There are too many pills. The global pharmaceutical industry is working with might, and new names appear every season, and even pharmacists are often confused. Цу has compiled a guide on the most critical drugs: it includes sales leaders in the United States – the main pharmacological market in the world, and those drugs about which you can hear everywhere. This is the list of the most popular drugs in the world.
Sales in 2006: $ 6,600,000,000
International name: Atorvastatin
Indications for use
It is reducing cholesterol in the blood – almost the main national idea of America. Not surprisingly, the best-selling drug in the US (and the world) is aimed at achieving this goal. In general, this is correct: elevated cholesterol is deposited on the walls of blood vessels, forms atherosclerotic plaques and leads to atherosclerosis, which causes up to 40% of deaths. Accordingly, the volume of the market is also impressive. The annual amount of its sales in the United States is approximately equal to the annual sales of all finished drugs in Russia.
- Pharmacologic effect
The substance atorvastatin, which is hidden under the brand Lipitor, is a representative of a large class of statins. These drugs reduce the activity of the enzyme that is involved in the synthesis of cholesterol in liver cells. Japanese Akira Endo, who was looking for new antibiotics, discovered Statins in the early 70s. For his discovery, Endo did not receive a penny: all the money went to corporations like Merck and Pfizer, which each developed its synthetic statin.
- Side effects
As the fattest piece of medicinal cake, atorvastatin is under constant attack from all sides. It is said that it can cause muscle aches, impotence, depression and liver problems. Worse, there is evidence that it increases the likelihood of breast cancer in women by a factor of 12.
Sales in 2006: $ 4,000,000,000
International name: Esomeprazole
The active substance, esomeprazole, blocks the so-called proton pumps, which create an acidic environment in the stomach. This reduces the risk of ingress of acid into the esophagus (this leads to heartburn) and the gradual healing of ulcers.
- Terms of sale from pharmacies
Initially, AstraZeneca launched the drug omeprazole. At first, it was marketed under the Losec brand, but the Federal Drug Administration (FDA) demanded that the company change its name to avoid confusion with the diuretic Lasix. AstraZeneca renamed omeprazole to Prilosec, but even then it got into trouble: due to poor medical writing, it was confused in pharmacies with the antidepressant Prozac. While the essence of the matter, the dispute has lost relevance. The validity of the AstraZeneca patent has come to an end, and analogs from other manufacturers have appeared on the market. What happened next is one of the classic examples of the corporate struggle to extend the monopoly on the sale of drugs. AstraZeneca has launched Nexium, also known as esomeprazole, which is chemically the same omeprazole but presented only as a single optical isomer.
- Optical isomers are identical molecules that are mirror images of each other. In omeprazole, there were both “left” and “right” molecules, and in esomeprazole, there were only “left” molecules. AstraZeneca proved that it is they who have medicinal properties, and therefore she was granted a new patent, now only for this form.
Sales in 2006: $ 3,300,000,000
International name: Lansoprazole
- Indications for use
Heartburn, as it turns out, is a severe problem for the ever-nervous Americans. The mechanism of action and the chemical structure of this drug is very similar to Nexium. Prevacid is slightly less effective, but it is better suited for use simultaneously with other medications. Numerous analogs of Prevacid are sold in Russia, among them – a drug from Obolensk, called “Epicurus” in honor of the founder of the philosophy of pleasure, including gastronomic pleasures.
- ADVAIR DISKUS
Sales in 2006: $ 3,100,000,000
International name: Salmeterol + Fluticasone
- Form of release
The most sold anti-asthma medicine on the American market is the latest achievement not so much of science as of mechanics. Advair is a combination of two well-known substances for inhalation in powder form: fluticasone and salmeterol. But the way of their packaging is a small, streamlined device of an incomprehensible type of appointment. It is probably the most consistent expression of the manufacturers’ desire to make the treatment not only convenient but also pleasant. The powder is packed with doses between two foil strips and, like a piston, is charged into a special inhaler. Before each use, you need to cock the lever, which pierces a single dose and then inhale the powder through the nozzle. Each tape has 60 treatments, so there is only one charge of asthma for a month.
- Side effects
A small “but”: in 2005, the FDA issued a warning that in rare cases, the use of salmeterol can lead to sudden death from an asthma attack.
Sales in 2006: $ 2,500,000,000
International title: Montelukast
- Pharmacologic effect
The drug is designed to combat the symptoms of allergies, as well as for the prevention of asthma. Acts on a new mechanism, different from steroids and antihistamines. Montelukast binds to receptors of leukotrienes, signaling molecules involved in the processes of inflammatory and allergic responses. As a result, the leukotriene signal system stops working, and the patient becomes better. In America, Montelukast is presented exclusively as a legal product of Merck.
- EFFEXOR XR
Sales in 2006: $ 2,300,000,000
International name: Venlafaxine
- Pharmacological group
The title of the main antidepressant in the most concerned with the mental health of the country of the world is a guarantee of getting into the annals of not only medicine but also pop culture, especially since most of the figures of this pop culture sit on antidepressants themselves. The drug Effexor, also known as venlafaxine, has replaced Prozac, which reigned in this area since the late 80s.
- Side effects
Like other antidepressants, venlafaxine has many disadvantages and side effects. The termination of its reception causes the most severe of all drugs in this group of withdrawal syndrome and the risk of suicide increases by 2-3 times. After the woman who took it drowned five of her children in 2001, Wyeth placed the “man-killing impulses” item on the list of possible rare complications, but only on the 36th page of the instruction.
- Form release
The letters XR in the title denote the drug delayed action. After taking one pill a day, the active substance enters the body gradually, which reduces unwanted effects and prolongs the therapeutic effect. In Russia, Effexor XR is not for sale, but the usual venlafaxine is available in three versions – from Croatia, Hungary, and for some reason from Iceland.
The medicine against the formation of blood clots
Sales in 2006: $ 2,200,000,000
International name: Clopidogrel
- Interaction with other drugs
Plavix previously ranked second after Lipitor, but in 2006 it became the target of a direct attack by the Canadian drugmaker Apotex. It all began in early spring: Apotex stated that it considers the patent of Bristol-Myers Squibb and its partner Sanofi-Aventis invalid and is about to start selling unbranded clopidogrel immediately. The patent owners sued, but then an amicable agreement was reached. Apotex receives $ 40 million in compensation and the right to start selling the analog eight months ahead of the expiration of the patent in 2011, but for this declines its plans to cancel the patent immediately. This would have ended the case, but the anti-monopoly committee did not approve the deal. It turned out that the cunning Canadians included so many reservations in the contract that now they could start selling their drug without fear of too many fines. During the month, while the patent owners ran through the courts, they managed to ship so much cheap medicine that they almost twice reduced the figures of the original Plavix.
Sales in 2006: $ 2 170 000 000
International title: Simvastatin
- Pharmacological group
Zocor is a drug from the same class of statins like Lipitor and lowers cholesterol by the same mechanism.
- Special instructions
Zokor was the first station, widely used in medicine, but now his best days are over, and sales are declining. Merck brought it to market a few years earlier than Pfizer, the Lipitor, so the patent protection for it expired in 2006. Immediately, a considerable amount of drug-analogs appeared, but Merck took an unusual step and lowered the price of Zocor to the level of new drugs. It turned out that the holder of the brand also released a second equivalent, leaving competitors with nothing.
- As you can see, even the most popular and high-quality drugs can have serious side effects. They can also lead to death. That is why you need to be careful and consult a specialist before you bu