Ask Your Doctor About

Summary

99% Invisible: “Ask Your Doctor About”
Host: Roman Mars | Reporter: Sean Cole | Airdate: May 12, 2026

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Episode Overview

This episode explores the surprisingly intricate and deeply creative world of naming prescription drugs. Roman Mars and reporter Sean Cole dive into the labyrinth of pharmaceutical brand naming, investigating not just the practical and regulatory hurdles, but also the subtle art and unexpected poetry that shapes the names we see in ads and on our pharmacy shelves. Featuring leading industry insiders—including creators behind iconic names like "Viagra"—the episode reveals the blend of marketing, linguistics, storytelling, and safety that results in those odd, often sci-fi-sounding drug names.

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Key Discussion Points & Insights

1. The Strange Sound of Drug Names

Timestamps: 01:51–04:00

• Sean Cole opens with a comic riff on the bizarre, unfamiliar drug names saturating daytime TV commercials: “What is the deal with pharmaceutical brand names? ...Watching TV in the middle of the day can make you feel like you’ve had a partial stroke that scrambled half the words on the screen…” (Sean Cole, 02:26)
• Roman and Sean acknowledge the public perception that these names sound like “Star Trek villains,” prompting the central question: is there logic or poetry behind it?

2. How Drugs Really Get Their Names

Timestamps: 04:11–11:04

• Interview with Scott Pierre Grossi, Head of Creative at Brand Institute, a company that claims to have named over 75% of new drugs on the market each year.
  • The process is rigorous and iterative—not whimsical inspiration (as lampooned in Kids in the Hall’s “Brain Candy”).
  • Initial brainstorming generates up to 500 possible names, which are slowly whittled down.
  • Client demands don't always align with what’s chosen: “Clients will say, just give me an easy to pronounce name...we’ll be lucky if we get to retain two of them.” (Scott Pierre Grossi, 06:46)

3. Sources and Methods for Name Creation

Timestamps: 07:14–10:12

• Early namers used foreign language dictionaries, theme-specific lexicons (like cowboy or surfer dictionaries), and now, AI platforms (Brand Institute’s “Brandy”) to generate ideas.
• Techniques include linguistic tricks (palindromes, anagrams), and envisioning how the drug might be depicted in media: “If it's on the cover of Time magazine...we might even try to mold that expression into a name.” (Scott Pierre Grossi, 08:09)
• Names reference desired outcomes: The name Lunesta fuses “lunar” (night) and “esta” (echoing “siesta”), while Belsomra nods to “somnus," Latin for sleep (09:10–09:48).
• Sometimes names use parts from the drug’s generic name or its mechanism of action, especially in oncology.

4. The Viagra Origin Story

Timestamps: 11:17–15:12

• Arlene Tech, a legendary pharmaceutical namer, tells how she combined “vigor” and “Niagara” (partly inspired by the idea of a “strong stream”) to invent “Viagra.”
  • “So I put vigorous plus Niagara equals Viagra.” (Arlene Tech, 12:47)
• The name was initially intended for a prostate drug, not erectile dysfunction. Pharmaceutical companies often “bank” unused names for later use.
• The angina drug that became Viagra gained its fame after a notorious side effect: “the medical term for it is lumpy trousers.” (Sean Cole, 14:02)
• Tech jokes about her fame: “Alice, my husband always used to say, I’m married to the Viagra woman.” (Arlene Tech, 14:56)

5. Why Drug Names Got Stranger

Timestamps: 15:12–18:17

• The “big bang” for modern brand naming was the 1988 debut of Prozac: short, punchy, and purely about marketing, not function.
  • “It was what they now call a blank canvas or empty vessel type name...” (Sean Cole, 15:54)
• There’s now explosive growth in new drugs—50 FDA approvals a year, up from 17 in 1988—creating fierce competition for original, trademarkable, and nonconfusing names.

6. The Role of Regulation

Timestamps: 18:17–23:58

• Strict FDA rules drive much of the eccentricity:
  • No big claims allowed (e.g., “Flowmax” wouldn’t pass today because it implies guaranteed result).
  • Names cannot resemble existing drugs; look-alike/sound-alike mix-ups can be deadly.
• Famous case: “Losec” and “Lasix” confusion resulted in a patient death, leading to "Losec" being rebranded as “Prilosec”—which then sounded too much like “Prozac” (20:07–21:44).

7. The Visual Shape of Names

Timestamps: 21:59–23:58

• Approvals can hinge on how a name looks in handwriting: names must have “ascending and descending letters” (like L or g), making their silhouette distinctive and avoiding confusion.
  • “If it doesn’t have that, doesn’t get approved.” (Arlene Tech, 22:04)
  • Scott emphasizes: “Y is the only vowel that has a visually differentiating quality to it.” (Scott Pierre Grossi, 23:30)
• This quest for visual uniqueness adds to the outlandishness of new names.

