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Naming of medicines, part one – introduction

1 September, 2020

In his poem The Naming of Cats, T.S. Eliot asserts that cats have three names:

The Naming of Cats is a difficult matter,
It isn’t just one of your holiday games;
You may think at first I’m as mad as a hatter
When I tell you, a cat must have THREE DIFFERENT NAMES.
The Naming of Cats, T.S. Eliot.

Likewise, medicines can go by a few different names.

All drugs have a scientific name based on its organic chemistry. And even though morphine can be written simply as C17H19NO3, to also accurately describe its structure it needs to go by (4R,4aR,7S,7aR,12bS)-3-Methyl-2,3,4,4a,7,7a-hexahydro-1H-4,12-methanobenzofuro[3,2-e]isoquinoline-7,9-diol which by any standards is a bit of a mouthful.

For this reason, drugs are given a shorter ‘generic’ name. Drugs of a similar class share the same stem, so for example a benzodiazepine will have the ending -azepam (clonazepam, diazepam, lorazepam).

The manufacturer also comes up with a name that they use to market the drug, its brand name. These have to follow the same rules for brand names for any product as well as meet regulators’ requirements that they are not easily confused with existing drugs.

I will discuss the rules for generic and brand names in a future edition. However, in the early days of medicines the rules around naming medicines used to allow more scope for the imagination.

One of the first drugs to be discovered was morphine in 1804 by Friedrich Sertürner. In typical style for the time, he tested the drug by taking it himself and promptly nearly became the first person to have a fatal overdose as well. Since it had a tendency to make people sleepy it was named after the Greek god of dreams, Morpheus (keeping up a family tradition as his father, Hypnos, has a whole class of drugs – the hypnotics – named after him). When a more potent version was discovered, Bayer named it after the fact that it could make you feel heroic – Heroin®.

However, it quickly became apparent that Heroin® also had some… non-heroic qualities (as Harry Hill put it, “It’s very moreish”). This, and also the fact that German companies like Bayer lost their trademarks after World War I, led to it becoming known by a more prosaic name: since it is the diacetyl- version of morphine, it became diamorphine.

Barbiturates were also discovered in this period – the name apparently derives from celebrating the discovery at the feast of St Barbara – which Bayer marketed under the name Veronal®, supposedly after what one of the discoverers thought the most peaceful place on earth: Verona, Italy. As with morphine, it quickly became obvious that Veronal® had properties not entirely reflected by the brand name – it was both addictive and could be fatal in overdose.

As newer drugs came out manufacturers started to use less emotive names to describe their drugs; the age of the evocative name was over. Even a drug like promethazine, which suggests the titan Prometheus, is actually just a shortening of propyl dimethylamine phenothiazine.