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Ever wondered what Philadelphia and New Orleans have in common? They both have passionate professional football fans: Philadelphians love their Eagles, and you might be viewed with suspicion if you live in New Orleans and don’t cheer for the Saints. Both cities host some of the most raucous parades in the country, and both have notable French influences in the architecture and culture.
Turns out, they have something else in common: the most prescribed drugs among SingleCare users in both cities is an antihypertensive medication known as amlodipine besylate. If you’re wondering why, read on to learn more about the popularity of this medication in those cities, as well as other commonly prescribed medications in the 50 largest cities in the United States.
Most common prescription drugs by city:
- Amoxicillin (Amoxil)
- Amlodipine besylate (Norvasc)
- Amphetamine/dextroamphetamine (Adderall)
- Cetirizine hydrochloride (Zyrtec)
- Ibuprofen (Motrin)
- Levothyroxine sodium (Synthroid)
- Lisinopril (Prinivil, Zestril)
- Vitamin D
Skip to city-by-city breakdown
1. Amoxicillin (Amoxil)
Most prescribed drug in Dallas; San Diego; San Jose, Calif.; Arlington, Texas; Oakland, Calif.
If you’ve raised children, you’ve almost certainly filled a prescription or two (or more!) of amoxicillin. It’s a very common antibiotic intended to knock out bacterial infections like bronchitis or strep throat. It’s in the same class of drugs as penicillin and can be taken in capsule, tablet, or suspension form.
It’s commonly prescribed for childhood ailments—and some experts believe that it’s overprescribed, contributing to the development of drug resistant bacteria, a growing issue of concern in the healthcare arena. “It’s probably the most over-prescribed medication in the country,” notes Aaron Emmel, Pharm.D., founder and program director of Pharmacy Tech Scholar.
But it’s not hard to imagine why it is so frequently prescribed, since some providers encounter pressure from parents to provide something to make their children feel better. Although antibiotics are only appropriate for bacterial infections, the symptoms of viral infections can mimic those of bacterial infections, and you may not understand the difference. You just know that you, or your child, feels bad and you may ask for an antibiotic.
But you can make a difference on that front. “Don’t set an expectation with your provider that you want to leave with a prescription,” Dr. Emmel says. “Let him or her perform an assessment and determine whether that is necessary.”
RELATED: What is antibiotic stewardship?
2. Amlodipine besylate (Norvasc)
Most prescribed drug in Memphis, Tenn.; Milwaukee; New Orleans; Omaha, Neb.; Philadelphia; Raleigh, N.C.; Washington, D.C.
Amlodipine is a calcium channel blocker. It’s used to treat high blood pressure, certain types of angina (chest pain), and coronary artery disease. It’s sometimes prescribed alone, but it can and is also used in combination with other meds. You may be familiar with the brand name version, Norvasc, although it’s available as a generic, which may be one reason for its popularity. “Amlodipine is extremely safe,” notes Dr. Emmel. “It’s also very inexpensive.”
Amlodipine isn’t just popular in Philadelphia, New Orleans, and these other cities. “Hypertension is a very common disease in the U.S.,” says Jagdish Khubchandani, Ph.D., professor of public health at New Mexico State University. “The prevalence of these problems is increasing.”
A 2020 report in the journal JAMA noted that amlodipine is one of the 10 most commonly prescribed medications in the United States. In fact, in 2018 alone, more that 76 million prescriptions for amlodipine were filled in the U.S.
That’s probably not surprising, when you consider that 45% of adults living in the U.S. have hypertension or are taking medication for it, according to the Centers for Disease Control and Prevention (CDC).
Hypertension is a risk factor linked to heart disease, notes Joanna Lewis, Pharm.D., the creator of The Pharmacist’s Guide. And when you consider areas of the country with higher death rates attributed to heart disease, you tend to find cities like Memphis and New Orleans.
RELATED: What are normal blood pressure levels?
3. Amphetamine/dextroamphetamine (Adderall)
Most prescribed drug in Atlanta; Austin, Texas; Boston; Charlotte, N.C.; Colorado Springs, Col.; Chicago; Denver; Indianapolis; Kansas City, Mo.; Louisville, Ky.; Minneapolis; Nashville, Tenn.; Portland, Ore.; San Francisco; Seattle; Tampa, Fla.; Tulsa, Okla.; Virginia Beach, Va.
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Surprised by the number of cities on the list for amphetamine/dextroamphetamine? You may know it better by the brand name Adderall. This combination medication is frequently used to treat attention deficit hyperactivity disorder (ADHD).
“[It is] used for ADHD, obesity, narcolepsy, and depression, just to name a few,” says Khubchandani. “The prevalence of these problems is increasing.”
And as you’ll notice from the list of cities with SingleCare users, its use is very widespread. According to the CDC, about 3 out of every 4 children with ADHD take medication to help them cope with their condition. In fact, more than 25 million prescriptions for this type of med were filled in 2018 in the U.S.