8. The “Poetry” of Drug Naming

Timestamps: 29:37–34:36

• Both Tech and Grossi admit how funny and strange some names sound to the public.
• Despite the technical and regulatory constraints, both emphasize that great naming is an art form.
• Tech, also a haiku poet, describes the “musicality” of good drug names, even “singing” them to herself:
  • “If a name can sing for you, if it’s easily—sing means it’s easily pronounceable.” (Arlene Tech, 30:48)
• She details the story-driven approach to the insulin name “Toujeo,” originating from the Haitian Creole word “toujou,” meaning “always.” The goal: a name that subtly evokes narrative and emotional resonance for patients (31:21–32:54).
• The thrill comes at the moment of invention, not after market success:
  • “…it was like a mental orgasm...when it sings and it looks good and it’s gonna work...it just lights you up all over.” (Arlene Tech, 33:50–34:09)
• Grossi is more pragmatic but confesses to rooting for certain names and even creating jingles for them in his head (34:09–35:13).

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Notable Quotes & Memorable Moments

• “Clients will say, just give me an easy to pronounce name…we’ll be lucky if we get to retain two of them.” (Scott Pierre Grossi, 06:46)
• “So I put vigorous plus Niagara equals Viagra.” (Arlene Tech, 12:47)
• “The medical term for it is lumpy trousers.” (Sean Cole, 14:02)
• “You have to have ascending and descending letters. If it doesn’t have that, doesn’t get approved.” (Arlene Tech, 22:04)
• “Y is the only vowel that has a visually differentiating quality to it...” (Scott Pierre Grossi, 23:30)
• “If a name can sing for you…means it’s easily pronounceable.” (Arlene Tech, 30:48)
• “…it was like a mental orgasm…when it sings and it looks good and it’s gonna work…it just lights you up all over.” (Arlene Tech, 33:50–34:09)

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Timestamps for Critical Segments

• 01:51–04:00 – Introduction to the puzzle of drug names
• 04:11–11:04 – Interview with Scott Pierre Grossi and the creative process at Brand Institute
• 11:17–15:12 – Arlene Tech recounts naming Viagra
• 15:12–18:17 – Evolution of name trends (Prozac as turning point)
• 18:17–23:58 – Regulatory restrictions and their impact
• 21:59–23:58 – Visual requirements for names (ascenders/descenders)
• 29:37–34:36 – Artistry, poetry, and the emotional satisfaction of naming

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Thematic Takeaways

• Naming drugs is a mix of science, linguistic craft, regulatory constraint, and artistry.
• The oddity of modern drug names comes from complex practical requirements: safety, trademark law, uniqueness, and the limitations of the alphabet, mixed with deeper narrative and poetic impulses.
• Behind every launched name—no matter how odd—there’s a story, an intention, and sometimes even a melody.

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Final Thoughts

If you’ve ever chuckled at a pharmaceutical ad and wondered why that drug is called “Vimzelics” or “Skyrizi,” this episode pulls back the curtain to reveal both the creativity—and the obstacles—behind every pill bottle label. As Sean Cole observes, you may never look at those pseudo-alien syllables the same way again.

Transcript

[Roman Mars]

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[Arlene Tech]

Learn.

[Roman Mars]

Less stress, less time, more results. Now with Indeed Sponsored Jobs and listeners of this show will get a $75 sponsored job credit to help get your job the premium status it deserves. Indeed.com podcast terms and conditions apply. Hiring do it the right way with Indeed. This is 99% invisible. I'm Roman Mars.

[Sean Cole]

Roman, what prescription drugs do you take? Do you take Journavox?

[Roman Mars]

This is Sean Cole, everybody. He's an old friend of mine.

[Sean Cole]

A friend of the show or Extensor? Do you take Extensor?

[Roman Mars]

I don't think I want to discuss,

[Sean Cole]

you know, like, Xiaflex.

[Roman Mars]

What is going on?

[Sean Cole]

Ask your doctor.

[Roman Mars]

Ask your doctor about X. Denvy.

[Shopify Advertiser]

Ask your doctor about Nexplanon.

[Simplisafe Advertiser]

Ask about Repatha.

[Roman Mars]

Ask about Nucala.

[Shopify Advertiser]

Ask your doctor about Caplita.

[Sean Cole]

Help. See more of the light inside of me.

[Roman Mars]

Okay, Shawn, why are we talking about this?

[Sean Cole]

So the reason I'm sitting here with you today can pretty much be boiled down to the Seinfeldian question. What is the deal with pharmaceutical brand names? It's like watching TV in the middle of the day can make you feel like you've had a partial stroke that scrambled half the words on the screen, which is Ironic considering that that's probably what some of the drugs they're advertising are supposed to prevent.

