Where once there were white pills, now there are peacock blues, pastel pinks, ocher yellows and translucent ambers. They come in a smorgasbord of shapes as well - hearts, hexagons, triangles and neat bow ties.
And the pills in the medicine cabinet aren't called just anything. At great cost, they are given names meant to conjure up just the right thoughts and feelings: Viagra, the pill to combat impotence, has a name combining vigor and the force of Niagara Falls.
A quiet change is occurring in the pharmaceutical industry. As it becomes more competitive and consumer-oriented, as it spends millions on ads encouraging patients to demand prescription drugs by name, firms are paying attention not just to what new drugs do but also to what they look and sound like.
"Traditionally, pharmaceutical companies have lived and died on the strength of their clinical studies," said Dan Cunagin, vice president of engineering at Logica, a design firm based in Minneapolis. "Now they face a sea of commodity-type products and are looking for ways to discriminate in the marketplace. It is hard to say that one brand of aspirin is better than another. Instead, small things are different, which have no clinical value but have experiential value."
Driving the change is the emergence of the generic drug market since the 1980s - with many versions of the same drugs on the market, companies hunt for ways to make their versions stand out. At the same time, new drugs are coming to market in bigger numbers, in part due to a 1992 law that accelerated the Food and Drug Administration's review process for new drugs. In 1987, the FDA approved 21 new drugs; in 1996, 53 got the go-ahead.
Color offers one way to differentiate and appeal to certain kinds of patients. It's hard to imagine Viagra, for instance, being pink (it's light blue). Paxil, the anti-depression drug, comes in soothing shades of pastel pink and sky blue.
"A logic is slowly emerging in the colors," said British design writer Hugh Aldersley Williams. "White is for cheap generics; pastels are increasingly used for stress relievers; bright colors try harder - they are for the fast-acting, the powerful, the expensive, the new."
Sometimes pills are symbolically contoured. Pills for heart-related illnesses, such as Zebeta and Ziac, are heart-shaped. Zocor, which protects against high cholesterol, is shield-shaped. Valium has a distinctive V cut through each pill.
A spokeswoman for drug giant Merck denied that the colors or shapes are "about making them look prettier."
"I have never seen a product where design has been any major factor in sales," she said. Instead, she stressed the practical role of design in helping doctors, patients and pharmacists distinguish among drugs or dosages and swallow them.
Once pills get too big, for instance, there are problems swallowing them, so they need to be capsule-shaped. And drugs need to look different to distinguish them from cheaper impostors, to fend off black-market sales or sustain sales when patents on drugs expire and other companies begin making them.
But while some pharmaceutical firms deny that design is playing more of a marketing role, other people say it has potential. "As advertisers are involved in earlier stages of drug development, we hope to have more influence over the shape and colors," said Kyle Barich, account director for Viagra at the advertising firm Kline, Davis and Mann.
Ron Haak, vice president of technical development at pharmaceutical company Alza of Palo Alto, Calif., agreed. "It's possible that somewhere down the line we will be able to identify which patient populations like particular shapes and colors."
Robert Hall, principal at GVO, a research and development consultancy in Palo Alto, said: "(Pharmaceutical companies) used to assume that because drugs were good for people, patients would take them. But they need to respond more to how people think about taking the drug. Whether they want people to see them taking the drug. Or whether it is a drug people brag about taking. So there are a lot of emotional aspects to consider."
This consumer focus has also affected the way a drug is named. "Now it needs to sound good, linguistically," said Jim Singer, president of MediBrand, an offshoot of Namebase, which specializes in naming products.
His company came up with the Viagra and Prozac names.
With Viagra, "the tripartite rhythm suggests preparation, action, and release or rest, yielding a pseudo-chronology of the desirable potency effect itself," wrote Singer and consultant Richard Hacken. The word also had the vigor and Niagara associations.
"Prozac starts with P, a plosive, a sound which causes pressure to build up in your mouth and forcefully pronounce the sound," they wrote. "With the Z you start to build up the force for the final letter, which zooms you to the end, so the drug sounds very efficacious."