The company said on Tuesday that it earned $2.75 billion, or 38 cents a share, in the first quarter. That compared with $1.79 billion, or 24 cents a share, a year earlier, when it took charges to boost productivity and address legal matters.
Excluding special items, Pfizer Inc. (PFE) earned 54 cents a share. Analysts on average expected 55 cents.
Revenue fell 9 percent to $13.5 billion, below Wall Street expectations of $13.99 billion. Demand for Pfizer's Prevnar 13 vaccine against pneumococcal bacteria fell because of wholesalers' purchasing patterns, the company said.
Pfizer said it expected full-year earnings of $2.14 to $2.24 a share, down from its previous forecast of $2.20 to $2.30. It noted that the falling Japanese yen was hurting sales in that important market.
Sales of Prevnar 13, the company's third-biggest product, fell 10 percent to $846 million. By contrast, sales of the vaccine used to prevent pneumonia and other infections had soared 19 percent in the prior quarter.
Moreover, Pfizer said sales grew only 5 percent in emerging markets due in part to reduced government purchases of Prevnar 13 and of the company's Enbrel treatment for rheumatoid arthritis and psoriasis. Emerging market sales had jumped 17 percent in the prior quarter.
Sales of generic medicines, which Pfizer calls established products and sells mainly overseas, fell 16 percent to $2.35 billion. That was also a reversal from the prior quarter, when they rose 3 percent.
Sales of cholesterol fighter Lipitor, which has been competing with cheaper generics since November, plunged 55 percent to $626 million, while sales of impotence drug Viagra fell 7 percent to $461 million.
The disappointing earnings report hit shares of Pfizer, which had risen 22 percent so far this year on high hopes for its pipeline of experimental drugs and the recent approvals of its treatments for cancer, rheumatoid arthritis and blood clots.
Pfizer has also attracted investors through its efforts to spin off nonpharmaceutical operations and return much of the proceeds to shareholders through bigger dividends and repurchases of common stock.
In November, Pfizer approved an additional $10 billion in share repurchases, after buying back almost $6 billion in stock in 2012 through an earlier $10 billion authorization.
The company in February spun off its animal health business into a new company called Zoetis. At the time, Pfizer said it would control roughly 80 percent of Zoetis, but divest its stake within 18 months and return much of the proceeds to shareholders in the form of stock repurchases.
Pfizer shares were down 3 percent at $29.52 in trading before the market opened.
(Updated at 8:32 a.m. ET)