June 7th, 2018

What’s Your Favorite Off-Patent Antibiotic Brand Name?

National Library of Medicine

Each time the FDA approves a new drug, they also approve a new brand name.

The FDA and other regulators want something safe. They critically want to avoid names that sound or look similar to existing drugs, which could trigger medication errors. And names that imply an ingredient or an action not supported by clinical data are also off-limits.

But what if you’re a pharmaceutical company? You probably want something snappy and memorable, something that becomes practically synonymous with treatment of the condition. In this review of the drug brand-naming process, Prozac (for fluoxetine) meets all these criteria perfectly.

Marketing bliss achieved!

To counteract this commercial force, I commonly correct ID fellows, residents, and students when they use brand instead of generic names of antimicrobials.

Some would call this pointless. Others, pedantic.

Said no one, ever: Thank you so much, Dr. Sax, for correcting me when I said Z—n instead of piperacillin-tazobactam — or “pip-tazo”, as you seem to be so fond of saying.

In compensation for these years of haranguing, I hereby present for your listening pleasure a podcast on antimicrobial brand names. Joining me is the always lively and scintillating Dr. Raphael (Raphy) Landovitz, an Associate Professor of Medicine at UCLA and a longtime friend and ID colleague.

In order to avoid infringing on complicated patent law, we stick with off-patent drugs. And since people get their podcasts from all sorts of places, here are several options:

If you have your own favorite brand names, that’s what the comments section is for — but remember, off-patent only!

18 Responses to “What’s Your Favorite Off-Patent Antibiotic Brand Name?”

  1. David says:

    Fortum for Ceftazidime

  2. Kim says:

    Augmentin ( or as patients like to call it: The Horse Pill).
    The generic name is a mouthful.

    • Loretta S says:

      I always thought Augmentin was a strange name. It sounds like it augments something else and isn’t able to treat an infection on its own.

  3. Loretta S says:

    (Sorry if this is a repeat. I am having trouble posting. Posts keep disappearing.)

    Darn it! Dr. Landovitz took the one I was going to list: Vibramycin. About a thousand years ago, when I was working as a pharmacy tech right out of high school, we dispensed a lot of Vibramycin, which was actually pretty pricey for that time. We had a very personable Pfizer drug rep, and I think he charmed all the local doctors into prescribing Vibramycin. (This was back in the days when all drug reps were actual licensed pharmacists. On busy days, this drug rep would join right in at the dispensing counter and help us clear out the backlog of Rxs. Imagine that. Wow, I feel old all of a sudden…)

    Vibramycin also gives me a chance to show off old drug names when I am lecturing and go into my rap about why nursing students hate learning antibiotics: everything — brand and generic — seems to end in “mycin” (or “micin” in some cases). Nothing there to give students a clue about the characteristics of the drug!

    Second choice for me would be Keflex. They took cephalexin, made the first consonant hard rather than soft and changed it to a “K”, got rid of the stuffy ph in the middle and changed it to an “f” and kept the “lex”. Keflex. Maybe invoking that the drug is “flexible” in its use. Nice, short, impressive-sounding name. Except it sounds like something that might be used to coat pots and pans to make them non-stick.

    Another story from my pharmacy tech days: I am old enough to remember when Keflex was a brand-new drug. And most people did not have prescription plans. Keflex cost $1.00 a pill retail. So I would bring the Rx out to the customer and 28 pills would be $28.00. Customers were outraged. “I’m not paying a dollar a pill! Take that back!”. My, how times have changed.

    No, Flagyl does not sound like a bird name to me. Maybe an anole or an iguana, but definitely not a bird.

    Thanks for the morning fun, Paul. BTW, thanks for a link with a transcript. Maybe you can do a poll to see how many prefer to read a transcript, rather than listen to a podcost. Or maybe I am the only one? 🙂

    • Paul Sax says:

      1) Keflex was a contender, at least for me — hard to get clinicians to say cephalexin. And 1.00/pill certainly seems like a bargain compared to the original list price of sofosbuvir!
      2) I maintain — Flagyl sounds like a bird.


