What is the primary reason that generic names are used by healthcare providers over chemical and trade names?

Table of Contents Show

Keep good records
Who names drugs?
How are generic drug names assigned?
What’s in a generic drug name?
Are there exceptions to the name game?

Medicine names can be confusing, because each medicine has at least two names and sometimes more.

Active ingredient

The active ingredient name is the name of the chemical in the medicine that makes it work. These active ingredient names are scientific and often quite difficult to remember and pronounce.

Brand name

A pharmaceutical company can give its medicine another, more memorable, name under which the medicine is sold. This is the brand name.

Original brand name

The original brand is the first patented brand of a medicine. When a pharmaceutical company develops a new active ingredient, it is granted a patent for a period of time during which no other company can manufacture and sell a medicine containing the same active ingredient.

This means that for many years, only one brand of medicine is available, and the original company has the opportunity to recoup its investment in researching and developing the new medicine.

Generic brand names

Once a patent expires, other companies can develop their own version of the medicine. These are known as generic brands. Their active ingredient name always remains the same, but they are marketed under different brand names.

Due to trade mark regulations, the packaging and sometimes the medicines themselves are made to look different from each other.

What difference will using alternative brands make?

As long as the active ingredient and strength of the medicine is the same, for most people there’s no difference between brands. What matters is the active ingredient.

So if you’re offered an alternative brand you can be confident that it will work the same – either way, it’s your choice.

For some people with allergies or intolerances, it's important to find out more about the other ingredients, or inactive ingredients in your medicines.

There may also be other situations that influence your decision to switch brands.

Many medicines with the same active ingredient are available under several different brands: an original brand and sometimes several generic brands. They work in the same way but have different brand names and packaging.

When your pharmacist offers you an alternative brand, it will always have the same active ingredient as the one on your prescription or in the medicine you usually take. The active ingredient is the chemical in the medicine that makes it work.

So if you are offered a choice, either way it’s okay.

Five questions to ask when you are offered an alternative brand of medicine

Is it okay for me to choose a different brand of my medicine?
What are the benefits and disadvantages for me if I use a different brand?
Is there a difference in cost?
Which of my usual medicines does this replace?
What is the active ingredient in my medicine?

All medicines sold in Australia must be approved by the government through the Therapeutic Goods Administration (TGA).

The TGA requires generic brands of a medicine to meet the same strict standards of quality, safety and effectiveness as the original brand (the first patented brand of that medicine). This applies to both prescription and over-the-counter medicines.

You will only be offered a generic brand of a prescription medicine if it is proven to be bioequivalent to the original brand.

This means that the active ingredient is identical and the medicine is manufactured to have the same effect in the body – so you can be confident that the generic brand will have the same potential health benefits as your usual brand, or the brand on your prescription. The potential side effects will also be the same.

Sometimes you won’t be offered an alternative brand because:

the same active ingredient is not bioequivalent between different brands.

For a small number of medicines (such as warfarin), different brands may contain the same active ingredient but are not bioequivalent. This means that the active ingredient in one medicine might not have exactly the same effect in the body as the same active ingredient in another medicine brand. This can sometimes happen because the way the medicines are manufactured has some differences. In these situations you should stick with your usual brand.

you cannot ingest or be exposed to other ingredients also contained in the medicine.

Some people cannot take certain brands of a medicine because of other ingredients (known as excipients) in the medicine, such as lactose, gluten, preservatives, sweeteners and dyes. You can find more information about the inactive ingredients in your medicines by reading the consumer medicines information (CMI) leaflets for the medicines. Check with your pharmacist if you are unsure.

you have a certain medical condition.

Sometimes a person living with a particular health condition may be advised to stick with their original prescribed brand.

If your doctor ticks the ‘Brand substitution not permitted’ box on the prescription, the pharmacist will know not to offer you an alternative brand. You can also request your usual brand if you don’t want to change.

A generic brand of medicine may be cheaper than another brand. If the pharmacist doesn’t have your usual brand in stock, you can use a generic brand and get the usual benefit of your medicine.

In some cases you may choose not to switch brands.