Areas with greater populations of children could be a factor, says Khubchandani. But it may also be worth considering that larger cities will have larger numbers of pediatric providers who can diagnose ADHD and will prescribe a medication like amphetamine/dextroamphetamine. “In addition, many other parents from nearby, rural underserved, or other states may visit these specialists or specialized medical centers to get children treated,” Khubchandani adds.
RELATED: ADHD statistics
4. Cetirizine hydrochloride (Zyrtec)
Most prescribed drug in San Antonio
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San Antonio, Texas, is home to the Alamo and many other popular destinations. But the city is notorious for its effect on allergy sufferers. According to the Asthma and Allergy Foundation of America, San Antonio is seventh on the list of the top 10 most challenging places to live for people with seasonal allergies.
Small wonder, then, that an antihistamine tops the list of commonly prescribed meds in this Texas city. Cetirizine hydrochloride reduces the amount of histamine that your body produces when provoked by an allergen of some sort. It belongs to a class of drugs known as H1 receptor antagonists.
Cetirizine is the name of the generic form, but you may be familiar with brand names like Zyrtec. It’s available over the counter, too. But when you have a prescription you can take advantage of SingleCare savings. Some providers may suggest it to you because, unlike an antihistamine like Benadryl, cetirizine shouldn’t make you feel as sleepy, as it has a low drowsiness profile.
“Because the weather is milder in certain areas of the country (e.g., Texas), trees and plants bloom earlier and longer,” Dr. Lewis says. “And because of this, allergens like pollen and ragweed will affect those with seasonal allergic rhinitis for a longer period of time.”
RELATED: Non-drowsy Benadryl: What are your options?
5. Ibuprofen (Motrin)
Most prescribed drug in Detroit; Fresno, Calif.; Houston; Jacksonville, Fla.; Long Beach, Calif.; Los Angeles
Ibuprofen belongs to a category of meds known as non-steroidal anti-inflammatory drugs, or NSAIDs. People take it for a wide variety of conditions, including menstrual cramps, pain from osteoarthritis, headache, fevers, toothaches, and backaches.
You might wonder why ibuprofen, which is available over the counter, might be a popularly prescribed medication in several cities. It could be ease of use: taking one or two prescription-strength ibuprofen may be easier for some people than gulping down multiple tablets of the OTC kind. Or it could be because their insurance formularies cover it. Dr. Emmel also speculated that it’s possible that people are very active in cities with the kind of weather that Los Angeles and Long Beach often have, and sometimes with physical activity comes injury and overuse.
But just because it’s also available over the counter doesn’t mean you should not be mindful about taking it in whatever form. “People think that because it’s over the counter, that it’s totally fine and benign,” Dr. Emmel says, “but it’s a pretty serious medication.” Dr. Emmel notes that NSAIDs can increase your risk of having a cardiovascular event like a heart attack or stroke. NSAIDs also come with a risk of GI (gastrointestinal) bleeding, ulceration, or perforation of the stomach or intestines. Ibuprofen can also interact with other medications that you may be taking, like blood thinners or certain high blood pressure meds.
“You always want to take it for a short period of time,” says DiGregorio. “You find yourself using it for longer than, I would say, five to seven days, then you would want to call your doctor and see if something else is going on.”
RELATED: Is it safe to take ibuprofen and Tylenol together?
6. Levothyroxine sodium (Synthroid)
Most prescribed drug in Albuquerque, NM; Mesa, Arizona
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People who receive a prescription for levothyroxine sodium probably have hypothyroidism, a condition that occurs when the thyroid gland doesn’t produce enough of the hormones triiodothyronine and thyroxine that keep your metabolism humming along. It tends to affect women more than men, and it’s more likely to develop after menopause. Levothyroxine sodium is also prescribed to treat enlarged thyroid (goiter) due to hypothyroidism, and certain kinds of thyroid cancer.
Levothyroxine sodium is a relatively inexpensive drug and available as a generic. Some of the common brand names for this medication are Synthroid, Levothroid, Levoxyl, and Unithroid.
This drug is frequently among the most commonly prescribed meds in the country, notes Dr. Lewis. “If [these top cities] have a larger population of women over 50, that may be a reason, too,” she says.
Dr. Khubchandani also points out that certain ethnic groups seem to be at higher risk for hypothyroidism, including Mexican Americans, people who are Hispanic, and people with Native American ancestry. “New Mexico and Arizona have high proportions of these groups compared to other parts of the country,” he says, adding that Mesa and Albuquerque are among the bigger cities and have more specialized clinics and providers where people can access specialized care for thyroid conditions, among others.
RELATED: What is Synthroid?
7. Lisinopril (Prinivil)
Most prescribed drug in Columbus, Ohio; Fort Worth, Texas; Las Vegas; Oklahoma City; Phoenix; Sacramento, Calif.; Tucson, Ariz.
Remember that statistic about 45% of U.S. adults having high blood pressure or taking medication for hypertension, per the CDC? Amlodipine isn’t the only commonly prescribed antihypertensive med. Lisinopril is another one.
