All medicines will have at least four different names as they make it from the laboratory to your medicine cabinet. When a drug is first developed, it is given a chemical name that describes its molecular composition. Chemical names are accurate descriptors but are complicated and cumbersome, with parentheses and subscripts, numbers and initials. The pharmaceutical company working to develop the drug for market usually will thus give the drug an in-house or code name.
The name usually includes letters abbreviating the company’s name (for example, or GSK for GlaxoSmithKline), followed by a number. After approval by the U.S. Food and Drug Administration (FDA), the ready-for-market medication is given both a generic and a trade name. Each generic and trade name must be unique and distinctive enough to avoid confusion with other products. In the United States, the United States Adopted Names Council assigns a drug its generic or nonproprietary adopted name. Outside of the United States, the World Health Organization is responsible for a drug’s generic international nonproprietary name.
The generic name for a widely prescribed, quick-relief, short-acting, inhaled β2 agonist medicine, for instance, is albuterol in the United States and salbutamol internationally. A medicine’s generic name is also its official name. The drug’s manufacturer then selects the medicine’s trade (or brand) name. The FDA must approve the trade name selected by the manufacturer. To use our previous example, the albuterol sulfate inhaler manufactured by the Schering Company is named Proventil HFA, whereas the inhaler produced by Glaxo-SmithKline is Ventolin HFA.
Trade names are often selected to be catchy and easily remembered. The trade name may also reflect a characteristic of the medicine. Many respiratory medicines incorporate air or vent (as in ventilation) as part of the trade name. Examples include Singulair, Advair, Aerobid, Maxair, ProAir, Xolair, Flovent, Serevent, Atrovent, Combivent, Ventolin HFA, and Proventil HFA.
When a new medicine is developed, its inventor applies for a patent for the discovery. The patent details the discovery and, in doing so, makes it public and open to all (including competitors) while protecting the inventor’s right to make, use, or sell the medicine for a defined period of time, after which the patent expires. When a medicine is new on the market and its manufacturer is the only producer of that medicine, only one form of the drug is available to the consumer. Eventually, however, the patent protection expires, and other companies may choose to produce the generic form of the medicine.
In most cases, the generic form of a medication sold in the United States is pharmacologically equivalent to the brand formulation. Most generic medicine sold in the United States generally costs less than the brand-name medicine and is of good quality; ordinarily, a pharmacist must provide a generic version of a drug unless the physician specifies otherwise. In the state of New York, for example, the pharmacist will dispense a generic formulation of the medication I prescribe for my patients unless I specify “DAW (dispense as written)” on the prescription. Similarly, your physician will have under most circumstances to approve that a prescription medicine be filled with a specific brand rather than a generic formulation.
It is easy to become confused by the fact that a medicine will be called by different names. I always ask my patients to bring all their medicines with them to the office so that we can make sure they understand what medicines they should take and how to take them. I have frequently encountered patients who think that they are taking “a lot of medicine,” only to discover that the two separate inhalers they are using are different only because two different manufacturers are producing the same medicine.
If a patient is using inhaled Proventil HFA along with inhaled Ventolin HFA, for example, he is really only using one type of drug: albuterol sulfate. Remember that the generic name of a medicine refers to the drug itself, whereas the trade name refers to a specific company’s product and brand. For example, aspirin is a generic product; Bufferin is not.
To find out the names of your medicines, ask the doctor or pharmacist, and read labels and package inserts. If you have been prescribed any of the inhaler medications, the label will always carry the drug’s trade name along with its generic name, although the generic name will usually be in smaller print. Over-the-counter medicines are also carefully labeled to specify generic and trade names. A trade name on the label is always followed by the ? or ? symbol, whereas the generic name is not.