Pfizer will pay $42.9 million to North Carolina and 32 other states to resolve allegations that the drug maker used unfair and deceptive practices to unlawfully promote its drugs Zyvox and Lyrica, Attorney General Roy Cooper said in a news release.

"Decisions about medication should always put health over profits," Cooper said. "Doctors and patients deserve to get accurate, trustworthy information about drugs."

Zyvox is an antibacterial agent approved to treat certain types of infections, including a type of pneumonia and complicated skin infections caused by methicillin-resistant staphylococ-cus aureus (MRSA).

Cooper and the other participating attorneys general contend Pfizer marketed Zyvox as superior to vancomycin, an antibiotic that has been on the market for nearly 50 years that is also used to treat MRSA infections, although there is no substantial evidence that Zyvox is superior for some of the uses that Pfizer claimed, the release said.

Pfizer reportedly continued to market Zyvox in this way even after being warned by the U.S. Food and Drug Administration (FDA) not to.

Lyrica is a medication approved by the FDA to treat certain kinds of nerve pain, seizures and fibromyalgia.

The states allege that Pfizer also marketed Lyrica for off-label, or nonapproved, uses, such as to treat migraines and chronic pain.

While doctors can prescribe drugs off-label, it's illegal for a drug maker to market its drugs for uses that haven't been approved by the FDA, the release said. The state's investigation found that Pfizer used an incentive plan to motivate its sales force to encourage physicians to convert their patients to Lyrica.

Under the settlement, Pfizer has agreed not to promote its products for off-label uses, and not to make false, misleading or deceptive claims when comparing the efficacy or safety of Zyvox to vancomycin. The company will also design financial incentives to ensure that its marketing personnel are not motivated to market Zyvox or Lyrica improperly, and will notify its sales force promptly of any FDA warning letters that affect their promotion of Pfizer products, the release said.

Pfizer will also pay a $42.9 million settlement to the participating states, including $1,349,167 to North Carolina, for consumer protection purposes. Under an additional settlement reached by Cooper's office, Pfizer will pay $421,325.34 to the NC State Health Plan and $7,431.66 to the state prison system.

Cooper's Medicaid Investigations Division previously recovered $25.5 million from Pfizer in a case that alleged that Pfizer paid illegal kickbacks and marketed drugs for unapproved uses in order to sell more of certain drugs, including Zyvox and Lyrica, the release said.