How INNs are created. Making drug names safer by contributing to INN selection.

The international nonproprietary names (INNs) of drugs proposed by the World Health Organization (WHO) are released for public consultation. These consultations provide an opportunity to identify any risks associated with INNs that could lead to confusion. Prescrire has submitted numerous comments since it began participating in the WHO's public consultations on proposed INNs in 2007. The WHO INN programme has occasionally taken our objections into account. It is easier to replace a proposed INN when a risk of confusion is identified early, before the drug is introduced to the market and the INN enters into use. Regular analysis of the INNs proposed by the WHO reveals some of the challenges of naming drugs and the influence exerted by pharmaceutical companies and the US drug nomenclature committee (USANC) in particular. The lack of an identifiable common stem in certain INNs, sometimes perceived as an obstacle to INN comprehensibility, is a consequence of the procedure for assigning INNs, because the INN programme wants to ensure that new common stems are not created prematurely. Critical analysis of proposed INNs during WHO public consultations offers an insight into the challenges involved in devising common stems. This analysis is useful for improving the quality and safety of INNs.