Joe Graedon and Dr. Teresa Graedon

Question: How do drug companies come up with such unpronounceable names for their new drugs? Most of the names don’t seem to be related to the use of the product. Many are advertised on TV and lack any kind of memorable moniker. It’s like having to learn another language.

Older drugs do have memorable and pronounceable names. They are short, like Motrin or Advil, something English speakers can relate to. Is there a formula that drug companies use for branding a new product?

Answer: Branding is a mysterious process. You are right that drug companies used to try to match the name to the condition. Think about sedatives and sleeping pills. Restoril sends a message of restfulness. Tranxene offered tranquility, and Halcion references “halcyon,” a fancy word for a peaceful time.

Now, brands such as Otezla (for psoriasis), Xeljanz (for ulcerative colitis) or Xarelto (for blood clot prevention) sound like they come from outer space. We don’t know why Xs and Zs are so popular.


Question: I have been on metformin for about three weeks for prediabetes and polycystic ovary syndrome (PCOS). I started with 500 mg, and I am supposed to ramp up to taking it three times a day, half an hour before each meal.

I don’t know if I can manage that. Right now I am experiencing stomach upset, nausea and diarrhea. It is hard to take. The doctor says this effect will go away. Is that true?

Answer: Diarrhea and nausea are very common side effects when people start taking metformin. Many people do find that the initial digestive distress diminishes with time. Certain others discover that the side effects continue, and they can’t tolerate the drug.

Metformin works by decreasing insulin resistance. That may be why it can help PCOS. This hormonal condition is associated with too much insulin, insulin resistance and chronic inflammation.


Question: Several years ago, I was hooked on Afrin. I could not breathe through my nose unless I used it.

My doctor prescribed a tapering dose of prednisone, and I could breathe freely within one day. I didn’t like the prednisone because it made me very agitated and prevented sleep. On the other hand, it did take care of the addiction.

I don’t plan on using Afrin for more than three days again. I don’t want to have to deal with prednisone anymore, as there are problems with that, too.

Answer: Nasal decongestant sprays like Afrin (oxymetazoline) have a clear warning: “Do not use for more than three days. Use only as directed. Frequent or prolonged use may cause nasal congestion to recur or worsen.”

The official name for rebound nasal congestion is “rhinitis medicamentosa.” That means a stuffy nose triggered by medication overuse.

When people use topical decongestants such as naphazoline, oxymetazoline, phenylephrine and xylometazoline for more than few days, their noses adapt to the vasoconstriction. When the medicine is stopped, blood vessels dilate and create congestion that can be challenging. Because allergies last longer than three or four days, decongestant nose sprays are inappropriate to treat the resulting congestion and runny noses.

Another reader found a different solution: “I have always been plagued with nighttime congestion, but I’ve had great success with NasalCrom. If I forget to use it, the congestion comes right back. When I start to use it again, my congestion is gone!”

Cromolyn sodium (NasalCrom) stabilizes mast cells in the nasal passages. These cells discharge histamine and other inflammatory compounds, but this spray prevents their release. It does not lead to rebound congestion.


Question: What’s the most effective bug spray to keep ticks off? We walk our dogs in the woods almost every day and would like to avoid tick-borne diseases.

Answer: According to Consumer Reports (July 2019), either putting DEET-containing bug repellent on your skin or wearing permethrin-treated clothing can help. Even with such precautions, however, you must perform tick checks whenever you come inside from your walks.

Questions for the Graedons can be sent to them using their website,, or by writing to the following address: Graedons’ People’s Pharmacy, King Features, 628 Virginia Drive, Orlando, FL 32803.

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Joe Graedon is a pharmacologist; Dr. Teresa Graedon is a medical
