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Derivative instruments - Schedule of Income and Expense Line Items (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2025	Mar. 31, 2024
Derivative Instruments, Gain (Loss) [Line Items]
Product sales	$ 8,149	$ 7,447
Other income (expense), net	1,518	(235)
Interest expense, net	(723)	(824)
Cross-currency swap contracts | Reclassification out of AOCI | Cash flow hedges
Derivative Instruments, Gain (Loss) [Line Items]
Other income (expense), net	83	(31)
Interest rate swap agreements
Derivative Instruments, Gain (Loss) [Line Items]
Gains (losses) on fair value hedging relationships, hedged items	(96)	49
Derivatives designated as hedging instruments	112	(28)
Product sales
Derivative Instruments, Gain (Loss) [Line Items]
Product sales	7,873	7,118
Product sales | Foreign currency forward contracts | Reclassification out of AOCI | Cash flow hedges
Derivative Instruments, Gain (Loss) [Line Items]
Product sales	$ 56	$ 51

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Amount of gain (loss) from the increase (decrease) in fair value of derivative and nonderivative instruments designated as fair value hedging instruments recognized in the income statement.

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Amount of the cost of borrowed funds accounted for as interest expense for debt.

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