[Roman Mars]

Once monthly. Ebglis is a treatment that can be used with or without topicals. Dupixent can help you stay ahead of eczema.

[Sean Cole]

Ingrezza, Vimzelics, Cobenfi, Prist, Caplita, Cap Facta, Cabenuva Jardians. Maybe we don't need a pill for everything. You can say that again. Kenan Thompson. But for managing weight, there's WeGovy, the first and only GP. It's funny that Kenan did a real pharmaceutical ad, given that he was also in this Saturday Night Live sketch about a fake hormone supplement for women. There's a new drug for gals over four.

[Roman Mars]

It's called the jj.

[Sean Cole]

I think it's for Jerded.

[Scott Pierre Grossi]

Whatever.

[Sean Cole]

Just dance. So we all laugh about these drugs, but the question becomes, why do they all sound like Star Trek Vill? Is that by design? Is it necessary for some reason? Is it simply wrong headed on the part of the marketers?

[Roman Mars]

I mean, those are a lot of questions, but do you have some answers for those questions?

[Sean Cole]

Yes, I got to the bottom of it and I'll just say underneath the noisiness of the names is not just a logic that you'd never guess is in operation. In a lot of cases there's. I know how this is going to sound. An actual poetry going on that I never imagined and that I now want everybody else to be thinking about the next time they see one of those ads.

[Roman Mars]

That's a big claim when you're talking about brand names of drugs.

[Sean Cole]

Okay, but just hear me out. We'll see what you think at the end. But just to start at the beginning.

[Scott Pierre Grossi]

Hello, Scott?

[Sean Cole]

Yes, Sean, hi, how are you? This is Scott Pier Grossi who is in practically every article you read about pharmaceutical brand names. And there's a reason for that. He's the head of creative at the Brand Institute, which is kind of a clearinghouse. They help Name More than 75% of the new drugs on the market in a given year.

[Roman Mars]

75%? One company?

[Sean Cole]

Yep. At least according to them. 75% of both brand names and generic names too, which are even longer and wilder sounding. As you know, they have a separate department for generics or non proprietary. They get upset when you say generics. Non proprietary names. But we are focusing on the brand names, the Brand Institute names.

[Scott Pierre Grossi]

Can I also respectfully correct you and say it's just Brand Institute?

[Sean Cole]

I'm sorry, I'm sorry. Yes. Lose the The. It's cleaner.

[Scott Pierre Grossi]

That's right. That's right.

[Sean Cole]

Scott's been at Brand Institute for more than 20 years, and I just asked him to, you know, take me through the process from the beginning. Like, where do they even start naming a drug?

[Scott Pierre Grossi]

Have you ever seen the movie Brain Candy?

[Sean Cole]

No. Should I?

[Scott Pierre Grossi]

You should see it. Absolutely. This is a Kids in the hall movie.

[Sean Cole]

That's Kids in the hall, the sketch comedy troupe from Canada.

[Scott Pierre Grossi]

And Brain Candy was about a new antidepressant drug that came to market.

[Roman Mars]

Hmm.

[Scott Pierre Grossi]

So. But they have a scene where the marketing guy comes into the boardroom and he tells the story of how he thought of the name.

[Kids in the Hall Actor]

Okay. I was driving around last night in my $62,000 car, and I'm trying to think up a name for the drug, and suddenly it hit me.

[Arlene Tech]

The name?

[Sean Cole]

No, A bird.

[Kids in the Hall Actor]

It hit my windshield. When that happened, I got depressed.

[Sean Cole]

Not you, Cisco?

[Kids in the Hall Actor]

Yeah, even me. But as soon as I got depressed, I got undepressed. Cause as I was cleaning the gleaming guts of that bird off my windshield, I thought of the name for the drug.

[Scott Pierre Grossi]

And he says, gleeman X. And everyone does, like, a slow applause. And it's the opposite of how it actually works.

[Sean Cole]

How it actually works is much more rigorous and time consuming. They meet with the client, be it Pfizer or Amgen or whomever, kind of get a sense as to what they're thinking. And from there, Brand Institute assigns a small team to come up with an initial list of, like, three to 500 ideas on their own.

[Roman Mars]

500 names. That's a lot of brainstorming for names that will not get used. It's amazing.

[Sean Cole]

It is. And at that point, the job is pretty much just figuring out which ones are actually viable and good enough to test out with the client.

[Scott Pierre Grossi]

It's funny, because clients will say, just give me an easy to pronounce name, and we'll call this a win. And then we present a slide, let's say, of 25, and we'll be lucky if we get to retain two of them. And they are. They are all solely easy to pronounce. And the client just like, meh, I just don't like it. And I'm like, but that's what you asked for. Just remember that that's what you asked for.