So, chances are, you probably know someone who’s taking lisinopril or a medication like it. Lisinopril belongs to a class of drugs known as angiotensin-converting enzyme (ACE) inhibitors, which are commonly prescribed to lower a person’s blood pressure. Like amlodipine, it’s one of the 10 most commonly prescribed medications in the United States, according to a June 2020 report in the journal JAMA.
Dr. Emmel ticks off a list of reasons why lisinopril is so commonly prescribed in these cities (and others): “It’s extremely inexpensive. It’s been around a long time. It’s extremely safe.”
It may not be surprising to see Columbus on the list, given that Ohio is a heart disease hot spot, per the CDC, Dr. Lewis adds.
RELATED: Blood pressure treatments and medications
8. Vitamin D
Most prescribed drug in Baltimore; El Paso, Texas; Miami; New York
What do El Paso and New York City have in common? If you’re stumped by that question, consider this: Vitamin D is the most prescribed drug in both of these cities.
You can get vitamin D through the food that you eat and from sun exposure. But if you’re not getting enough foods containing vitamin D, and if you tend to cover up and stay out of the sun, you might not be getting enough. The latter might apply to residents of El Paso, which gets a whopping 302 days of sunshine every year on average.
Turns out, most people in the United States aren’t getting enough of this important fat-soluble vitamin, according to the National Institutes of Health. Your doctor might prescribe vitamin D if you’re at risk for developing osteoporosis, a condition that occurs when your bones become weak, brittle, and fragile. Your bones need vitamin D in order to absorb calcium, which helps you maintain bone density and strength.
It’s probably not a good idea to start taking vitamin D without consulting your healthcare provider first, though. Vitamin D supplementation is not appropriate for everyone, notably people with chronic kidney disease who may have high calcium levels.
“If you have risk factors for osteoporosis, there are indications for supplementation with vitamin D as you get older,” Dr. Emmel says. “So it really depends on your underlying risk for osteoporosis.”
RELATED: How much vitamin D should I take?
City-by-city breakdown of the most prescribed drugs
- Albuquerque, N.M.: Levothyroxine sodium
- Arlington, Texas: Amoxicillin
- Atlanta: Amphetamine/dextroamphetamine
- Austin, Texas: Amphetamine/dextroamphetamine
- Baltimore: Vitamin D
- Boston: Amphetamine/dextroamphetamine
- Charlotte, N.C.: Amphetamine/dextroamphetamine
- Chicago: Amphetamine/dextroamphetamine
- Colorado Springs, Colo.: Amphetamine/dextroamphetamine
- Columbus, Ohio: Lisinopril
- Dallas: Amoxicillin
- Denver: Amphetamine/dextroamphetamine
- Detroit: Ibuprofen
- El Paso, Texas: Vitamin D
- Fort Worth, Texas: Lisinopril
- Fresno, Calif.: Ibuprofen
- Houston: Ibuprofen
- Indianapolis: Amphetamine/dextroamphetamine
- Jacksonville, Fla.: Ibuprofen
- Kansas City, Mo.: Amphetamine/dextroamphetamine
- Las Vegas: Lisinopril
- Long Beach, Calif.: Ibuprofen
- Los Angeles: Ibuprofen
- Louisville, Ky.: Amphetamine/dextroamphetamine
- Memphis, Tenn.: Amlodipine besylate
- Mesa, Ariz.: Levothyroxine sodium
- Miami: Vitamin D
- Milwaukee: Amlodipine besylate
- Minneapolis: Amphetamine/dextroamphetamine
- Nashville, Tenn.: Amphetamine/dextroamphetamine
- New Orleans: Amlodipine besylate
- New York: Vitamin D
- Oakland, Calif.: Amoxicillin
- Oklahoma City: Lisinopril
- Omaha, Neb.: Amlodipine besylate
- Philadelphia: Amlodipine besylate
- Phoenix: Lisinopril
- Portland, Ore.: Amphetamine/dextroamphetamine
- Raleigh, N.C.: Amlodipine besylate
- Sacramento, Calif: Lisinopril
- San Antonio: Cetirizine hydrochloride
- San Diego: Amoxicillin
- San Francisco: Amphetamine/dextroamphetamine
- San Jose, Calif.: Amoxicillin
- Seattle: Amphetamine/dextroamphetamine
- Tampa, Fla.: Amphetamine/dextroamphetamine
- Tucson, Ariz.: Lisinopril
- Tulsa, Okla.: Amphetamine/dextroamphetamine
- Virginia Beach, Va.: Amphetamine/dextroamphetamine
- Washington, DC: Amlodipine besylate
Popular prescription drug information reflects the scripts most filled through SingleCare from Jan. 1, 2020 through Oct. 31, 2020, excluding opioids and weight-loss drugs. The cities included reflect the top 50 most populous cities in the U.S., as estimated by the U.S. Census Bureau.