      • Federico Tomasella MD says:

        Flagyl: at first sight, it sound to me as “fragile”, maybe because it was named due to it´s side effects if you take it with liquor!

  4. David Larson says:


  5. Test for dementia
    I have a 95 year old patient who lives alone. Her daughter-a retired schoolteacher- keeps on telling me that Mom is losing it.
    On a weekend recently Mom got sick with a cough -no fever- and was taken by the daughter to an urgent care center where she predictably got a certain antibiotic that comes in a six tablet package.to be taken over five days.

    I saw Mom for a follow up on Tuesday and she was feeling fine. I asked her how she was doing with her Z-pak. She said “What’s that” The daughter said “You know Mom, the antibiotic”. And Mom said-instantly- “Oh you mean the azithromycin!”

    Mom may be 95 but she can certainly learn new things! And that was the first time in the past 20 or so years that I ever heard that word said by any patient.

  6. I graduated 50 years ago. We were encouraged to use generic names in medical school but often had problems remembering them. Once out in practice it was much easier to recall the brand names and we were further encouraged to use brand names by the drug reps who visited our offices with lots of free samples. Much easier to write “Bactrim” rather than trimethoprim-sulfamethoxazole or “Bicillin LA or BLA” instead of Penicillin G benzathine long acting, “Zithromax” for azithromycin. “Biaxin” for clarithromycin.

    Numerous examples come to mind among the non-antibiotic medications. “Oncovin” for vincristine “Phenergan” for promethazine “Demerol” for meperidine, “Medrol” for methylprednisolone, “Valium” for diazepam (when it went off patent the manufacturer came out with a new tablet with a V-shaped hole in it to distinguish it from the generics) and “Benadryl” for diphenhydramine (still sold as a brand even though the original manufacturer – Parke-Davis – went out of business years ago), “Plavix” for clopidogrel, etc.

  7. Bernard Hirschel says:

    Reminds me of the medical student who was asked how to treat gonorrhea.

    “Peniscillin” he said

  8. Joel Gallant says:

    Let’s not forget the antiparasitics. I just learned that diethylcarbamazine for dog heartworm is called “Filaribits,” a name any good dog would wag his tail over. Then there’s Sklice (topical ivermectin), which doesn’t role off the tongue but sounds bad from the point of view of a head louse.

  9. chris wall says:

    worked in tanzania a few years ago. we imported our ceftriaxone from india. it was appropriately called POWERCEF. every morning on rounds there always seemed to be a void that was filled by this wonderful antibx.

  10. Roger Clark says:

    My favorite name is actually for the veterinary form of amoxicillin-clavulanate. Ever since I saw Clavamox, I thought the marketers of human drugs had missed out on a great name. I love names that help me remember what is in the medication!

    I too have a pet peeve about using trade names, but find myself violating it all the time. If I have a choice of saying “trimethoprim/sulfamethoxazole” vs “Bactrim”, I go with the latter most of the time (when writing it I can use TMP/SMX, but that doesn’t flow very well when speaking).

  11. David K says:

    I always thought Noxafil was a terrible name. It sounds noxious, and like it will fail. And yet somebody probably made 6 figures coming up with that.

  12. Andrew Carr says:

    Although I stray slightly off topic, my favourite name of all time was an option for darunavir before it was marketed. Instead of the “Prezista” we finally got, we were originally offered “Impactus”. The room erupted – all I could think of was my 3 months doing gastroenterology.

  13. Renée says:

    From the pod cast, along the line of a parakeet named Flagyl, I take care of lots of people with HIV and TB and have a cat named Iris.

HIV Information: Author Paul Sax, M.D.

Paul E. Sax, MD

Contributing Editor

NEJM Journal Watch
Infectious Diseases

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