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Derivative instruments (Locations and Effective Portions of Gain (Loss) Reclassified out of AOCI) (Details) - USD ($) $ in Millions | 3 Months Ended | 9 Months Ended
--- | --- | ---
Sep. 30, 2018 | Sep. 30, 2017 | Sep. 30, 2018 | Sep. 30, 2017
Derivative Instruments, Gain (Loss) [Line Items] |  |  |  |
Interest and other income, net | $ 126 | $ 267 | $ 519 | $ 627
Interest expense, net | (355) | (325) | (1,040) | (972)
Income before income taxes | 2,094 | 2,381 | 7,360 | 7,383
Product sales [Member] |  |  |  |
Derivative Instruments, Gain (Loss) [Line Items] |  |  |  |
Product sales | 5,510 | 5,453 | 16,532 | 16,226
Accumulated net gain (loss) from cash flow hedges [Member] | Reclassification out of Accumulated Other Comprehensive Income [Member] |  |  |  |
Derivative Instruments, Gain (Loss) [Line Items] |  |  |  |
Income before income taxes | (33) | 140 | (221) | 601
Accumulated net gain (loss) from cash flow hedges [Member] | Reclassification out of Accumulated Other Comprehensive Income [Member] | Foreign currency contracts [Member] | Product sales [Member] |  |  |  |
Derivative Instruments, Gain (Loss) [Line Items] |  |  |  |
Product sales | 3 |  | (51) |
Accumulated net gain (loss) from cash flow hedges [Member] | Reclassification out of Accumulated Other Comprehensive Income [Member] | Cross-currency swap contracts [Member] |  |  |  |
Derivative Instruments, Gain (Loss) [Line Items] |  |  |  |
Interest and other income, net | (36) |  | (170) |
Accumulated net gain (loss) from cash flow hedges [Member] | Reclassification out of Accumulated Other Comprehensive Income [Member] | Cash flow hedge [Member] |  |  |  |
Derivative Instruments, Gain (Loss) [Line Items] |  |  |  |
Income before income taxes | (33) | 140 | (221) | 601
Accumulated net gain (loss) from cash flow hedges [Member] | Reclassification out of Accumulated Other Comprehensive Income [Member] | Cash flow hedge [Member] | Foreign currency contracts [Member] | Product sales [Member] |  |  |  |
Derivative Instruments, Gain (Loss) [Line Items] |  |  |  |
Product sales | 3 | (2) | (51) | 88
Accumulated net gain (loss) from cash flow hedges [Member] | Reclassification out of Accumulated Other Comprehensive Income [Member] | Cash flow hedge [Member] | Cross-currency swap contracts [Member] |  |  |  |
Derivative Instruments, Gain (Loss) [Line Items] |  |  |  |
Interest and other income, net | (36) | 143 | (170) | 514
Accumulated net gain (loss) from cash flow hedges [Member] | Reclassification out of Accumulated Other Comprehensive Income [Member] | Cash flow hedge [Member] | Forward interest rate contracts [Member] |  |  |  |
Derivative Instruments, Gain (Loss) [Line Items] |  |  |  |
Interest expense, net | $ 0 | $ (1) | $ 0 | $ (1)

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