[Sean Cole]

Because why don't they like those ones? Like, what is it when they say no?

[Scott Pierre Grossi]

They can't see it. They can't see it as the product. It doesn't fit.

[Roman Mars]

And how are they generating these ideas in the first place? Like, when they're coming up with all these ideas. Where are the ideas coming from?

[Sean Cole]

Well, historically, how it worked was everybody was just sort of foraging omnivorously anywhere and everywhere for different combinations of words and letters. Magazines, foreign language dictionaries. Another company I read about. So not Brand Institute, but a competitor said they sometimes leaf through cowboy dictionaries and surfer dictionaries.

[Roman Mars]

What's a cowboy dictionary?

[Sean Cole]

I looked it up. There's one from 1968 called Western Words by Ramon F. Adams. I see a little hoss is soon curried.

[Roman Mars]

Well, I'll take your word for it.

[Sean Cole]

Brand Institute has also started using an AI platform called Brandy. Cute. That's just helping out with the initial phase of the process. Scott says a lot of the work is still done by humans.

[Scott Pierre Grossi]

You might explore types of names like palindromes or anagrams. One of the more helpful exercises we do is we try to get the client to state, like, if it's on the COVID of Time magazine, for example, what would the headline say? And then we actually might even try to mold that expression into a name.

[Sean Cole]

Hang on. So you would try to take that sentence?

[Scott Pierre Grossi]

Yeah. So let's say a drug alters your course in life. Altacore. So that name is true.

[Sean Cole]

I want a drug that does that. By the way, if I could take

[Scott Pierre Grossi]

Altacors, boy, oh, boy, alter course.

[Sean Cole]

Or they could look at the drug and say, okay, what is the hopeful outcome of taking this thing?

[Arlene Tech]

And.

[Sean Cole]

And then explore that from a bunch of different angles. So, for example, sleep aids. They could say, okay, this is a drug that helps you stay asleep through the night. Or this is a drug that leaves you feeling refreshed in the morning. Same section of the drugstore. Two different ways of looking at it. So, for example, there's Lunesta, a drug that Scott's company named.

[Scott Pierre Grossi]

The reason Lunesta works is because of the lunar imagery. The suffix esta has a inference of

[Sean Cole]

restorative sleep, as in siesta.

[Roman Mars]

Ah, okay. Very cool.

[Sean Cole]

See what they're doing there?

[Scott Pierre Grossi]

But really, the lunar is what anchored it. So nighttime sleep. Within the category, you have Ambien. What is Ambien? It's ambn. Good morning. So that's the good. The good morning, husband. Then you have newer products like Belsomra. That's a beautiful night's sleep. With Belsomra Bell som is somnus, which is sleep in Latin.

[Sean Cole]

Then there's other sources of little name building blocks. They might grab a few letters from the generic name of the drug or the active ingredient for Example, bupropion hydrochloride. That's the active ingredient in the antidepressant Wellbutrin. And then sometimes the name is derived from the science of how the drug works. A lot of cancer drugs are like that, Scott says, because the audience is really more the doctor than the patient in those cases.

[Scott Pierre Grossi]

So oftentimes we want to highlight what's unique about that product from a scientific standpoint because that'll resonate with oncologists. And about half of new cancer therapies are derived from the mechanism of action. So the science behind the drug, that

[Sean Cole]

is what the drug is actually doing and to what part of you. So there's this one drug called Imdeltra. It's I M, D E L L

[Scott Pierre Grossi]

T R A M Deltra is a DLL3 immunotherapy.

[Roman Mars]

Well, of course.

[Sean Cole]

I mean, everybody knows about that.

[Scott Pierre Grossi]

So the double Ls and the TRU suggesting three is so intentional to represent the mechanism of action of the product quite elegantly.

[Sean Cole]

And if Scott Pierre Grossi sounds ever so slightly defensive about the name Indeltra, it's because another drug namer I talked to did not agree with him.

[Arlene Tech]

It satisfies a meaning that. But look how it looks, and that doesn't really look that good. Emdeltra. It's hard even to say.

[Roman Mars]

Okay, so who's this?

[Arlene Tech]

I am Arlene Tech. I have worked in brand naming for 30 plus years, most of those naming pharmaceuticals.

[Sean Cole]

Arlene is kind of a legend in pharmaceutical branding. And once I learned a little bit about her and her background, I. I couldn't not reach out to her to get her perspective on how prescription drugs get their names.

[Roman Mars]

And does she sort of predate the Brand Institute style of naming?

