America's Most Common Prescription Drug

Well, I began by searching the most commonly prescribed drug in America. It is a painkiller. In 2011, according to Time, the most common prescription was the combination of hydrocodone and acetaminophen marketed under different names including Lortab or Vicodin.

 

Hydrocodone is a synthetic version of a compound discovered originally in opiates. Acetaminophen is the compound found in Tylenol, discovered through drug compound research in the nineteenth century. When administered together in a single tablet, these duo create a powerful pain killer. We don't understand exactly how either one functions. Loosely, hydrocodon works on the central nervous system, and acetaminophen works on the periphery. Acetaminophen is absorbed from the gut, has a half life of 1.5 - 3 hours, is metabolized by the liver, and excreted by the kidneys into urine. Hydrocodone has a half life of about 4 hours and a more complex metabolism. These drugs get rid of pain and are used widely, except in cases where breathing is too slow or where there may be rising pressure in the brain.

 

So, where does it come from?

 

I begin by reviewing drugs@FDA to find an application approval in 1996 to a company called UCB Inc for the combination drug Lortab: 500mg acetaminophen, 10mg hydrocodone bitartrate in oral tablet form. Apparently, Lortab is the "Reference Listed Drug" (RLD) for its class. This means it is the approved drug product to which new generic versions are compared to show that they are bioequivalent. The site lists five other companies make drugs considered bioequivalent to Lortab: Amneal, Mallinckrodt, Sun, Vintage, and Watson. Lortab, it turns out, has another incarnation listed in 1982 as a drug in the class of Vicodin (which was the RLD itself). The difference with the 1996 Lortab is one of dosing: previously, Lortab contained only 5mg of hydrocodone, not the 10mg in its newest listing.
 

What, then, is "UCB"?

 

It's website tells us that it is "aspiring to be the patient-centric biopharma leader", and lots of happy images corroborate that image. Yay! It does business in 40 countries with annual revenue of 3.2 billion euros in 2011. The company was founded in 1928 in Brussels. 49% of sales is from Europe, 33% from North America. Its US headquarters happens to be located just outside of Atlanta in Smyrna. Interestingly, it is quite difficult to discover that Lortab is one of its drugs. For it lists Lortab as the last drug under the category of "Immunology" drugs...somewhat of a stretch! The drugs most touted are some rarely-used ones for compelling conditions like Crohn's and Parkinson's, not the habit-forming pain-killer reminiscent from House.

 

The "Products" site neglects to list Lortab, but does say  "For additional information on other products not listed here, contact UCB Medical Information at +1.877.822.9493." We'll pick up the trail here another day!