omega-3-acid ethyl esters

  • Pharmacy Author:
    Annette (Gbemudu) Ogbru, PharmD, MBA

    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.

  • Medical and Pharmacy Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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What is omega-3-acid ethyl esters (Lovaza), and how does it work (mechanism of action)?

Lovaza is an fat-regulating (antilipemic) 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). It is similar to Epanova (omega-3 carboxylic acid). 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) 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.

What brand names are available for omega-3-acid ethyl esters (Lovaza)?

Lovaza

Is omega-3-acid ethyl esters (Lovaza) available as a generic drug?

GENERIC AVAILABLE: Yes

Do I need a prescription for omega-3-acid ethyl esters (Lovaza)?

Yes

What are the side effects of omega-3-acid ethyl esters (Lovaza)?

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.

Quick GuideFoods to Avoid If You Have High Triglycerides

Foods to Avoid If You Have High Triglycerides

What is the dosage for omega-3-acid ethyl esters (Lovaza)?

The daily dose of Lovaza for reducing triglycerides 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.

The dose of Lovaza as a dietary supplement is 1 to 2 capsules every 8 hours with meals.

Which drugs or supplements interact with omega-3-acid ethyl esters (Lovaza)?

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.

Is omega-3-acid ethyl esters (Lovaza) safe to take if I'm pregnant or breastfeeding?

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.

 Lovaza is excreted in human milk and caution should be exercised when administering Lovaza to nursing women.

What else should I know about omega-3-acid ethyl esters (Lovaza)?

What preparations of omega-3-acid ethyl esters (Lovaza) are available?

Capsules: 1 gm

How should I keep omega-3-acid ethyl esters (Lovaza) stored?

Lovaza should be stored at 25 C (77 F) and not frozen.

Reference: FDA Prescribing Information

Last Editorial Review: 10/28/2014

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Reviewed on 10/28/2014
References
Reference: FDA Prescribing Information

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