[Sean Cole]

Yeah, she's like a OG and unlike Brand Institute with its teams of 15 people or whatever, the places Arlene's worked, people tend to tackle projects on their own. And just to give you another picture of how drug names are invented, there's this one drug she was assigned back in 1992 that was for benign prostatic hyperplasia. Enlarged prostate, basically, which makes it difficult to pee. In trying to figure out what to name this drug, Arlene ran a focus group with a bunch of urologists. And this one doctor in particular said something that stuck with her.

[Arlene Tech]

It was at the end of the group, and I asked the doctor, what's it like when the drug worked and the guy got well. And the doctor said, visualize a strong

[Sean Cole]

stream, A strong stream of urine.

[Scott Pierre Grossi]

Yeah.

[Arlene Tech]

So when I was home and I was writing the notes up, I thought to myself, well, a strong stream that would be vigorous. And the first thing I could think of that was stream like that was Niagara.

[Roman Mars]

No.

[Sean Cole]

Yes.

[Arlene Tech]

So I put vigorous plus Niagara equals Viagra.

[Roman Mars]

Oh, my God.

[Sean Cole]

I know. I met the woman who named Viagra. She gave me her pen. I'm going to keep it forever and ever.

[Roman Mars]

But wait a second. So. But Viagra is for erectile dysfunction, not like the enlarged prostate that makes it hard for you to pee. So what is that about?

[Sean Cole]

It is. And this is where this naming business gets even more complicated. Super interesting trick of the industry. Just to digress here for a second. So Arlene came up with the name Viagra for this drug to treat prostate enlarged man. But for a lot of complicated reasons. They didn't end up using the name Viagra for that benign prostatic hyperplasia drug. And as far as Arlene knows, they just held onto the name. It's true that companies can bank names in certain circumstances and use them later when a better fit comes along. And around that same time, Pfizer was testing a completely different drug which had nothing to do with the prostate. That drug was supposed to treat angina, which is chest pain due to a heart condition.

[Arlene Tech]

And the test was very successful. Everybody was complying with it. And some, some of the guys came back and asked for more because while

[Sean Cole]

it didn't work very well for angina, it did have this crazy side effect. I think the medical term for it is lumpy trousers.

[Arlene Tech]

And so they thought, well, that would be a much better way to sell this drug if it did that. And they tried to do the whole thing right. They tried to have a focus group,

[Sean Cole]

a focus group to name their new miracle erection drug.

[Arlene Tech]

And the names that came up just weren't that good. They were either too overtly sexual, and then some of the names were just not male enough.

[Sean Cole]

If you want to sell a drug to Treaty D, it should have a pretty masculine name. And they just so happened to have the one that Arlene thought up stored away. So they went with that. So how, how does it feel to have named Viagra?

[Arlene Tech]

Different.

[Sean Cole]

Different than having not named Viagra.

[Arlene Tech]

Alice, my husband always used to say, I'm married to the Viagra woman.

[Sean Cole]

That could mean a lot of things.

[Arlene Tech]

Yes, it could. Well, I have also told people that I have a one word resume.

[Roman Mars]

You know what's funny about that story is that it really is a lot more like that scene in the Kids in the hall movie where the guy comes up with Gleeman X. I mean, she was just, like, trying to think of a name for a drug, and then this thing happened, and it made her think of another thing, and it led her to the name Viagra.

[Sean Cole]

It really is much more like that. Yeah.

[Roman Mars]

So why can't all drugs, you know, have that same approachability? Like, Viagra is a very approachable name. Lunesta is an approachable name. But why aren't they still. Like, when you started, you started naming all these things, things like Skrillex or

[Sean Cole]

something, you know, like, Skrillex is a dj. I think you mean Skyrizi.

[Roman Mars]

Okay, Skyrizi. And, you know, Wegovy, whatever. Like, how do we get to there?

[Sean Cole]

Okay. So just to start back in time a bit, even farther back from when Arlene named Viagra. So the big bang of pharmaceutical naming, as Scott Pierre Grossi calls it, comes in 1988 with the introduction of Prozac. That was the first real blockbuster name. It's short, punchy, and it was all about marketing as opposed to even indicating what the drug did. It was what they now call a blank canvas or empty vessel type. Name obviously caught the public attention. It became a household word. The guy who named it, David Wood, is now in the Medical Advertising hall of Fame.

[Roman Mars]

There's actually a Medical Advertising hall of Fame.

[Sean Cole]

Of course there's a Medical Advertising hall of Fame.

[Roman Mars]

Nice.

[Sean Cole]

David wood died in 2007, and Arlene was really a protege of his. She worked really closely with him.

[Arlene Tech]

Basically, I think he was trying to do a name that was semi abstract. Everybody knew that the word pro meant something positive. You were for something. And the zach was simply a syllable that woke people up.

[Sean Cole]

It's like, zap, zang, zip.

[Arlene Tech]

Well, the K sound on the end, Zach, had a sharpness to it. You know, a sharp sound might indicate something that was more targeted.

