Medications A-Z

Brand: Tylenol, Panadol, Mapap; paracetamol (international)

Mild-to-moderate pain, Fever

Acetaminophen does not have meaningful race-specific efficacy differences. The equity angle is largely overlap with other pain medications:Pain under-treatment. When acetaminophen alone …

Brand: ProAir, Proventil, Ventolin; salbutamol (international)

Asthma (rescue), COPD exacerbation, Exercise-induced bronchospasm

Albuterol is one of the most consequential examples of race-specific pharmacogenomics in asthma:Pharmacogenomics. The ADRB2 gene encodes the beta-2 receptor. The Arg16Gly …

Brand: Norvasc, Katerzia

Hypertension, Angina, Coronary artery disease

Amlodipine is one of two guideline-preferred first-line antihypertensives for Black adults without CKD or heart failure (the other being a thiazide-type diuretic). …

Brand: Amoxil, Moxatag; with clavulanate as Augmentin

Otitis media, Strep pharyngitis, Sinusitis, UTI, Dental prophylaxis, H. pylori component

No meaningful race-specific efficacy differences. Three relevant points:Penicillin-allergy labeling. Approximately 10 percent of US adults carry a penicillin-allergy label, but testing confirms …

Brand: Adderall, Adderall XR, Mydayis

ADHD, Narcolepsy

ADHD diagnosis and treatment are significantly race-biased in the US:Diagnostic gap. Black children with ADHD are 30–50 percent less likely to be …

Brand: Eliquis

Atrial fibrillation, DVT/PE treatment and prevention

The ARISTOTLE trial (Granger et al., NEJM 2011;365:981–92, PMID 21870978) showed apixaban superior to warfarin for stroke prevention in atrial fibrillation, with …

Brand: Tenormin

Angina, Post-MI, Hypertension (second-line)

Beta blockers, including atenolol, are not recommended as first-line therapy for uncomplicated hypertension in any adult — Black or non-Black — per …

Brand: Lipitor

Hyperlipidemia, Primary and secondary CV prevention

Statins work across racial groups, with consistent LDL reductions and CV outcome benefits in pooled analyses. Specific evidence in Black patients:Jackson Heart …

Brand: Zithromax, Zmax, Z-Pak

Community-acquired pneumonia, Atypical pneumonia, Chlamydia, Gonorrhea (with ceftriaxone), Strep pharyngitis (PCN-allergic)

Two race-relevant concerns:QT prolongation and cardiovascular death. A 2012 NEJM analysis (Ray et al., 2012;366:1881–90, PMID 22591294) found a small but real …

Brand: Biktarvy

HIV-1 treatment (initial and switch)

Biktarvy's pivotal trials (Sax et al., Lancet 2017;390:2073–82; Gallant et al., Lancet HIV 2017;4:e154–60) enrolled clinically meaningful proportions of Black participants and …

Brand: Symbicort, Breyna

Asthma (including SMART), COPD

Symbicort SMART has several advantages relevant to Black patients with asthma:Lower total beta-agonist exposure. SMART therapy reduces total SABA use compared to …

Brand: Wellbutrin, Zyban, Aplenzin

Depression, Seasonal affective disorder, Smoking cessation, ADHD (off-label)

Bupropion is an important option for Black patients for two reasons:Tobacco disparity. Black Americans smoke at slightly lower rates than white Americans …

Brand: Coreg, Coreg CR

Heart failure, Post-MI, Hypertension

Carvedilol has the most favorable evidence base for Black patients with heart failure among beta blockers. The COPERNICUS trial (Packer et al., …

Brand: Thalitone

Hypertension, Edema

Chlorthalidone has the strongest outcome evidence of any first-line antihypertensive in Black adults. The ALLHAT trial randomized 15,094 Black participants and found …

Brand: Plavix

Post-MI, Post-stent, Stroke prevention (lacunar), PAD

Clopidogrel has one of the most clinically significant pharmacogenomic stories in cardiology, with important race implications:CYP2C19 loss-of-function alleles (*2 and *3) reduce …

Brand: Tivicay, Dovato (with lamivudine), Triumeq (with ABC/3TC)

HIV-1 treatment

Dolutegravir has the largest cumulative Black-patient data of any ART, from WHO-recommended use across sub-Saharan Africa. Key points:Virological efficacy is equivalent to …

Brand: Trulicity

Type 2 diabetes, Cardiovascular risk reduction in T2D

The REWIND trial (Gerstein et al., Lancet 2019;394:121–30, PMID 31189511) enrolled 9,901 T2D patients and showed a 12 percent relative reduction in …

