The 10 Most-Prescribed Drugs in the U.S.

And the winner is . . .

Abilify may be the best-selling drug in the U.S. by dollar volume, but in terms of sheer numbers of prescriptions, it doesn't even come close to the prescription-drug leader: hydrocodone compounded with paracetamol. (You might know it as Vicodin, although it comes by many other names.) It's a Schedule II narcotic, basically a synthetic opiate for pain management. It's been the best-selling drug in the U.S. for at least ten years.

The rest of the Top Ten in terms of number of prescriptions filled, according to WebMD (2010 data):

Drug Name and Its Uses	Number of Prescriptions
Hydrocodone/paracetamol	131.2 million
Generic Zocor (simvastatin), cholesterol lowering statin	94.1 million
Lisinopril (brand names include Prinivil and Zestril), blood pressure control	87.4 million
Generic Synthroid (levothyroxine sodium), synthetic thyroid hormone	70.5 million
Generic Norvasc (amlodipine besylate), angina/blood pressure control	57.2 million
Generic Prilosec (omeprazole), antacid	53.4 million
Azithromycin (brand names include Z-Pak and Zithromax), antibiotic	52.6 million
Amoxicillin (various brand names), antibiotic	52.3 million
Generic Glucophage (metformin), diabetes	48.3 million
Hydrochlorothiazide (various brand names), diuretic, blood pressure control	47.8 million

Hydrocodone's status as the top prescription drug in the U.S. will come as no surprise to anyone who's been inside an American drug rehab center. Hydrocodone and its virtually identical twin, oxycodone, are widely used recreationally (and for committing suicide). Where I live, in Florida, there are "Pain Clinics" on all the major highways. These "clinics" accept no insurance; cash only. Most are walk-in facilities (they don't require an appointment). You go in, pay your $250 to $300, see a doctor for a few minutes, pretend you're in pain, tell him or her which recreational drug you're interested in (Xanax, Vicodin, and Roxicet, etc.), and you leave with a prescription in your pocket a few minutes later. If you want to see how this works, with your own eyes, right now, just go to http://topdocumentaryfilms.com/oxycontin-express/ and watch the Peabody-Award-winning documentary The Oxycontin Express.

As for the other drugs in the chart: Most of the names should come as no surprise, given that heart disease is still (today, as a hundred years ago, before these medications existed) the No. 1 cause of death in the United States. Diabetes is the No. 7 cause of death in America (and is killing about 3% more people every year), hence metformin's strong showing in the chart is not unexpected. Likewise, you'd expect an antibiotic or two to be in the best-seller list.