Omega-3 Fatty Acid Supplement

Aka: Omega-3 Fatty Acid Supplement, Fish Oil Supplement, Lovaza, Vascepa

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II. Indications

  1. See Omega-3 Fatty Acid

III. Physiology

  1. See Omega-3 Fatty Acid
  2. Omega-3 Fatty Acids are available as two different products (often combined)
    1. Eicosapentaenoic Acid (EPA, icosapentaenoic acid)
      1. May reduce Cardiovascular Risk
    2. Docosahexaenoic Acid (DHA, ethyl ester)
      1. Reduces Triglycerides, but not shown to alter Cardiovascular Risk

IV. Medications: Supplements (OTC)

  1. Supplement sources
    1. Cod liver oil
    2. Standard fish body oil
    3. Omega-3 Fatty Acid concentrate
  2. Supplement Capsules (1 gram)
    1. Eicosapentaenoic Acid (EPA, icosapentaenoic acid): 180 mg
    2. Docosahexaenoic Acid (DHA, ethyl ester): 120 mg
  3. Liquid
    1. Variable concentrations per manufacturer
  4. Food sources for acquiring in diet
    1. See Omega-3 Fatty Acid

V. Medications: Prescriptions

  1. Lovaza
    1. Contents (per 1 gram capsule)
      1. EPA 465 mg
      2. DHA 375 mg
    2. Efficacy (4 gram/day dose)
      1. Lowers Triglycerides 45%
      2. Risk of increased LDL Cholesterol
  2. Vascepa
    1. Contents (per 1 gram capsule)
      1. EPA 1000 mg
    2. Efficacy (4 gram/day dose)
      1. Lowers Triglycerides 27%
  3. References
    1. (2013) Presc Lett 20(1):1-2
    2. Ballantyne (2012) Am J Cardiol 110(7):984-92 [PubMed]

VI. Dosing

  1. Standard dosing: 1 gram capsule or equivalent liquid daily
    1. Coronary Artery Disease Prevention
    2. Does not appear effective (at 1 g dose) for CAD primary prevention in those without CAD
      1. Halim (2012) Ann Intern Med 157(4):JC2-3 [PubMed]
  2. Higher dose: 2-4 grams per day
    1. Hypertriglyceridemia
    2. Currently being researched as to benefits and risks
      1. Hypertension
      2. Rheumatoid Arthritis

VII. Efficacy

  1. See Omega-3 Fatty Acid

VIII. Adverse Effects

  1. Well tolerated in most patients
  2. Fish after-taste
  3. Gastrointestinal upset
  4. Prolonged Bleeding Time
  5. Increased LDL Cholesterol
  6. Mercury Poisoning risk (depending on source of extract)
  7. Atrial Fibrillation
    1. Longterm Marine Omega 3 Fatty Acids (esp. >1 g/day) are associated with an increased risk of Atrial Fibrillation
    2. Mean study age >60 years old
    3. Hazard Ratio (HR) 1.25
    4. Gencer (2021) Circulation 144(25):1981-90 +PMID: 34612056 [PubMed]

IX. References

  1. Covington (2004) Am Fam Physician 70(1):133-40 [PubMed]

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Cost: Medications

lovaza (on 12/2/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
LOVAZA 1 GM CAPSULE Generic $0.18 each
vascepa (on 12/29/2021 at Medicaid.Gov Survey of pharmacy drug pricing)
VASCEPA 0.5 GM CAPSULE $1.66 each
VASCEPA 1 GM CAPSULE Generic $1.76 each
FPNotebook does not benefit financially from showing this medication data or their pharmacy links. This information is provided only to help medical providers and their patients see relative costs. Insurance plans negotiate lower medication prices with suppliers. Prices shown here are out of pocket, non-negotiated rates. See Needy Meds for financial assistance information. GoodRx is another tool for finding lower drug prices.

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