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Official websites use. Share sensitive information only on official, secure websites. Medications usage has become a significant part of contemporary life. Many studies indicate that there is an excessive use and a considerable waste of medicines. This descriptive study aims at identifying the most used medicines in Saudi Arabia from to according to the statistics of specialized companies in the field. Comparison of the most commonly used drugs with those in the United States aims at clarifying similarities and differences. The results showed that the use of antibiotics and analgesics still accounted for the bulk, followed by proton pump inhibitors and anti-diabetics respectively, then anti-hyperlipidemic agents and erectile dysfunction treatments. The causes of this overuse vary according to the studies concerned between the self-medications and the over-prescription of the medication and the failure of the diagnostic and treatment procedures malpractice. The recommendations are the strict application of prescribed and non—prescribed dispensing systems and the further establishment and application of national guides in the diagnosis and treatment of communicable diseases. The repetition of such studies is useful in reviewing health policies and regulations related to health practice in general and pharmacological policies in particular. The utilization of pharmaceutical medications has become an essential part of our standard of living all round the world. Prescription drugs, particularly, are continuously considered as complicated issue: talk of pharmaceutical company endorsements, the rising cost of drugs and doctors over-prescribing their patients. Needless to say, that these drugs have an enormously affect on the life of the individual and community. For example, the misuse of antibiotics may lead to serious complications that can affect the patient and increase multi-resistant organisms within the community. Moreover, mean medication wastage was estimated to be Meaningful the most utilized drugs amongst the population in Saudi Arabia may open new areas of research. It may also help legislative and executives authorities in Saudi Arabia to improve the policies and regulations regarding the distribution and consuming of pharmaceutical drugs. Reviewing the available literature in Saudi Arabia indicates that this issue has not been previously investigated deeply. The first step in this regard is to determine drug utilization pattern in KSA with actual figures. The main aim of this study is to determine the top ten used drugs in Saudi Arabia. Furthermore, comparing these significant figures to other world leading countries like the USA United States of America in regards of most utilized drugs amongst the population will give more realistic picture. Finally, recommendations based on the results will be provided. IMS Health is an American company that provides information, services and technology for the healthcare industry. It is the largest vendor of U. The firm uses its own data to produce syndicated reports such as market forecasts and market intelligence. Focusing on prescribing drugs not OTC is the main objective of this study from the year till Our choice of comparison is the US as it is a leading country in healthcare services and many published papers regarding this subject have been covered in their country, therefore, it is ideal for evaluation Lindsley, , Kantor et al. It is appeared in Fig. Diclofenac products were amongst top four drugs from to In years from to the top prescribed medication amongst all types of drugs and analgesics was the original brand of diclofinac. However, the local generic especially G1 product of diclofenac showed gradual increasing in usage throughout the years which result in leading analgesics class in and after while the original brand usage dropped heavily in The trend of the top 10 sold drugs in KSA during the years — the volume unit is Million. Amoxicillin plus clavulanic acid complex was the only antibiotic in the top ten list represented by two generic products. The local generic G1 was the 3rd in the top ten list of the most commonly used antibiotic from to with steady increase. There are an antibiotic close to top ten list showed a notable increasing in usage which is ceftriaxone. The use of two proton pump inhibitors pantoprazole and esomeprazole was high in Saudi from to and shared the same level of consuming in and In and , pantoprazole was higher in consuming than esomeprazole. However, esomeprazole was the higher in A combination of metformin plus sitagliptin became one of the top 10 utilized medications starting from The two remaining drugs on the list were: tadalafil and atorvastatin respectively with notable increasing, and closely to them sildenafil came with notable increasing. The noteworthy result was that no antibiotics or analgesics were listed on the most utilized drug list of till in the United States of America. The pattern of the top 10 prescribed drugs in USA during the years — the volume unit is Million. The present study illustrated the utilization pattern of drugs in Saudi Arabia during the years — We are unaware of any previously published study focused on such aspect. Results showed that analgesics represent most utilized drug class in Saudi Arabia, in particular the potent non-steroidal anti-inflammatory drug NSAID diclofenac. It is common in the society to use the OTC form of this drug like ointments and jells Cooper, , Sharma et al. However, the public use of analgesics can be explained, partially, by self medication Suleiman, , and the over prescribing of analgesics can be linked to poor control of prescription drugs in community pharmacies in Saudi and the loss of proper national guidelines Khan, One of key element in good prescribing practice is conserving the need and objectivity of the patient. In the USA, there were no analgesics in the list of top ten prescribed drugs. Over-utilization of diclofenac is worrisome since this drug has been linked to risk of cardiovascular disease especially when used with high doses and for long duration Antman et al. It has been noticed from study results that two antibiotics consistently appeared in the top 10 utilized drugs in Saudi. On the contrary, antibiotics were not found in the top 10 used drugs in USA, although USA had a similar concern before and it has been solved by controlling the prescription of antibiotics Roumie et al. However, irrational use of antibiotics