The most popular drugs in the top 50 U.S. cities

Creator: SingleCare
Published: 2019-12-20T10:00:42-05:00

By Dawn Weinberger | Dec. 20, 2019 Medically reviewed by Gerardo Sison, Pharm.D.

Columbus, Ohio, and Las Vegas are as different as two cities can be. In Columbus, the average high temperature is 62.5° F. In Las Vegas, it’s 80° F. Tourism in Las Vegas is huge, bringing in $60 billion per year. Columbus doesn’t even come close—the entire state of Ohio “only” brings in $46 billion. Vegas boasts at least 125 Starbucks locations. Columbus? Barely 80 in the entire metro area (and many of those are inside other retail establishments). One thing the two cities do have in common? Lisinopril, a prescription medication that treats high blood pressure and heart failure. In both cities, it is the most prescribed drug among SingleCare users.

This interesting statistic begs the question why? Why is Lisinopril so popular in Las Vegas and Columbus (it topped the charts in Phoenix, too). It also piqued our curiosity about popular medications in other cities, so we checked the data and uncovered some intriguing (and in some cases, surprising) information. Curious to know which medication is the most-commonly prescribed in your location? Our list of the top 50 states in the U.S. is below.

Amphetamine-dextroamphetamine

Most prescribed drug in New York; Chicago; Austin, Texas; Seattle; Denver; Atlanta; Raleigh, N.C.; Virginia Beach, Va.; Nashville, Tenn.; Jacksonville, Fla.; and Minneapolis, Minn.; Kansas City, Mo.

If you or your child has attention deficit hyperactivity disorder, a behavioral condition characterized by an inability to focus, impulsivity, restlessness, and poor time management, you’ve probably heard of amphetamine-dextroamphetamine—although you might be more familiar with the drug’s brand names, Adderall and Mydayis. These medications help with attention and concentration, allowing people with ADHD to be more productive at work or school. Amphetamine-dextroamphetamine is also used (albeit not as often) to treat narcolepsy, a sleep disorder that leaves people with uncontrollable and excessive daytime drowsiness.

In terms of the long list of cities associated with amphetamine-dextroamphetamine, Karen Kier, Ph.D., RPh, director of drug and health information at Ohio Northern University, theorizes that it is related to population and availability of healthcare services.

“With those bigger cities you’re going to have better access to pediatricians, better access to pediatric hospitals, and [better access to] specialists in the area of ADHD whether you’re an adult or child,” Keir says, adding that people in rural areas might not have the same type of access and therefore are less likely to receive a prescription to treat the condition.

Amoxicillin

Most prescribed drug in Los Angeles; Houston; San Diego; San Jose, Calif.; Washington, D.C.; Dallas; Fort Worth, Texas; Arlington, Texas; and Long Beach, Calif.

A very common antibiotic in the penicillin family, amoxicillin is familiar to almost anyone who has experienced a sinus, ear, or some other upper respiratory infection. In fact, it is the most frequently prescribed outpatient antibiotic, with 56.7 million prescriptions written in 2016 alone, according to the Centers for Disease Control and Prevention (CDC).

And while frequent and/or unnecessary antibiotic use can definitely pose a problem, amoxicillin certainly has its place. If you are diagnosed with strep, bronchitis, pneumonia, tonsillitis, one of the other aforementioned infections, or even a urinary tract infection, amoxicillin is often the first line of defense. The caveat? Due to the proliferation of antibiotic-resistant infections, the drug might not be as effective in certain regions of the country, meaning your doctor would need to prescribe something else, Kier explains.

Fortunately, if you live in one of the above cities, this probably won’t be an issue (at least not yet). Kier says healthcare providers tend to prescribe based on documented resistance patterns in their regions, and the fact that these cities churn out a lot of amoxicillin prescriptions shows that its effectiveness in these places is still going strong.

