The complete list of top 100 most prescribed medications in the United States from July 2013 to June 2014 was released by the research firm IMS Health. It has shown some changes in trends of monthly prescribed medications since the previous year. Crestor (cholesterol lowering medication), Diovan (high blood pressure medication), and Lantus SoloStar (long-acting insulin for diabetes mellitus) were amongst the top 10 drugs prescribed. Whereas, antibiotics such as azithromycin and amoxicillin (ranked in top 7 and 8 in 2013) did not make it to top 10 in 2014. Also, metformin (ranked in top 9 in 2013) was replaced by Lantus SoloStar for top prescribed diabetes mellitus medication. Synthroid (thyroid medication) and Ventolin HFA (asthma medication) continued to be one of the top prescribed medications in 2014.
The total number of prescriptions for Synthroid: 22,554,826
The total sales of Synthroid: $927,886,999. (Ranked in top 61 drugs by sales)
Synthroid is a thyroid medication. It is used for replacing thyroid hormone in patients with hypothyroidism. Some of its major adverse reactions include flushing, increased pulse, angina pectoris, congestive heart failure, arrhythmias, diarrhea, anxiety, heat intolerance, headache, insomnia, alopecia (hair loss), weight loss, and decreased bone mineral density. It is contraindicated with sodium iodide I-131 and sucroferric oxyhydroxide. It interacts with heparin dalteparin, argatroban, fondaparinux, protamine, and warfarin.
The total number of prescriptions for Crestor: 22,557,735
The total sales of Crestor: $5,672,991,435. (Ranked in top 4 drugs by sales)
Crestor is a HMG-CoA reductase inhibitor, which is a lipid-lowering agent. It is used to lower cholesterol to reduce risk of cardiovascular disease. The adverse reactions include myalgia (muscle pain), arthralgia (joint pain), pharyngitis (inflammation of pharynx), headache, weakness, abdominal pain, and constipation. It is contraindicated in patients with active liver disease such as hepatitis and jaundice. It is also contraindicated for using during pregnancy and in breast-feeding women. Some serious interactions can be found with gemfibrozil, fenofibric acid, colchicine, lopinavir, and niacin.
The total number of prescriptions for Nexium: 18,656,464.
The total sales of Nexium: $6,303,738,580. (Ranked in top 3 drugs by sales)
Nexium is a proton pump inhibitor (PPI) approved for healing and maintenance of gastroesophageal reflux disease (GERD). Some of the adverse reactions include headache, flatulence (gas accumulation in intestine), indigestion, nausea, diarrhea, dizziness, and constipation. Nexium is metabolized in the liver so the dose should be adjusted in patients with severe liver disease. Its drug interactions include ketoconazole, digoxin, clopidogrel, and nelfinavir.
The total number of prescriptions for Ventolin HFA: 17,556,646
The total sales of Ventolin HFA: $771,201,081. (Ranked in top 80 drugs by sales)
Ventolin HFA is a moderately selective short-acting beta-2-receptor agonist (SABA) administered by inhalation. It is indicated for the management of asthma exacerbations or chronic obstructive airway diseases. Some of the adverse reactions include tremor (shakiness), nausea, vomiting, bronchospasm, cough, and dry mouth. Ventolin HFA should be used with caution in patients with cardiovascular disorders, high blood pressure, arrhythmias, diabetes mellitus, and hyperthyroidism. It interacts with saquinavir, amitriptyline, linezolid, nortriptyline, and trazodone.
The total number of prescriptions for Advair Diskus: 15,003,169
The total sales of Advair Diskus: $5,064,138,456. (Ranked in top 6 drugs by sales)
Advair Diskus is a combination of a corticosteroid (fluticasone) and a beta-agonist (salmeterol) administered by inhalation for treating asthma and chronic obstructive pulmonary disease (COPD). It is not recommended for acute asthma attacks, but it is approved for the long-term maintenance of asthma or COPD. Some adverse reactions include upper respiratory tract infections, headache, throat irritation, muscle pain, cough, and fatigue. Advair Diskus should be used with caution in patients with cardiovascular disorders, high blood pressure, diabetes mellitus, and hyperthyroidism. It is not indicated in children less than 12 years of age. Its drug interactions include ritonavir, amitriptyline, doxepin, imipramine, isoniazid, linezolid, natalizumab, phenelzine, tacrolimus, and trazodone.