You may not want to change brands to avoid confusion. It’s best not to keep switching brands, especially if you take several different medicines.
For a few people, there may be risks in changing brands, such as having an allergy or intolerance to an inactive ingredient in a different brand of medicine. Inactive ingredients can include fillers, binders or coatings used in the manufacturing process.
People with certain conditions may be advised to stick with their original prescribed brand. Your doctor will explain if this is the case.

Remember, the choice between a generic medicine and the original brand is yours.

Be medicinewise about your choices by discussing your options with your doctor or pharmacist.

Keep good records

Recording all the names of your medicines on a medicines list can help you, your doctor and your pharmacist keep track of your medicines and choice of brands.

It’s also a handy way to remember the active ingredient name in your medicines. If someone helps care for you, you might find it useful to keep a copy for them.

You can keep a paper medicines list, or download the free MedicineWise app for your smartphone.

Find out more about keeping a medicines list or about the MedicineWise app.

As well as the active ingredient, medicines contain other ingredients known as inactive ingredients or excipients.

The active ingredient is the important thing as this is the chemical that makes the medicine work, but the inactive ingredients are needed in the manufacturing process for a variety of reasons. An inactive ingredient may be included:

as a filler if the quantity of active ingredient is very small
to stabilise the active ingredient so that it stays effective for longer
to help the active ingredient be absorbed more effectively by the body
as a binder to hold all the ingredients together
to sweeten or flavour the medicine to make it easier to take
to coat tablets or capsules so that they’re easier to swallow.

For most people, the inactive ingredients won’t matter. However, if you have particular allergies or intolerances, or choose to avoid certain substances for cultural or medical reasons, you may need to know what excipients are in your medicine. Ingredients such as lactose, gluten, sugar, preservatives and dyes might matter to you. If so, be medicinewise and check with your pharmacist or doctor before you choose a different medicine brand.

Finding information about medicine ingredients

You can find a list of excipients under ‘inactive ingredients’ within the consumer medicine information (CMI) for prescription and pharmacist-only medicines. The CMI is sometimes included as a small leaflet inside the medicine’s packaging, or may be provided as a printout by your pharmacist or doctor. You can also search for the CMI of any medicine using the NPS Medicine Finder.

At some point in your life, you’ll likely find yourself with a prescription from your doctor to fill. While it’s important to keep track of all the medications you’re taking, that can be hard to do when the names of so many of these drugs are difficult to pronounce and even harder to remember.

In my role as a pharmacist, I’ve helped countless patients figure out exactly which medication they were taking for what ailment. Some wonder why they were prescribed the medication in the first place, or need help differentiating between drugs with names that seem like complete gibberish.

But there is a rhyme and a reason to drug names. All prescribed medications follow a standard nomenclature that describes what the drug is made of and how it functions.

Who names drugs?

Drugs get both a brand, or proprietary, name and a generic name that is nonproprietary. Each is assigned in a slightly different process.

As long as a drug compound isn’t trademarked, drug companies decide on a proprietary brand name for the medications they sell. Usually the brand name relates to the conditions the drug is intended to treat and is easy for both providers and patients to remember but doesn’t follow a standardized naming guideline. For example, the drug Lopressor helps lower blood pressure.

On the other hand, generic drug names all follow a standard nomenclature that helps medical providers and researchers more easily recognize and classify the drug. Lopressor, for example, has a generic name of metoprolol tartrate. The U.S. Adopted Names Council, composed of representatives from the Food and Drug Administration, American Medical Association, U.S. Pharmacopeia and American Pharmacists Association, works with the World Health Organization to assign international nonproprietary names, or INNs, to drug compounds. Similar organizations exist internationally.

Generic drugs are named using standard guidelines intended to minimize confusion and aid in classification. Marko Geber/DigitalVision via Getty Images

A globally recognized naming process makes an otherwise confusing name game more manageable. It helps the medical community easily learn and categorize newly approved medications and reduce prescribing errors by providing a unique, standard name that reflects each active ingredient in the drug.