Brand: Jardiance, Synjardy, Glyxambi

Type 2 diabetes, Heart failure (reduced + preserved EF), CKD

Empagliflozin's outcome evidence in Black patients is robust across multiple landmark trials:EMPA-REG OUTCOME (Zinman et al., NEJM 2015;373:2117–28, PMID 26378978) — 38 …

Brand: Lexapro

Depression, Generalized anxiety disorder

The STAR*D and CO-MED trials enrolled reasonable numbers of Black participants (~18 percent in STAR*D). Remission rates with citalopram (closely related to …

Brand: Prozac, Sarafem

Depression, OCD, Bulimia, Panic disorder, PMDD, Pediatric depression

Fluoxetine is primarily metabolized by CYP2D6 (with contributions from CYP2C9 and 3A4). CYP2D6 allele distributions vary by ancestry, but variant effects on …

Brand: Advair Diskus, Advair HFA, Wixela, AirDuo

Asthma, COPD

Advair's Black-patient evidence base is mixed and politically fraught:SMART trial (Nelson et al., Chest 2006;129:15–26, PMID 16424409) raised concerns that salmeterol alone …

Brand: Lasix

Heart failure, Edema, Advanced CKD, Hypertension with low eGFR

Furosemide itself has no major race-specific efficacy signal — it works through a transporter (NKCC2) that is not genetically variable in ways …

Brand: Neurontin, Gralise, Horizant

Post-herpetic neuralgia (FDA), Epilepsy adjunct; widely used off-label for neuropathic pain, fibromyalgia, anxiety, insomnia

Gabapentin's rise as a de facto 'non-opioid' pain medication has had complex equity effects for Black patients:Pain under-treatment pattern. Gabapentin is increasingly …

Brand: Glucotrol

Type 2 diabetes

Sulfonylureas work similarly across racial groups. But the ADOPT trial (Kahn et al., NEJM 2006;355:2427–43, PMID 17145742) showed glyburide (a related sulfonylurea) …

Brand: Microzide, HCTZ

Hypertension, Edema

Thiazide-type diuretics are guideline-preferred first-line agents for Black adults with uncomplicated hypertension (2017 ACC/AHA, Whelton et al., 2018). Importantly, however, leading hypertension …

Brand: Advil, Motrin, Nuprin

Pain, Fever, Inflammation, Menstrual cramps

Ibuprofen efficacy does not differ meaningfully by race. But several use-related concerns map disproportionately onto Black adults:Blood pressure. All NSAIDs raise blood …

Brand: Humalog, NovoLog, Lantus, Basaglar, Tresiba, Toujeo, Levemir, Humulin, Novolin

Type 1 diabetes, Type 2 diabetes, Gestational diabetes, DKA

Insulin itself works equally well across racial groups. But Black patients face documented disparities in insulin access, starting, and adherence that drive …

Brand: Synthroid, Levoxyl, Tirosint, Unithroid, Euthyrox

Hypothyroidism, TSH suppression in thyroid cancer

Levothyroxine itself has no meaningful race-specific efficacy difference. Two Black-patient points worth noting:TSH reference ranges and overdiagnosis. NHANES data show slightly lower …

Brand: Prinivil, Zestril, Qbrelis

Hypertension, Heart failure, Post-MI, Diabetic kidney disease

The 2017 ACC/AHA hypertension guideline (Whelton et al., Hypertension 2018;71:e13–e115) recommends that Black adults without chronic kidney disease be started on a …

Brand: Cozaar

Hypertension, Diabetic kidney disease, Stroke prevention in LVH

ARBs share the same efficacy caveat in Black patients that ACE inhibitors do: as monotherapy for uncomplicated hypertension, ARBs lower blood pressure …

Brand: Natrol, Nature Made, various OTC brands

Jet lag, Delayed sleep phase disorder, Insomnia (off-label), Shift-work sleep disorder

Melatonin works modestly for jet lag and delayed sleep phase. Evidence for chronic insomnia is weak. Two equity-related points:Shift-work exposure. Black Americans …

Brand: Glucophage, Glumetza, Fortamet, Riomet

Type 2 diabetes, Prediabetes, PCOS

Metformin works effectively across racial groups. The UKPDS, Diabetes Prevention Program (DPP), and subsequent trials found consistent A1C reductions and consistent cardiovascular …

Brand: Lopressor (tartrate), Toprol XL (succinate)

Heart failure, Post-MI, Angina, Atrial fibrillation rate control

Metoprolol is not first-line for uncomplicated hypertension in Black adults, for the same reasons as atenolol. But it is a first-line drug …

Brand: Singulair

Asthma (add-on), Allergic rhinitis, Exercise-induced bronchospasm

Montelukast is modestly effective in asthma — less so than an ICS. GINA and NAEPP guidelines generally position it as a second-line …

