Pharmaceutical names appear to be assembled from random syllables, and they are in fact constructed under strict international conventions. The oddness is a safety feature.
Every drug carries more than one name
A medicine has a chemical name describing its structure, a generic name identifying the substance internationally, and a brand name owned by the company selling it.
The chemical name is precise and unusable in conversation, running to dozens of characters that describe bonds and side chains.
The generic name is the compromise: unique worldwide, pronounceable in many languages, and free for anyone to use once patent protection ends.
The ending tells you the class
Generic names are built around a common stem placed at the end, and that stem identifies the family the molecule belongs to.
Once the convention is known, a clinician encountering an unfamiliar name can infer roughly how the drug acts and what interactions to consider.
The remainder of the name is chosen to distinguish the individual compound, which is why the beginnings look arbitrary while the endings repeat.
Names are screened against confusion
Regulators reject proposed names that look or sound like existing ones, because misread handwriting and misheard instructions cause medication errors.
Testing includes reading names aloud under noisy conditions and examining them in poor handwriting, since both are realistic clinical situations.
That screening removes most ordinary-sounding options, and the surviving candidates are necessarily unusual, which is a large part of why they sound invented.
Brand names are marketing under constraint
Companies want a name that is memorable and suggests benefit, while regulators forbid names implying efficacy or overstating what the product does.
Letters such as x, z and q appear frequently because they produce distinctive combinations unlikely to collide with anything already registered.
A name must also clear trademark searches and avoid unfortunate meanings across many languages, which eliminates most of what remains.
The two-name system confuses patients
The same substance may be sold under several brand names in different countries and as a generic under its international name everywhere.
Patients can consequently take two products believing them to be different medicines, which is a recognised source of accidental duplication.
Anyone uncertain about what they have been prescribed should check with a pharmacist or prescriber, who can identify the substance behind whichever name is on the box.