily 70% different from nitrous oxide (laughing gas), so I hope it's OK.

Reach Brad Stanhope at bradstanhope@outlook.com.