Brand: Aleve, Naprosyn, Anaprox

Pain, Inflammation, Menstrual cramps, Gout flare, Arthritis

Naproxen's CV profile (compared to ibuprofen or celecoxib) makes it the preferred NSAID for patients at elevated cardiovascular risk — a group …

Brand: Prilosec, Zegerid

GERD, Peptic ulcer disease, Erosive esophagitis, H. pylori (with antibiotics)

No race-specific efficacy differences. But two equity-adjacent issues:CYP2C19 metabolism. Omeprazole is activated by CYP2C19. Poor metabolizers (more common in some Asian populations; …

Brand: Protonix

GERD, Erosive esophagitis, Zollinger-Ellison syndrome

Same class concerns as omeprazole. The main prescribing point relevant to Black patients is that pantoprazole has less CYP2C19 inhibition than omeprazole, …

Brand: Paxil, Pexeva, Brisdelle

Depression, Anxiety disorders, OCD, PTSD, Vasomotor symptoms of menopause (Brisdelle)

Paroxetine is a potent CYP2D6 inhibitor and is itself metabolized by CYP2D6. This creates pharmacokinetic complexity that is not specifically race-differential but …

Brand: Xarelto

Atrial fibrillation, DVT/PE, PAD (low dose + aspirin)

ROCKET-AF (Patel et al., NEJM 2011;365:883–91) showed rivaroxaban non-inferior to warfarin for AF stroke prevention. The Black subgroup was small (~3 percent). …

Brand: Crestor, Ezallor

Hyperlipidemia, Primary and secondary CV prevention

The JUPITER trial (Ridker et al., NEJM 2008;359:2195–2207, PMID 18997196) randomized 17,802 adults with low LDL but elevated CRP and showed a …

Brand: Ozempic, Wegovy, Rybelsus

Type 2 diabetes, Obesity, Cardiovascular risk reduction

Semaglutide's cardiovascular and glycemic benefits are consistent across racial groups in the trials that enrolled Black participants:SUSTAIN-6 (Marso et al., NEJM 2016;375:1834–44, …

Brand: Zoloft

Depression, Anxiety, PTSD, OCD, Panic disorder, PMDD

SSRIs as a class have more complex race-specific evidence than cardiovascular drugs. Three themes matter:Response rates. Post-hoc analyses of STAR*D (Lesser et …

Brand: Zocor

Hyperlipidemia, CV prevention

Simvastatin's outcome data comes principally from 4S (Lancet 1994;344:1383–9) and HPS (Lancet 2002;360:7–22) — trials with few Black participants. Extrapolation across race …

Brand: Aldactone, CaroSpir

Resistant hypertension, Heart failure, Primary aldosteronism, Acne, PCOS hirsutism

Spironolactone has a disproportionately important role in Black patients with resistant hypertension, defined as blood pressure above goal on three drugs at …

Brand: Truvada (TDF/FTC), Descovy (TAF/FTC)

HIV pre-exposure prophylaxis (PrEP), HIV treatment component

PrEP is one of the sharpest equity failures in US healthcare:In 2021 CDC surveillance data, Black Americans accounted for approximately 40 percent …

Brand: Mounjaro, Zepbound

Type 2 diabetes, Obesity, Obstructive sleep apnea with obesity

SURPASS-2 (Frías et al., NEJM 2021;385:503–15, PMID 34170647) and SURMOUNT-1 (Jastreboff et al., NEJM 2022;387:205–16, PMID 35658024) established tirzepatide's glycemic and weight-loss …

Brand: Ultram, ConZip, Ultracet (with acetaminophen)

Moderate to moderately severe pain

Tramadol has the most race-relevant pharmacogenomic profile of any common analgesic, and the most problematic equity implications:CYP2D6 metabolism. CYP2D6 poor metabolizers convert …

Brand: Desyrel, Oleptro

Depression (FDA); Insomnia (off-label, most common US use)

Low-dose trazodone for insomnia has weak clinical-trial support across all populations — a 2017 Cochrane review found only small, short-term benefits. But …

Brand: Effexor, Effexor XR

Depression, Generalized anxiety, Social anxiety, Panic disorder

Venlafaxine is metabolized to its active metabolite desvenlafaxine (Pristiq) by CYP2D6. CYP2D6 poor metabolizers — more common in some Black populations for …

Brand: Coumadin, Jantoven

Atrial fibrillation, DVT/PE, Mechanical heart valves, Antiphospholipid syndrome

Warfarin dosing has one of the largest race-specific evidence bases in all of pharmacology, rooted in pharmacogenomics. The key points:Two genes dominate …