The total number of prescriptions for Diovan: 11,401,503. (July 2013 - June 2014)
The total sales of Diovan: $2,177,824,165. (Ranked in top 24 drugs by sales)
Diovan is a specific angiotensin II antagonist used for treating high blood pressure. It is also approved to treat heart failure in patients who are intolerant to ACE inhibitors (another class of blood pressure medication). Diovan may be used either alone or in combination with other blood pressure medications. Some of its adverse reactions include dizziness, hyperkalemia (increase in potassium level), hypotension (drop in blood pressure), tiredness, and headache. Diovan should be discontinued immediately when pregnancy is detected since it cause fetal injury. It should not be combined with aliskiren or ACE inhibitors such as benazepril and lisinopril.
The total number of prescriptions for Lantus SoloStar: 10,154,739
The total sales of Lantus SoloStar: $3,829,943,226. (Ranked in top 9 drugs by sales)
Insulin is a pancreatic hormone, which is essential for the breakdown of glucose. Lantus is a long-acting insulin analog that provides insulin coverage consistently for 24 hours. It is indicated for use in patients with type 1 and type 2 diabetes mellitus to lower glucose levels. Some of its adverse reactions include hypoglycemia (low blood glucose level), local injection site reaction, back pain, diarrhea, headache, influenza-like symptoms, increased pulse, and peripheral edema. It should not be combined with pramlintide. Blood glucose levels should be closely monitored to prevent severe hypoglycemia.
The total number of prescriptions for Cymbalta: 10,065,788
The total sales of Cymbalta: $2,839,722,673. (Ranked in top 17 drugs by sale)
Cymbalta is a serotonin-norepinephrine reuptake inhibitor, which is used to treat major depressive disorder, including associated painful physical symptoms such as back pain and shoulder pain, and diabetic peripheral neuropathy. It is also approved for generalized anxiety disorder (GAD) and management of fibromyalgia (chronic muscle pain). Some of the adverse reactions include nausea, dry mouth, headache, tiredness, constipation, diarrhea, insomnia, and sexual dysfunction Drugs that interact with Cymbalta include phenelzine, procarbazine, amitriptyline, bupropion, cimetidine, fluoxetine, modafinil, paroxetine, sertraline, tramadol, trazodone, and warfarin.
The total number of prescriptions for Vyvanse: 10,019,178
The total sales of Vyvanse: $1,940,313,035. (Ranked in top 28 drugs by sales)
Vyvanse is a prodrug of dextroamphetamine, which is a centrally acting stimulant. It is indicated for patients with attention-deficit hyperactivity disorder (ADHD). It is a DEA schedule II controlled substance. It should not be used within 14 days of taking monoamine oxidase inhibitors (MAOI) due to risk of severe elevation of blood pressure. Some of its adverse reactions include insomnia, anorexia (loss of appetite), dry mouth, headache, and upper abdominal pain. It interacts with linezolid, phenelzine, probarbazine, trazodone, and rasagiline.
The total number of prescriptions for Lyrica: 9,684,884
The total sales of Lyrica: $2,782,036,977. (Ranked in top 19 drugs by sales)
Lyrica is an anticonvulsant (seizure) medication also FDA-approved for management of neuropathic pain and fibromyalgia (muscle pain). It should be used with caution in patients with cardiovascular disease or kidney impairment. Anti-seizure drugs may increase risk of suicidal thoughts, unusual changes in mood or behavior. Other adverse reactions include dizziness, insomnia, edema, tiredness, weight gain, tremor (shakiness), and blurred vision. Lyrica interacts with benazepril, lisinopril rosiglitazone, naloxone, and barbiturates.
IMS Institute for Healthcare Informatics