5 Best-Selling Medications In The World – One Is Not That Effective

My curiosity was raised recently when a news report claimed that one of the top 5 medicines in the world has recently been found to be not that effective.

First of all, the top five are:

1. Lipitor – the wonder drug for lowering blood cholesterol. USD 13 billion sales annually.

2. Plavix –  the blood-thinner that works by preventing blood platelets from sticking together. USD 6 billion annually.

3. Seretide – aka Advair, is a combination steroid-betaagonist( to relax the air passages in the lungs) that is inhaled by asthma patients. USD 6 billion.

4. Nexium – the wonder drug for the treatment of stomach ulcers and gastritis. USD 5 billion .

5. Norvasc – the top-selling medication for blood pressure. USD 4.8 billion.

Its interesting to see that many side-effects have been reported worldwide when using the above drugs, which brings one to the maxim – all drugs have side-effects and using it is a balance between its benefits and its risks. Some of these side-effects are quite harmless, like feet swelling up with Norvasc, but others can be potentially life-threatening.


Such is the case with one of the above –  Plavix aka clopidogrel – which has recently been issued a “black box” warning by the FDA here. A boxed warning is the FDA’s toughest warning and appears prominently at the top of a drug’s label to warn users of a serious warning. In the case of Plavix, 2-14% of users will not respond to its benefits (the anti-clotting action) and therefore will be at risk of a blood clot forming in the arteries of their heart or brain despite taking the medication. The inefficacy is determined genetically and its possible for potential users to have themselves screened in the near future to see whether they should take the medication or not.

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2 responses

  1. Does this mean heart patients should drop Plavix entirely?

    Doctor2008 replies: Well, not really. At the moment, its difficult to know on whom Plavix is not effective. The test to know this is relatively expensive (about USD 500) and not readily available. Discuss with your health provider on the alternatives, one of which is to rely on the older but time-tested medications which can be just as effective – aspirin and ticlopidine.

  2. my mum is on Norvasc, no wonder she has swollen feet every now and then!
    Doctor2008 says: Yup, especially distressing for women for cosmetic reasons, but otherwise quite harmless!

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