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For a translator, choosing a specialisation is not easy – it involves evaluating your capabilities and interests. Specialising in medical and pharmaceutical translation can be a conscious decision, or due to unforeseen events and life circumstances. All medical translators share a love of languages and of everything medical. This does not mean that they have superhuman knowledge of the entire field. After all, knowledge is not something we are born with, but rather a treasure earned with innate curiosity and hard work. Two invaluable resources for all medical writers and translators are the International Statistical Classification of Diseases and Related Health Problems (ICD) and international nonproprietary names (INN). Both provide a wider and clearer picture of the subject matter, thus enabling deeper understanding and, in the case of translators, more accurate translations.

International classification of diseases (ICD)

The International Statistical Classification of Diseases and Related Health Problems (ICD) is a global standard for health data, clinical documentation, and statistical aggregation. The ICD was created in 1948 by the World Health Organisation (WHO), which has been responsible for managing and updating it ever since.

The ICD is the international standard for disease and health condition reporting, as well as for all purposes related to diagnosing, treating, and researching medical conditions. Ever since the 1960s, WHO member states have been required to use the current version of the ICD for recording and reporting national and international mortality and morbidity statistics. The ICD is regularly updated, since by definition, it has to follow all developments in medicine and pharmaceuticals. ICD-10 (i.e. the 10th revision of the ICD) took effect in May 1990. Since then, it was actively used by more than 150 countries and translated into more than 40 languages. As of 1 January 2022, it will be superseded by the 11th revision, ICD-11.

As stated on the WHO website, “the ICD defines the universe of diseases, disorders, injuries, and other related health conditions, listed in a comprehensive, hierarchical fashion”. This hierarchical quality makes it perfect for use in medical and pharmaceutical translation. The disease terminology is crucial for medical translators, but ICD also delineates terms related to medications, allergens, chemicals, and histopathology, all of which is indispensable for pharmaceutical translators.

International nonproprietary names (INN)

Another useful resource coordinated by the WHO since the early 1950s, is the international nonproprietary name (INN) system. Also known as a generic name, an INN is intended to facilitate communication between different countries about each unique active substance that is to be marketed as a pharmaceutical. Since medicines may be sold under different brand names and/or may contain more than one active substance, having unambiguous and globally recognised names for active substances is crucial for patient safety as it decreases the likelihood of prescribing errors. So far, over 7000 names were designated since the inception of INN in 1953, with up to 150 new INNs added each year.

Before the inception of the INN system, many countries devised their own nonproprietary naming standards and the names created under these older systems are still in use today. This old system caused confusion. Paracetamol, a common analgesic prescribed all over the world, is known as acetaminophen in the US and Japan. You can read about this in our blog post Medical terminology and variants of English #2: Terminology.

As the WHO describes in their guidance on INN: “nonproprietary names are intended for use in pharmacopoeias, labelling, product information, advertising and other promotional material, drug regulation and scientific literature, and as a basis for product names, e.g. for generics. Their use is normally required by national or, as in the case of the European Community, by international legislation. As a result of ongoing collaboration, national names such as British Approved Names (BAN), Dénominations Communes Françaises (DCF), Japanese Adopted Names (JAN) and United States Adopted Names (USAN) are nowadays, with rare exceptions, identical to INN”.

The WHO issues INNs in English, Latin, French, Russian, Spanish, Arabic, and Chinese. The names are often adopted by other languages with only minor spelling differences.

Active substances in the same therapeutic or chemical class have names with the same suffix, for example:

  • -ase for enzymes (e.g. alteplase, tilactase)
  • -azepam for benzodiazepines (e.g. lorazepam, diazepam)
  • -caine for local anaesthetics (e.g. lidocaine, cocaine)
  • -olol for beta blockers (e.g. propranolol, bisoprolol)
  • -pril for ACE inhibitors (e.g. ramipril, benazepril)
  • -sartan for angiotensin II receptor antagonists (e.g. losartan, valsartan)
  • -tinib for protein kinase inhibitors (e.g. lorlatinib, neratinib)
  • -vastatin for a group of cholesterol-lowering agents (e.g. simvastatin, rosuvastatin)
  • -vir for antivirals (e.g. atazanavir, ritonavir)

Sometimes, names may be formed using a prefix, for example:

  • cef- for cephalosporins (e.g. cefalexin, cefaclor)

To avoid errors, drug brand names (trademarks) should not be derived from or contain common stems used in INNs. An INN can be registered coupled with a manufacturer’s name, however, as long as it does not prevent another manufacturer from using the same approach. Rules for naming medicinal products are usually detailed for each country by the competent national regulatory agency (JAZMP in Slovenia), but they all follow the same principles, including the INN.

Why is the INN system so useful for medical and pharmaceutical translators? It is especially important when translating between two different national naming systems (e.g. for paracetamol, as we have seen). Each active substance has to be named correctly in the target language. For active substances that have a designated INN, spelling may still differ in different languages, which naturally the translation has to reflect.

Choosing to specialise in translating medicine and/or pharmaceuticals is a potentially life-changing decision. It takes commitment, constant learning, curiosity, and impressive research skills to be able to provide top-notch, accurate translations. At Alamma, we are dedicated to working with linguists that possess these qualities, and are always on the lookout for new translators. This way, our clients can rest assured that their medical and pharmaceutical texts are in the best hands. Are you interested in testing our quality? Reach out to us at info@alamma.eu.