Drugs Get Named by the norms set by the World Health Organization, they assign international nonproprietary names (INN), also known as common names, to compounds upon request from drug developers. Structures of INNs are publicly available and represent a source, albeit underused, to understand trends in drug research and development. Here, we explain how a common drug name is composed and analyze chemical entities from 2000 to 2021. In the analysis, we describe some changes that intertwine chemical structure, newer therapeutic targets (e.g., kinases), including a significant increase in the use of fluorine and of heterocycles, and some other evolutionary modifications, such as the progressive increase in molecular weight. Alongside these, small signs of change can be spotted, such as the rise in spirocyclic scaffolds and small rings and the emergence of unconventional structural moieties that might forecast the future to come.

INNs are issued upon request to the WHO and, in particular, to the Secretariat of the Expert Advisory Panel of the International Pharmacopoeia and Pharmaceutical Preparations, designated for this purpose, also known as the “INN Expert Group”. The INN Expert Group is composed of experts from all over the world that are led and coordinated by a Secretariat. Experts may include, among others, medicinal chemists, pharmacologists, biochemists, molecular biologists, and clinicians. Given that experts change over time and the scientific community modifies viewpoints on what is important in a drug, the composition of the group may also have an impact on the names chosen for a particular substance, with more or less emphasis given to the chemistry/structure, to the nature of the active principle, or to the mechanism of action.

The first step in coming up when drugs get named, is selecting its generic, or non-proprietary name. The generic-naming process arose in the 1950s, says Quinlan, as a way of establishing a standard so that drugs had the same name everywhere. “Generic names came about because of the world growing smaller,” says Quinlan. People were traveling abroad more frequently, and it became clear that in other countries, their drugs might be known by another name than back home and would not be able to be identified. Today, two different organizations must approve the names of generic drugs — the United States Adopted Names (USAN) Council and the World Health Organization (WHO) INN Program — so that regardless of where someone is located, patients and health care professionals will be able to safely communicate about medications.

Generic names are, in part, based on a formula. The suffix, or, as Quinlan calls it, “the family name,” imparts an important piece of information to health care professionals about how the substance works in the body. Take Viagra, for example. Its generic name is sildenafil. The suffix, “afil,” explains the way it works, says Quinlan, referring to its role as a PDE 5 inhibitor, meaning it helps control blood flow. “Afil” is also the suffix of other erectile dysfunction generics, such as tadalafil (Cialis), vardenafil (Levitra and Staxyn) and avanafil (Stendra).