In August, we broke down the prescription drugs filled most commonly by SingleCare users, a list that was dominated by blood pressure medications and prescription vitamin D. Now we’re taking a closer look at the most prescribed drugs for 2019—and while many of them overlap, there are a couple of new additions.
More notably, though, is what this current list of drugs tells us about prescription medication use across the board in the United States. Why are some drugs prescribed more often than others? Is a drug’s popularity good or bad? What health conditions are the most common among Americans?
To find the answers to these questions, we asked two physicians to weigh in on the top drugs of the year and share their insights about the trends. Here’s what they had to say.
Generic vs. brand-name drugs
Every one of the prescription drugs on the 2019 list is available in generic form, which makes them relatively cheap and easy to obtain, says David Cutler, MD, a family medicine physician at Providence Saint John’s Health Center.
“They are not the novel, blockbuster, money-making drugs you read about on the front pages,” he says. “They are the drugs in everybody’s medicine cabinet.”
Why is this significant? For starters, name-brand drugs drive up both patient out-of-pocket costs and the societal costs of health insurance, says Joshua Septimus, MD, internist at Houston Methodist. Since generic drugs are widely accepted as being just as good as name-brand ones, the shift toward generic prescriptions is a positive one.
“I’m so pleased to see that doctors are getting away from name-brand medications because there was a time when doctors were largely writing prescriptions for very expensive ones,” Dr. Septimus explains. “But now the widely prescribed meds are generic, and they’re cheap and have long-standing data to go with them.”
What do the most prescribed drugs tell us?
Interestingly, the most prescribed drugs of 2019 fall into a handful of common categories: blood pressure medications, thyroid treatments, antibiotics, and ADHD medications.
This makes sense, says Dr. Septimus, since high blood pressure and hypothyroidism are two of the most common adult diseases. As for the other medications? Broad-spectrum antibiotics will likely always be popular because people will always get sick and need treatment, and the list is filled out with a handful of other common drugs like steroids and anxiety medications.
Want to learn more about the most prescribed drugs of 2019, according to SingleCare data (maybe one you take is on the list!) or find the drug that’s most common in your state this year? Read our drug-by-drug breakdown.
What is the most prescribed medication?
- Amlodipine (generic Norvasc) and lisinopril (generic Zestril, or Prinivil)
- Levothyroxine sodium and Synthroid
- Amphetamine-dextroamphetamine (generic Adderall)
- Prescription vitamin D
- Alprazolam (generic Xanax)
Amlodipine and lisinopril
Most commonly prescribed for: High blood pressure
Most popular prescriptions in: Alaska, Alabama, Arkansas, Connecticut, Delaware, Georgia, Iowa, Illinois, Indiana, Kansas, Kentucky, Louisiana, Massachusetts, Minnesota, Missouri, Mississippi, North Carolina, Nebraska, New Hampshire, New Mexico, Nevada, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Virginia, Vermont, Washington, Wisconsin, West Virginia, Wyoming
High blood pressure is a common condition that’s easily treated, and there is tremendous benefit in getting it under control—including a reduced risk of heart attack and stroke, according to Dr. Cutler. And that’s not the only reason high blood pressure meds like amlodipine and lisinopril are so popular right now, either.
“The diagnostic criteria defining who has hypertension have been lowered, bringing more people into the category of being diagnosed with high blood pressure,” explains Dr. Cutler.
He’s referring to a 2017 update to guidelines previously established in 2003; the American College of Cardiology and the American Heart Association removed a “prehypertension” category and reorganized other stage classifications for hypertension. It was estimated that this shift would classify many more people as having high blood pressure, especially younger adults, and could lead to earlier intervention.
As far as these two drugs go, Dr. Septimus says that both ACE inhibitors (like lisinopril) and calcium channel blockers (like amlodipine) are acceptable ways to treat high blood pressure, with amlodipine being an easy-to-use medication with low side effects and lisinopril a safer option for people who also have diabetes or heart disease.
Most commonly prescribed for: Bacterial infections of the ear, nose, and throat
Most popular prescription in: California, Washington, D.C., Maryland, New Jersey, Texas
Dr. Septimus calls amoxicillin a “bedrock of therapy” for respiratory infections, including ear infections and strep throat, which helps explain why it was the most popular drug in four states this year.
“If you look at where most antibiotics scripts are written, it’s in children, since they tend to be treated frequently for those conditions,” he says.
While anyone who’s ever spent time around children knows they are magnets for viruses and infections, there is still some concern among physicians about the rate at which antibiotics are prescribed—especially when they’re used to treat viral infections rather than bacterial ones, which contributes to increasing rates of antibiotic resistance.
“There are extensive efforts underway to reduce unnecessary exposure to antibiotics through stewardship programs,” Dr. Cutler says. “People need to be made more aware of the dangers posed by excessive, unnecessary, and harmful antibiotic use.”
