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Derivative instruments (Summary of Income and Expense Line Items) (Details) - USD ($) $ in Millions | 3 Months Ended
--- | ---
Mar. 31, 2019 | Mar. 31, 2018
Derivative Instruments, Gain (Loss) [Line Items] |  |
Interest and other income, net | $ 185 | $ 231
Interest expense, net | (343) | (338)
Amortization of cumulative amount of fair value hedging adjustments for discontinued hedging relationships | 3 |
Interest rate swap agreements [Member] |  |
Derivative Instruments, Gain (Loss) [Line Items] |  |
Gains (losses) on fair value hedging relationships, Hedged items | (130) |
Gains (losses) on fair value hedging relationships, Derivatives designated as hedging instruments | 133 |
Reclassification out of Accumulated Other Comprehensive Income [Member] | Cash flow hedges [Member] | Cross-currency swap contracts [Member] |  |
Derivative Instruments, Gain (Loss) [Line Items] |  |
Interest and other income, net | (42) |
Product sales [Member] |  |
Derivative Instruments, Gain (Loss) [Line Items] |  |
Product sales | 5,286 | $ 5,343
Product sales [Member] | Reclassification out of Accumulated Other Comprehensive Income [Member] | Cash flow hedges [Member] | Foreign currency contracts [Member] |  |
Derivative Instruments, Gain (Loss) [Line Items] |  |
Product sales | $ 14 |

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