Lisinopril

Most prescribed drug in Phoenix; Columbus, Ohio; Las Vegas; Sacramento, Calif.; Tulsa, Okla.; and Oklahoma City

We’ve already mentioned lisinopril, but to expand—lisinopril is one of many medications in the ACE inhibitor (angiotensin-converting enzyme) category, used to treat hypertension, high blood pressure, and congestive heart failure. It is also sometimes prescribed to patients with diabetes because it helps preserve kidney function, Kier says.

Regardless of where you live, this is a very popular medication. In 2016, lisinopril was prescribed to more than 100 million people, which makes sense considering CDC statistics show that 75 million Americans have high blood pressure. But why the higher numbers in Phoenix, Columbus, Las Vegas, Sacramento, Kansas City, Tulsa, and Oklahoma City?

Kier speculates that it is likely health plan driven—meaning, that for whatever reason, patients living in these cities tend to have health plans that prefer patients to use lisinopril over similar drugs. This, she says, could be explained by the fact that lisinopril was one of the first ACE inhibitors to go generic, making it very inexpensive.

Amlodipine besylate

Most prescribed drug in Philadelphia; Boston; Charlotte, N.C.; Indianapolis; Milwaukee; New Orleans; and Omaha, Neb.

Another high blood pressure drug, amlodipine besylate is a calcium channel blocker that also treats chronic chest pain. Like lisinopril, it is widely used and very affordable based on the fact that it “went generic” early on, says Kier, adding that patients tend to respond well to amlodipine besylate. She says it is popular everywhere (more than 75 million people take it), but as for Philly, Boston, Charlotte, Indianapolis, Milwaukee, New Orleans, and Omaha?

This could be another health-plan based situation, or it could even have to do with the overall health of the city residents. Other health-related factors could make these city-dwellers more apt to seek medical attention for high blood pressure.

Finasteride

Most prescribed drug in San Francisco

Sold under the brand names Proscar and Propecia, finasteride is a prescription medication used to treat an enlarged prostate (known clinically as benign prostatic hyperplasia, or BPH) and male pattern baldness, says Jeff Fortner, Pharm.D., a professor of pharmacy at Pacific University in Forest Grove, Oregon. BPH affects 50% of men between the ages of 51 and 60 and up to 90% (wow!) in the 80+ category. So, it isn’t a surprise to see it on a list of popular medications—especially considering that BPH can cause problems like trouble urinating and urinary tract infections.

The drug works, Dr. Fortner explains, by blocking the conversion process between testosterone and dihydrotesterone (or DHT). It is this blockage that allows the medication to do its job, whether that means combating hair loss or treating an enlarged prostate (or both). Unfortunately, the drug does come with some potential side effects—so be sure to talk to your doctor about the pros and cons of talking it. Also, be aware that while finasteride is sometimes used off label for women with hirsutism (a condition characterized by excessive hair growth), in general, women should avoid even handling the drug due to its propensity to cause severe birth defects, Dr. Fortner says.

Why is it popular in Fog Town? This is a mystery, especially since the population in the city is not predominantly male (the breakdown is pretty much 50-50).

Aspirin

Most prescribed drug in Detroit

Aspirin is typically an over-the-counter medication used to treat pain, inflammation, and fever. This 200-year-old pharmaceutical is also very useful as a blood thinner—many patients use it to help prevent strokes and blood clots. However, the American Heart Association advises against using it for this purpose unless you have already experienced a cardiac-related event (so speak to your doctor before adding it to your regimen).

Though most people just pay out of pocket for aspirin, some insurance plans will cover it if it has been prescribed by a doctor. This could explain why it is popular in Detroit—more than 25% of deaths in the state of Michigan in 2013 were due to cardiovascular disease and stroke, according to a report prepared by the Michigan Department of Community Health. Does this mean doctors are working with patients to lower that number? Quite possibly!

Levothyroxine sodium

Most prescribed drug in Albuquerque, N.M.; Tucson, Ariz.; Mesa, Ariz.; Colorado Springs, Colo.; and Portland, Ore.