[Sean Cole]

So that year 1988, only 17 drugs were approved by the FDA for therapeutic use. 17 prescription drugs that needed brand names. And that number has just trended upward over the years. So last year, almost 50 new drugs hit the market. Number of letters in the Alphabet still 26.

[Roman Mars]

And, like, why are there so many more drugs being approved now?

[Sean Cole]

Just sheer growth in the industry, for one thing. More and more drugs being developed, especially with cancer, is a big push on that front. And then a few other reasons that, believe me, are too wonky even for this show.

[Roman Mars]

I'm going to try not to take that personally.

[Sean Cole]

Please don't. Meanwhile, the Scots and the Orleans of the world are trying to accomplish something that in this climate just gets harder and harder. I mean, in every case, they want to come up with something totally new if they can manage it. A singularly unique name is the goal. Why? Trademarkability, for one thing, and just plain marketability. They want the product to stand out. But the main factor driving this ceaseless crusade for nominal innovation, Roman, is the fda.

[Roman Mars]

Huh? And so why does the FDA do this? Like, what are the rules?

[Sean Cole]

So two big things to focus on here. Number one, what? A drug seems to be promising. The FDA doesn't want a name to sound like, oh, this is some miracle drug. So no big claims in the name.

[Scott Pierre Grossi]

I'm sure you're familiar with Flomax.

[Sean Cole]

Sure. I don't remember what it does.

[Scott Pierre Grossi]

Flomax is for bph, that is benign

[Sean Cole]

prostatic hyperplasia, that same enlarged prostate condition that was the very first inspiration for the name Viagra.

[Scott Pierre Grossi]

So maximum flow.

[Sean Cole]

Flow max.

[Scott Pierre Grossi]

Simple, right? Simple. So that name was approved in the late 90s, I believe, and that name is an example of one that probably today would be more challenged. And this is me speculating. I have no data to say this, but based on the guidance. What is maximum flow? Right. What is that?

[Sean Cole]

I know how to determine maximum flow.

[Scott Pierre Grossi]

Go ahead.

[Sean Cole]

Pissing contest.

[Scott Pierre Grossi]

Oh, geez.

[Sean Cole]

Sorry. Anyway, that's why Scott, when he talks about these drugs is he's pretty circumspect. Like, he'll. He'll be like, he'll name a drug and then be like, it comes from this. I mean, if you were potentially able to extrapolate that connotation. Because nobody wants to come right out and say, like, you know, take. You'll definitely sleep through the night at all. Oh, it's on sale. You know, they want some plausible deniability. Another thing the FDA very much wants to avoid is christening a new drug with a name that sounds or even looks too much like a drug that's already out there, which is a big deal in terms of our actual physical safety. Medication errors kill people. And sometimes it's because of that lookalike sound alike problem. And there's this sort of poster case that people point to regarding that kind of mix up.

[Arlene Tech]

There were two drugs. One was called Lasix L A S I X, which I believe was a diuretic. And the other one was called Losec L O S E C, which helped people with ulcers and different types of heartburn.

[Sean Cole]

In short, this one patient was admitted to the hospital. This was like the late 80s, early 90s, had a lot of health issues, including an ulcer for which the doctor prescribed Lowseq. But the attending nurse gave her Lasix and the patient ultimately died. So the FDA got involved and said, you know, you gotta change one of these names. And somehow it was decided that Losik would be the one to change.

[Arlene Tech]

So Losik came to David Wood and said, we need this help. And David Wood realized that there was already a lot of investment in the name Losek. Doctors all knew it, and if there was too much change going on, doctors wouldn't recognize it, might not prescribe it, the company would lose sales. So what he did was he left Losesec the same and added a three letter prefix. It became Prilosec.

[Sean Cole]

Oh yeah, you've heard of Prilosec? Yeah, yeah, it's a better name, I think.

[Roman Mars]

Yeah, I think so too. Yeah, Prilosec works. I remember it. And I don't remember a lot of drug names.

[Sean Cole]

Yeah. Problem being that then Prilosec started to become confused with Prozac.

[Roman Mars]

Oh, true story. Maybe it's why I like it, because it sounds like Prozac.

[Sean Cole]

Right. Also to point out with the Lasix and low sick example, the doctor had written a prescription by hand. So it was a visual mix up, which namers try to avoid by honing in on the physical shape of the name.

[Arlene Tech]

It has to have ascending and descending letters. If it doesn't have that, doesn't get approved.

[Sean Cole]

It has to have ascending and descending

[Arlene Tech]

letters because other than that, the silhouette of the name would be flat.

[Roman Mars]

Describe this. The silhouette of a name.

[Sean Cole]

So if you picture like a city skyline reflected in a river that you can think of, that's what the name looks like, right? There's skyscrapers and they're little low warehouses. And these are all built out of lowercase letters.

