What’s in a name?

The International Nonproprietary Name (INN) Expert Group

October 2013

I belong to everyone and yet no one owns me.
I am pronounced the same way in most languages and I have the same meaning throughout the world.
I am similar to my close relations but am distinctly different from the other 8500 who came before me.

I am an International Nonproprietary Name (INN) – a unique generic name – allocated to almost every active pharmaceutical substance used in medicine worldwide.

Twice a year, the INN Expert Group gathers at WHO to painstakingly consider and create names for new substances used in medicines.

One generic name worldwide

The aim is come up with a single name – an INN – that can be recognized and used globally by doctors, pharmacists, scientists, medicines regulators and patients.

"By assigning a single international name to drugs, WHO helps ensure that a prescription filled abroad is what the doctor ordered back home."

WHO’s Director-General, Dr Margaret Chan

The task is not a simple one, explains Dr Raffaella Balocco Mattavelli, who manages the INN programme at WHO. “Each INN must be unique, distinctive in sound and spelling,” she says. “It must not be liable to confusion with other names in common use, in particular trade names for medications or with diseases that it may have been developed to treat.”

INNs usually contain a common syllable (known as a stem) to indicate the pharmacological or chemical family to which the substance belongs. The ending –mycin, for example – denotes a type of antibiotic. Syllables, letters or separate words are then added to differentiate between substances in the same family – such as kanamycin, erythromycin.

New INNs must be accepted and easily used by many different languages and cultures. “Global representation on the committee helps ensure that we don’t invent an INN that is difficult to pronounce or would not be accepted by certain cultures because we want to encourage worldwide use of one generic name.”

Since WHO established the INN programme in 1950, it has allocated some 8500 names. There are currently around 4000 INNs in active use worldwide. The list grows by 120–150 new INNs each year as new pharmaceutical substances request an INN.

Patient safety is key

Trademarks may expire or change but the INN needs to last for the entire life of a substance. Substances such as aspirin and morphine do not have INNs because these names were already in wide use when the system began and they were well established names.

A photo of various non-labelled medicines.

“It is extremely important that trademarks and brand names are completely different to their own INN, as well as from other INNs, as this can lead to confusion and pose a serious risk to patient safety,” says Dr Balocco Mattavelli.

WHO encourages the use of the INNs on all pharmaceutical product labels and in medical prescriptions. This ensures that everyone – from the manufacturer to the patient – is clear about which medication is in use.

“Some activities undertaken by WHO are largely invisible, quietly protecting every person on this planet,” says WHO’s Director-General Dr Margaret Chan. “By assigning a single international name to drugs, WHO helps ensure that a prescription filled abroad is what the doctor ordered back home.”

WHO works closely with the World Intellectual Property Organization, national trademark authorities, drug regulatory authorities and pharmaceutical researchers to ensure that the majority of active pharmaceutical substances in use worldwide now have their own INN.

Science poses new challenges

As global recognition of INNs grows in importance, the programme faces an increasing number of challenges. Pharmaceutical products are becoming more complex and new scientific developments for the treatment and prevention of diseases are constantly emerging. For example, new products that require unique names now include biotechnology and advanced therapy products such as used in gene therapy and cell therapy.

WHO’s INN committee of international experts considers more than 300 requests for names for new substances every year. A substance must have reached the clinical phase to be eligible for consideration.

Twice a year, new proposed INNs are published online for a four-month period to allow for public consultation before they can be accepted as recommended INNs.

More than 13 000 registered users – from researchers to health professionals to customs agencies – regularly make use of the INN database in their daily work. The INN Cumulative list is published in Arabic, Chinese, English, French, Latin, Russian and Spanish.

The next INN expert committee meeting will be held in Geneva on 22–24 October 2013.