evolved in both developing and developed countries Morgan et al. Irrational use of antibiotics has two dimensions, improper prescribing and dispensing. Some doctors prescribe antibiotics to patients based on incorrect diagnosis for instance, viral upper respiratory tract infections Stone et al. This can be even complicated by lack of adherence to the prescribed antibiotic therapy by some of patients, increasing risk of antibiotic resistance Bebell and Muiru, A cross-sectional study investigated selling pattern of antibiotics in community pharmacies in Riyadh, the capital city of Saudi Arabia. The researchers found that more than three quarters of visited pharmacies sold antibiotics to consumers without prescriptions. They also reported that majority of those who dispensed antibiotics without prescription recommend the antibiotics to the patients without direct request from them Bin Abdulhak et al. This behavior has been confirmed in another city in Saudi Arabia Al-Mohamadi et al. Another study showed that most commonly sold drugs without prescriptions in Riyadh were antibiotics and analgesics Aljadhey et al. Two thirds of all antibiotics are sold without prescription, through unregulated private sectors Holloway and Van Dijk, Even in those countries where over-the-counter delivery of antibiotics is not permitted, patients use antibiotics without prescription Suda et al. Moreover, Low adherence levels by patients are common; many patients take antibiotics in under-dose or for shortened duration Ranji et al. Low adherence can be referred to many causes, and Table 1 summarized major predictors of poor adherence to medicine Dimatteo, , Osterberg et al. Investigators found that irresponsible self-medication is common in Saudi Arabia and most participants had poor knowledge, and negative perceptions regarding self-medication. Generally, antibiotic prescriptions were Similarly, In Saudi Arabia, Practitioners tend to prescribe antibiotics frequently in winter and people tend to use antibiotics during this season and their attitude toward common cold management related to their level of education AlKhamees et al. Adapted from Osterberg et al. However that does not reflect the proper utilization of this class of medications. This improper prescribing pattern of PPIs, particularly by non-gastroenterologist, was observed earlier in another tertiary teaching hospital Alzahrani et al. Such studies indicating that Saudi Arabia, like other countries, suffers from widespread misuse of PPIs in hospital practice Jones et al. Collaboration between pharmacists and physicians to Implant correct measures of prescribing and develop evidence-based practice guidelines and adherence to it will produce improvement in this regard. The other drug classes in the list such as antidiabetics and antihyperlipidemic may reflect the current situation of chronic disease in Saudi Arabia Alqurashi et al. For instance, the presence of diabetes treatment for type 1 and type 2 in USA list of the top ten utilized drugs should be noticed. The increase in the prescribing of drugs used to chronic disease is expected due to the increase in the prevalence of disease treated by these agents. On the other hand, the effect of insurance coverage in type and number of medication should be considered. The influence of insurance coverage in prescribing behavior is a common problem in other countries. Starting from , there was an interesting increase in the utilization of erectile dysfunction agents. Two reasons can explain such results; the high prevalence of type 2 diabetes mellitus in Saudi and self-medication. It has been estimated that almost one-quarter of Saudi Population suffer from type 2 diabetes mellitus Al-Daghri et al. The latter is a well-established risk factor for macro- and microvascular complications including sexual dysfunction Maiorino et al. Over the counter selling of erectile dysfunction is common in community pharmacies. Recent study investigated the use of phosphodiesterase 5 inhibitors PDEIs in a sample of Saudi men and reported that vast majority of PDEIs users bought them without prescription Alshahrani et al. Finally, the list of top ten for Saudi Arabia reflects the notable using of local generic drugs beside the original drugs indicating probably good awareness of prescribers about the comparable effectiveness of generic and original drugs Ahire et al. Our study has some limitations. Results showed that analgesics were the highest class of drugs used in Saudi Arabia followed by antibiotics as the second largest group with 2 antibiotics in the list of top ten throughout the years the study was conducted. Activation of an electronic tracking system will help observing that inappropriate medications prescription and dispensing by health professionals which can be a major factor in the over and misuse of those medications. This paper shows alarming increase in utilization of antibiotics and hence regulatory actions are needed to combat antibiotics misuse for better impact on the society. National guidelines for the management of common diseases are essential to minimize unnecessary over utilization of certain medications in health facilities. Finally more prescribing patterns within each specialty will help in that regard. Hopefully, this study will initiate a platform for further research on the use of pharmaceutical drugs and prescribing patterns in Saudi Arabia. In addition it may help directly the public awareness. As a library, NLM provides access to scientific literature. Saudi Pharm J. Box , Riyadh , Saudi Arabia. Find articles by Osama A AlKhamees. Find articles by Khaled A AlNemer. Find articles by Mohammed W Bin Maneea. Find articles by Faisal A AlSugair. Find articles by Bassam H AlEnizi. Find articles by Adel A Alharf. Open in a new tab. Patient-related limitations Barriers to care or medicine Psychological problems, particularly depression Poor relationship between patient and provider Cognitive impairment Missed appointments Asymptomatic disease Lack of health insurance Inadequate follow-up or discharge planning Cost of copayment or coinsurance Side effects of medicine Complexity of treatment Patient lacks belief in benefit of treatment Access restrictions e. Peer review under responsibility of King Saud University. Similar articles. Add to Collections. Create a new collection. Add to an existing collection. Choose a collection Unable to load your collection due to an error Please try again. Add Cancel.

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