We have a tendency to call prescriptions by their brand names long after they’ve been available as generics. That’s because the generic name is often hard to pronounce. For example: fludarabine, alglucerase, chlorothiazide. They aren’t exactly names that roll off the tongue.

I’ve never given much thought to where generic names come from. I guess I just assumed the drug companies came up with them. Or some sort of random generator? In reality, the names come from the United States Adopted Names Council, and they are predominantly the work of two women: Stephanie Shubat and Gail Karet.

According to the Los Angeles Times, Shubat and Karet make the recommendations, which go to a five-person council. The council meets twice per year in person, but does most of its work via email.

How do Shubat and Karet come up with the names? They have a few guidelines. One is that the generic name can’t resemble the original name; otherwise that gives the original manufacturer an advantage once generics can be made.

Another is the use of “stems,” which help indicate the type of medication. For example, “azepam” is the end of a class of anti-anxiety medications, like Lorazepam. “Profen” is for certain anti-inflammatory prescriptions, such as flurbiprofen. They add syllables onto the stems to come up with the name, avoiding letters that are difficult for non-English speakers such as W, H, and Y.

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Coming up with 200 new names per year is a bit of a challenge. According to the Los Angeles Times, the two ladies find inspiration in lots of places, including license plates and the names of pets.

Personally, I love that two women are responsible for something that’s such an important part of our lives and health.

Even if no one really knows about it.