[Arlene Tech]

And you have letters that stick up

[Sean Cole]

like L, T and H, letters that stick down like P, Q and G

[Arlene Tech]

and letters that are flat, you know, like A, E, S and all that sort of thing. And if that silhouette was just a flat thing like that, that's easily confused by. There are too many other flat things like that. So you have to have, you know, the silhouette would have something that goes up someplace, something that goes down someplace, you know, and then you get a different perceptual silhouette.

[Sean Cole]

Now strictly speaking, there are names that get through without sticky up, sticky down letters. But it is true that variation helps a lot in terms of approval, which when you think about it, is another huge reason why the names are so kooky. If you want a K sound, sure you could use a lowercase C there, but you could also use a lowercase q which has the tail that sticks down. Or instead of the letter I, you could use a lowercase y. Scott really

[Scott Pierre Grossi]

likes a lowercase Y. Y is the only vowel that has a visually differentiating quality to it. A, E, I, O, U all exist in the same visual plane. And here comes Y with that downstroke quality to it. So now you're seeing trip tier I believe was last year approval. T, R, Y, P, T, Y, R. That's like a double whammy differentiation visually. So yes, 100%. Give me a B, give me a K. Give me a Z. Give me an X.

[Sean Cole]

What's that spell? Yes, and that name was approved last year also. So putting this all together again, no big claims, no lookalike, sound alike names, stricter enforcement of those rules. Which means the goal now is to come up with something completely novel in an age where there are more and more new drugs coming out all the time. And this, I think, is where the artistry of drug naming really comes to life. But let's talk about that after this break.

[Roman Mars]

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[Sean Cole]

They do.

[Roman Mars]

Okay.

[Sean Cole]

They do. I talked about that a lot with Scott. I even went down the list of last year's approved names with him and was like, you know, this one's crazy and these are drugs that brand institute named. I'm like, are you aware that people are comparing these names to sci fi characters?

[Scott Pierre Grossi]

That is absolutely something that we hear. But understand that where we are is the result of there being 26 letters in the Alphabet. Right. And you have to combine them in a way that is distinctive and differentiating and contending with this path to a global regulatory approval for the same name across the world. And this is oftentimes the type of names that come out of that process. So that's why I don't get too offended when people say, oh, you know, they joke about drug names. It's like, well, I completely get it. It's like a couple gut punches. But then you get over it, right? Because as a creative, you want your work to be lauded and everyone to love it. And you do get names that come out and they're like instant hits. They instantly. People love saying them. And then you get other ones where nobody even wants to say it, but that's all just part of the job.

[Sean Cole]

And it is a job. But like I was saying at the beginning, there's also this distinct artistic and even poetic aspect to it that I wasn't expecting. That I think is apparent in some of the things we've talked about already, but especially as regards Arlene, because Arlene, as well as inventing drug names, writes haikus.

[Roman Mars]

She's a poet.

[Sean Cole]

She's a poet.

[Roman Mars]

As are you.

[Sean Cole]

You're a poet, as am I. And at first she insisted. Insisted that her drug naming and her haikuing have nothing to do with each other. But finally she conceded that, yes, in both pursuits, the sound of the thing is really important, the tonality. You should read your haikus out loud when you're writing them, she says. And you should do the same with a drug name.

[Arlene Tech]

It has to feel like it fits in your mouth. It has to flow in conversation. So when you tell somebody, I am taking Viagra, you know, that's an easy sentence to say, not awkward. It's not like you're gonna try to say, I am taking emdeltra.

[Roman Mars]

God, she really hates the name Mdeltra.

[Sean Cole]

She really does.

[Arlene Tech]

What I would do is I would sort of sing them to myself.

[Sean Cole]

Sing them, sure.

[Arlene Tech]

If a name can sing for you, if it's easily, sing means it's easily pronounceable.

[Sean Cole]

And they literally sing.

[Arlene Tech]

Well, not like operatic, but.

[Sean Cole]

I see.

[Roman Mars]

Is that a real drug name that she's singing? Toujeo.

[Sean Cole]

It's. Yeah, it's an insulin shot for diabetics. And it's with Toujeo that I think you can really see the poetical nature of Arlene's thinking when she sits down to name a drug.

[Roman Mars]

So explain what you mean?

[Sean Cole]

So the thing about Toujeo is that it's longer lasting than a similar drug that came before it. Instead of 24 hours, it's effective for like 30 hours, give or take. And as Arlene and her team were brainstorming, they developed this. They do this sometimes. They developed a prompt, they call it a platform, this prompt to riff off of. And the prompt was your friend for life. And from there, Arlene unspooled this whole story in her head, a kind of romantic story about young people, young adults just beginning their adult lives.