Levothyroxine sodium and Synthroid
Most commonly prescribed for: Hypothyroidism
Most popular prescription in: Arizona, Colorado, Florida, Idaho, Montana, Oregon, Puerto Rico, Virgin Islands
Hypothyroidism, a condition in which the thyroid stops making enough hormone to regulate key body functions, affects roughly five out of every 100 Americans, per The National Institute of Diabetes and Digestive and Kidney Diseases.
“Low thyroid function is most commonly an autoimmune condition with no known trigger or prevention,” Dr. Cutler says, adding that the signs can be subtle, such as fatigue or constipation. People with hypothyroidism may also experience joint or muscle pain, dry skin, irregular menstruation, or weight gain.
Levothyroxine sodium is what’s known as a thyroid replacement, and Dr. Septimus says it’s popular because there really aren’t any other drugs that can replace the missing thyroid hormone. Thankfully, he also says levothyroxine sodium has a high rate of effectiveness and helps the majority of patients who take it.
Amphetamine-dextroamphetamine (generic Adderall)
Most commonly prescribed for: ADHD
Most popular prescription in: Michigan, North Dakota, Rhode Island, Utah
Amphetamine-dextroamphetamine is commonly prescribed for the treatment of ADHD symptoms, which can range from hyperactivity and difficulty concentrating to fidgeting and poor judgment, according to Dr. Septimus. Along with the fact that more people are being diagnosed with ADHD, including young children, this drug’s popularity continues to grow because it’s generally considered safe and effective—and is now available in generic form.
The exact mechanism of how amphetamine-dextroamphetamine helps patients (aside from working in the central nervous system) is not fully understood, but according to ADDitude Magazine, the drug has been extensively studied for decades and appears not to cause major health concerns for the majority of patients who take it.
The remaining drugs on 2019’s list don’t fit into any of the above categories, but were the number one prescribed drug in their respective states.
Prescription vitamin D
Most commonly prescribed for: Vitamin D deficiency
Most popular prescription in: New York
Prescription vitamin D, the top drug in New York, is used to treat vitamin D deficiency. But Dr. Septimus says the fact that it’s being prescribed so commonly indicates that physicians are still proactively screening for vitamin D, a practice the U.S. Preventive Services Task Force has advised against. While taking prescription vitamin D might be necessary for a handful of patient populations (like those with osteoporosis), it’s likely being prescribed unnecessarily in many other cases.
Most commonly prescribed for: Inflammation
Most popular prescription in: Maine
Prescribing patterns for respiratory tract infections like bronchitis, pneumonia, and sinusitis is probably why so much prednisone was doled out in Maine this year. A corticosteroid that treats a variety of inflammatory and autoimmune conditions, Dr. Septimus says that some doctors are simply more likely to rely on it when a patient complains of swelling, pain, or discomfort because of an acute or chronic condition. Taking prednisone can lead to several side effects, which become more severe the longer you take it, so it’s good that it isn’t being overused across the country.
Most commonly prescribed for: Anxiety
Most popular prescription in: Tennessee
For fast relief of symptoms associated with panic attacks or phobias, alprazolam is typically prescribed to help people cope with acute situations such as traveling by plane when you have a fear of flying. While Xanax can be prescribed for chronic anxiety, selective serotonin reuptake inhibitors (SSRIs) or other anti-anxiety medications are more likely to be utilized.
As for why alprazolam (Xanax) might be so popular, Dr. Septimus says it works more quickly than other drugs in its class, making it ideal for conditions that require a quick onset of action.
“[However], that also makes its addiction potential far higher,” he warns. “It’s a good drug when used safely, but judiciously.”
Most commonly prescribed for: Erectile dysfunction
Most popular prescription in: Hawaii
Sildenafil, a.k.a. the erectile dysfunction pill Viagra, was the top prescribed drug in Hawaii this year. Overall, experts know that sildenafil is being prescribed more frequently because it benefitted from a major drop in cost back in 2017 when it became available in generic form. Though it’s still more typically used by wealthier patients with the means to purchase non-essential, “recreational” drugs, the lower price tag has allowed more patients with erectile dysfunction to utilize the treatment.
Arizona: Levothyroxine sodium
Colorado: Levothyroxine sodium
Washington, D.C.: Amoxicillin
Florida: Levothyroxine sodium
Idaho: Levothyroxine sodium
Montana: Levothyroxine sodium
North Carolina: Lisinopril
North Dakota: Amphetamine-dextroamphetamine
New Hampshire: Lisinopril
New Jersey: Amoxicillin
New Mexico: Lisinopril
New York: Vitamin D
Oregon: Levothyroxine sodium
Puerto Rico: Synthroid (name-brand for levothyroxine sodium)
Rhode Island: Amphetamine-dextroamphetamine
South Carolina: Amlodipine
South Dakota: Lisinopril
Virgin Islands: Levothyroxine sodium
West Virginia: Lisinopril
Popular prescription drug information reflects the scripts most filled through SingleCare for 2019, excluding opioids and weight-loss drugs.