For example, several Type 2 diabetes medications fall under one class called glucagon-like peptide-1 (GLP-1) receptor agonists. Although all medications in this class have different brand names, each of the generic versions ends in the suffix “-tide.” This helps health providers identify all the drugs that belong to this medication class. A few examples include Byetta (exenatide), Trulicity (dulaglutide) and Victoza (liraglutide).

How are generic drug names assigned?

The naming process starts when a drug company submits an application to the U.S. Adopted Names Council with a proposed generic name. USAN considers a number of factors when evaluating a name, such as whether it relates to how the drug works, how translatable it is to other languages and whether it is easy to say. In general, the name should be simple – fewer than four syllables long – and should not be easily confused with other existing generic drugs.

Once a name is agreed upon by USAN and the drug company, it is then proposed to the INN Expert Group. Sponsored by the World Health Organization, the INN Expert Group is composed of global specialists who represent the pharmaceutical, chemical, pharmacological and biochemical sciences. They may either accept the proposed name or suggest an alternative. Once the drug company, USAN and the INN Expert Group come to an agreement about a name, it is placed in the WHO Drug Information journal for four months for public comments or objections before final adoption.

What’s in a generic drug name?

Generic names follow a prefix-infix-stem system. The prefix helps distinguish a drug from other drugs in the same class. The infix, used more occasionally, further subclassifies the drug. The stem at the very end of the name indicates the drug’s function and marks its place within the name game.

Stems are composed of one or two syllables that describe a drug’s biological effects as well as its physical and chemical qualities and structure. Drugs with the same stem share features like the conditions they treat and how they work in the body. The WHO publishes a regularly updated stem book to keep everything in line.

For example, the stem “-prazole” indicates that the drug is chemically related to a class of compounds called benzimidazoles that have similar functions. As a result, drugs such as lansoprazole (Prevacid), esomeprazole (Nexium) and omeprazole (Prilosec) all treat acid reflux, ulcers and heartburn. The “e” prefix of esomeprazole differentiates it from omeprazole, which has a slightly different chemical structure.

Another common example is drugs that use the stem “stat,” which means enzyme inhibitors. Atorvastatin (Lipitor), rosuvastatin (Crestor) and simvastatin (Zocor) all belong to the same class of inhibitors that block a key enzyme in the body’s cholesterol production process. As a result, these cholesterol-reducing “statins” are used to prevent cardiovascular conditions like heart attack and stroke.

Are there exceptions to the name game?

Although generic names stay consistent, there have been multiple changes to brand names over the past couple of decades after increases in prescribing and dispensing errors. Some examples include the acid reflux and stomach ulcer drug omeprazole, which was rebranded from Losec to Prilosec because it was frequently confused with the diuretic Lasix. Another example is when the antidepressant Brintellix was changed to Trintellix because it was commonly confused with the blood thinner Brilinta.

Some generic medications may work at multiple targets in the body and be used for multiple conditions. For example, drugs with the stem “-afil,” such as tadalafil (Cialis), sidenafil (Viagra) and vardenafil (Levitra), belong to a class of drugs that relax smooth muscle and widen the blood vessels. Although commonly prescribed for erectile dysfunction, they can also be used to treat pulmonary arterial hypertension, a specific type of elevated blood pressure that affects the arteries in the heart and lungs.

Pharmacists and other health care professionals can help patients decipher complex drug names. Marko Geber/DigitalVision via Getty Images

In addition, nomenclature guidelines aren’t set in stone, and the U.S. Adopted Names Council anticipates that they will continue to change as newer, more complex substances are discovered, developed and marketed.

For example, a rise in the number of drugs developed with different salts and esters has led to the use of a modified naming process to incorporate the inactive parts of the compound.

As you can guess, it takes health care providers countless months and years to learn and understand this naming process. We are taught the science behind each chemical structure and how it works, which makes it easier to know the rules of the name game. But for those without a background in chemistry and biology, it can be like reading a foreign language.

There are several resources that can help you navigate the drug name game, however. Ask your health care provider or pharmacist if you have questions about how your medication works or what it is used for. They are generally a phone call or visit away.