[Arlene Tech]

Imagine, you know, especially when they're going out to working in their first jobs, and they're meeting new people. There's always the idea of after work, the spontaneous sexual flirtation.

[Sean Cole]

But if you're worried about having to take your next insulin shot, you can't be spontaneous. Unless, again, that shot lasts long enough to give you the freedom to stay out later.

[Arlene Tech]

So that if somebody wanted to go on a date after work, you know, they'd simply have to get home before 4 o' clock in the morning or something like that to get their shot. It'll become your friend for life because it will permit you to enjoy your evenings if you want tojeo. Came from the Haitian Creole word toujou, T O U, J O U, which came originally from the French word toujour, which means all the days, always. And toujou was the Haitian Creole version of it, always.

[Sean Cole]

So she's got this whole narrative arc that she wants to express somehow, in a word, in a musical word. She doesn't need people to know the story. She just needs them to feel its resonance.

[Roman Mars]

I see. So that's the real poetry of it.

[Sean Cole]

That's right. A whole story, a whole world that you just need to feel the underlying resonance of in the music of a word. When you're naming drugs and you've named a lot of them, how did, like, how did it feel when finally it was out on the market? Was there a thing where you're like, oh, man, I'm immortal. Like, I'm in people's households?

[Arlene Tech]

No. What the feeling was not then. It was when I originally came up with the name and wrote it down on paper, and I said, this is going to be a good one. That's when I had the good feeling.

[Sean Cole]

Say more about that.

[Arlene Tech]

Well, it was like a mental orgasm. You. You get something that you know is good, you know that you've done other things not that good. And here comes this. And you know, when it sings and it looks good and it's gonna work, you know, and all that. It just lights you up all over.

[Scott Pierre Grossi]

I'm a little more reserved in my feelings. I'd say. I'm also a little more pragmatic.

[Sean Cole]

Scott doesn't even like to talk about himself as an autonomous being in this regard. Like. Like, he's all about the team and the partnership and literally will say that he gets his pleasure out of creating a lot of great names at scale, but there are those ones. There are those names that he favors in his heart.

[Scott Pierre Grossi]

Sometimes there's a good name. And I'll say internally, I'm like, what's going on with that name? Is it still alive? Has it died yet? What's going on? How could we keep it in? I do keep an eye on some projects, and I say, I hope that makes it. We do have one coming up for a weight loss drug that I'm very excited about.

[Sean Cole]

Can you say.

[Scott Pierre Grossi]

Can you say, oh, absolutely not? Can I say I like my job? No, we do have one or two. A lot going on in the weight loss category, but, you know, I hope it works. We're waiting regulatory feedback. So it's still, like, up in the air. And I have a jingle in my head for it, too.

[Sean Cole]

So, dude, if this name passes, I am so going to ask you what I will.

[Scott Pierre Grossi]

I'll let you know.

[Sean Cole]

Okay. Please do.

[Scott Pierre Grossi]

And I'll just say this. I'll just say this, this name. And the jingle or the song associated with it will be so obvious. If and when the name gets approved, you'll text me and you're like, I get it. I get it.

[Roman Mars]

Okay.

[Sean Cole]

You're right.

[Scott Pierre Grossi]

I'll leave it at that.

[Sean Cole]

And I'm sitting here like, I never thought I would be hoping for the moment that I see a TV ad for a weight loss drug with one of those names, and I'm like, that's the one. I really hope that happens.

[Roman Mars]

I hope so, too. You see, this is why we love to have you do stuff for this show. This was so great, Sean, thank you.

[Sean Cole]

Always a pleasure. Roman.

[Roman Mars]

99% Invisible was reported this week by Sean Cole. Produced and edited by Christopher Johnson Mixed by Martin Gonzalez Music by Swan Real fact checking by Naomi Barr. Like I mentioned earlier, Sean is a longtime friend of the show and a friend of mine. He's been doing stories for us for, like, more than a decade. So go to our website and check out all of his greatest hits, including one on how to hack your IKEA furniture, the one on cow tunnels, and that everyone loves. They still mention it to me to this day. And my personal favorite about the album Art of Devo. Check them out. Cathy Tew is our Executive producer. Kurt Kohlstedt is the digital director. Delaney hall is our Senior editor. The rest of the team includes Chris Farube, Jason De Leon, Emmett Fitzgerald, Vivian Lesh, Madonna, Joe Rosenberg, Kelly Prime, Jacob Medina, Gleason, Talon and rain Stradley and me, Roman Mars. The 99% of his logo was created by Stefan Lawrence. We are part of the SiriusXM podcast family now, headquartered six blocks north in the Pandora building in beautiful uptown Oakland, California. You can find us on all the usual social media sites as well as our new Discord server. There's a link to that as well as every past episode of [e-mail].

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