Levothyroxine—known by the brand names Levothroid, Levoxyl, Synthroid, Tirosint, and Unithroid—is used to treat hypothyroidism (low thyroid levels), goiter (enlarged thyroid), and certain types of thyroid cancer, says Kier. In short, the medication is a type of hormone replacement therapy. It works, she says, by providing a synthetic version of the hormone that the body is not making enough of, thereby regulating thyroid hormone levels (which would be low, given the diagnosis).

Though it is difficult to determine with any degree of certainty, Kier says that the popularity of levothyroxine in these three Southwestern cities could be related to genetics. Statistics indicate that the majority of the Native American population lives in 10 specific states—New Mexico and Arizona being two of them. Likewise, some research indicates that Native Americans are predisposed to thyroid disease. She suspects a potential correlation. As for Colorado Springs and Portland—that is anyone’s guess.

Fluzone quadrivalent

Most prescribed drug in Oakland, Calif.

Did you get your flu shot yet? If you live in Oakland, probably so—it is the most popular medication on the bright side of the bay. We may not need to explain what the flu shot is or why it is important, but just in case: the quadrivalent flu shot is a vaccination that protects against four strains of the potentially deadly seasonal virus. Everyone over the age of 6 months should get it, and it is covered by insurance. Skipping the flu shot is risky business, experts say—61,200 people died from flu-related complications in the 2018-2019 season (it was 80,000 the year prior).

So what is it about Oakland that has people lining up to get their vaccinations? Kier attributes it to an effective marketing program. One of the nation’s largest HMO’s is headquartered in Oakland, and the organization—which insures a large percentage of Oakland residents—does a great job getting the word out about the importance of the flu shot and providing lots of opportunities for people to receive their shots. “They have a very good program in place,” she says.

Alprazolam

Most prescribed drug in Tampa, Fla.

Alprazolam is an anti-anxiety drug, sold under the brand name Xanax. Xanax is in a class of drugs known as benzodiazepines, and these particular medications (while very effective in treating acute anxiety) are addictive, not to mention overprescribed according to some experts (one recent study even found that doctors are prescribing benzos with increasing frequency, despite concerns across the medical community about their addictive nature). However, anxiety is a real problem among the adult population in the United States. Forty million adults age 18 and older suffer from an anxiety disorder, according to the Anxiety and Depression Association of America.

Dr. Fortner says that, despite the anxiety that would be caused by living with the constant fear of tropical storms and hurricanes, he can’t think of any specific explanation as to why Xanax use would be higher in Tampa. The city did, however, recently rank 74th on a top 100 most stressed out cities list. Perhaps that provides a glimpse into the story behind the data.

Vitamin D

Most prescribed drug in El Paso, Texas; Fresno, Calif.; Louisville, Ky.; Miami; Memphis, Tenn.; Baltimore, Md.; and San Antonio

Vitamin D is as confusing as it is necessary. An estimated 1 billion people worldwide are vitamin D deficient, according to the Harvard T.H. Chan School of Public Health. But what exactly does “deficient” mean? And if you are deficient (more likely if you live in a northern state), how many IUs do you need to take in order to reverse the deficiency? The answers depend on several variables, but anyone with concerns should talk to their doctor about a blood test to check levels. If they are off, you’ll need to work with your healthcare provider on a good supplementation plan because vitamin D is essential for everything from mood to bone health and beyond.

Will you need an actual prescription? Well, that depends. Most people purchase it over the counter. There are some medical conditions, however, that could render a prescription necessary, says Kier. “We will use prescription vitamin D in renal failure patients because [due to their condition] their bodies are not able to convert [regular] vitamin D into the form they need,” Kier says.

Patients with diseases of the liver, pancreas, and intestines may also need a prescription-strength version of the supplement. What do we mean by prescription strength? It’s a lot—50,000 IUs per capsule, usually taken once a week. In comparison, the general recommendation for an average adult is 600 IUs per day.

Like lisinopril, Kier suspects the high number of vitamin D prescription is health plan driven (it certainly isn’t related to kidney disease—Florida actually has lower levels of renal failure than many other states, according to the National Kidney Foundation). Dr. Fortner also wonders if frequent use sunscreen has something to do with it, as that can actually lead to vitamin D deficiency, he says.