Dr. Gbemudu received her B.S. in Biochemistry from Nova Southeastern University, her PharmD degree from University of Maryland, and MBA degree from University of Baltimore. She completed a one year post-doctoral fellowship with Rutgers University and Bristol Myers Squibb.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
DRUG CLASS AND MECHANISM: Lovaza is an antilipemic or fat-regulating drug
that is used in addition to diet to
reduce triglyceride (TG, a fat-carrying
particle in the blood) levels in adult patients with severe elevations in blood
levels of TG (≥mg/dL). TG is composed of three fatty acids as well as
glycerol, and like cholesterol, comes from either the diet or the liver. High
levels of TG in the blood are associated with conditions such as obesity,
insulin resistance, poorly controlled
diabetes mellitus amongst others that
contribute to the risk of atherosclerosis or hardening of the arteries
(progressive build up of waxy plaque on the inside of blood vessels) which, in
turn, is responsible for coronary artery disease (angina and
heart attacks) and
strokes.
The precise way in which Lovaza works is not clear; however, its proposed
mechanism of action is by decreasing the amount of TG produced by the liver and
increasing the removal of TG by the liver. Other drugs that reduce TG levels
include fibric acids such as gemfibrozil (Lopid), nicotinic acids such as niacin
(Nicobid, Nicolar, Slo-Niacin), and statins such as atorvastatin (Lipitor).
Lovaza was FDA approved on November 10, 2004.
PRESCRIPTION: Yes
GENERIC AVAILABLE: No
PREPARATIONS: Capsules: 1 gm
STORAGE: Lovaza should be stored at 25 C (77 F) and not frozen.
PRESCRIBED FOR: Lovaza is indicated as an adjunct to diet to reduce TG levels
in adult patients with severe elevations of TG (≥ 500 mg/dL). Off-label uses of
Lovaza include prevention of atherosclerosis and prevention of angina, heart
attacks, and strokes.
DOSING: The daily dose of Lovaza is 4 grams per day. The daily dose may be
taken as a single 4 gram dose (four capsules) or as two, 2 gram doses (two
capsules given twice daily). Patients should be advised to swallow Lovaza
capsules whole. They should not break open, crush, dissolve, or chew Lovaza
capsules.
DRUG INTERACTIONS: Taking Lovaza with an anticoagulant (blood thinner)
affecting coagulation such as aspirin, nonsteroidal antiinflammatory drugs
(NSAIDS) such as ibuprofen (Motrin), warfarin (Coumadin), and heparin (Hep-Lock
U/P) should be monitored periodically as Lovaza may increase the risk of
bleeding.
Since some drugs may increase TG levels, patients should tell their doctor or
pharmacist of the following medications before using Lovaza since their doctor
may want to change the doses of these medications or monitor their effects;
beta-blockers such as atenolol (Tenormin), diuretics or water pills such as
hydrochlorothiazide (Diuril), and
vitamins/supplements (fish/flaxseed/cod liver
oils).
Lovaza contains ethyl esters of omega-3 fatty acids which are obtained from
the oil of several fish sources. Lovaza should therefore be used with caution in
patients with known sensitivity or
allergy to fish and/or shellfish.
PREGNANCY: There are no adequate and well-controlled studies in
pregnant
women. Lovaza should be used during pregnancy only if the potential benefit to
the patient justifies the potential risk to the fetus.
NURSING MOTHERS: It is not known whether Lovaza is excreted in
human milk and
caution should be exercised when administering Lovaza to nursing women.
SIDE EFFECTS: Upset stomach, burping, and strange tastes in may occur. If
these effects persist or worsen, patients should notify their doctor. They also
should tell their doctors immediately if any of the following rare but serious
side effects that suggest increased bleeding occur: easy bleeding from
cuts/bruising,
black/tarry stools, vomitus that looks like coffee grounds.
Diabetes mellitus is a chronic condition characterized by high levels of sugar (glucose) in the blood. The two types of diabetes are referred to as type 1 (insulin dependent) and type 2 (non-insulin dependent). Symptoms of diabetes include increased urine output, thirst, hunger, and fatigue. Treatment of diabetes depends on the type.
A stroke results from impaired oxygen delivery to brain cells via the bloodstream. A stroke is also referred to as a CVA, or cerebrovascular incident. Symptoms of stroke include: sudden numbness or weakness of the face, arm or leg. Sudden confusion, trouble speaking or understanding. Sudden trouble seeing in one or both eyes, sudden trouble walking, dizziness, or loss of balance, and/or sudden severe headache with no known cause. A TIA, or transient ischemic attack is a short-lived temporary impairment of the brain caused by loss of blood supply. Stroke is a medical emergency.
Angina is chest pain that is due to an inadequate supply of oxygen to the heart muscle.
Angina can be caused by coronary artery disease or spasm of the coronary
arteries. EKG, exercise treadmill, stress echocardiography, stress thallium, and cardiac
catheterization are important tests used in the diagnosis of angina.
Heart attack happens when a blood clot completely obstructs a coronary
artery supplying blood to the heart muscle. A heart attack can cause chest pain, heart failure, and electrical
instability of the heart.
Insulin resistance is the diminished ability of cells to respond to the action of insulin in transporting glucose (sugar) from the bloodstream into muscle and other tissues. Causes of insulin can include conditions such as stress, obesity, metabolic syndrome, and steroid use. Some of the risk factors for insulin resistance include fatty liver, heart disease, strokes, peripheral vascular disease, high cholesterol, and smoking. Treatment for insulin resistance are lifestyle changes and if necessary, medication.
Heart disease (coronary artery disease) is caused by a buildup of cholesterol deposits in the coronary arteries. Risk factors for heart disease include smoking, high blood pressure, heredity, diabetes, peripheral artery disease, and obesity. Symptoms include chest pain and shortness of breath. There are a variety of tests used to diagnose coronary artery disease. Treatment includes life-style changes, medications, procedures, or surgery.
Obesity is the state of being well above one's normal weight. A person has traditionally been
considered to be obese if they are more than 20 percent over their ideal weight.
That ideal weight must take into account the person's height, age, sex, and
build.
The major goal in treating diabetes is controlling elevated blood sugar without causing abnormally low levels of blood sugar. Treatment for type 1 diabetes is with insulin, exercise, and a diabetic diet. Treatment for type 2 diabetes is first treated with weight reduction, a diabetic diet, and exercise. When these measures fail to control the elevated blood sugar, oral medications are used. If oral medications are still insufficient, insulin medications are considered.
The risks for developing type 2 diabetes include family history, ethnicity, birth weight, metabolic syndrome, and obesity. Warning signs pointing to an increased risk for developing type 2 diabetes include irregular menstruation, impaired fasting glucose, inflammatory markers, and other risks. Gestational diabetes is also a risk factor for developing type 2 diabetes later in life. Prevention of type 2 diabetes can be achieved through a healthy diet (Mediterranean diet), exercise, weight control, not smoking, and medication.
Heart attacks are the major causes of unexpected, sudden death among men and women. A heart attack is also a significant cause of heart failure. Learn the risk factors for heart attack such as high blood pressure, diabetes, and other heart conditions. Lowering your risk factor, lifestyle changes, and in some cases medication are the most effective way of preventing a heart attack.
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