omega-3-acid ethyl esters (Lovaza)
Annette (Gbemudu) Ogbru, PharmD, MBA
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:
GENERIC NAME: omega-3-acid ethyl esters
BRAND NAME: Lovaza
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.
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.
Reference: FDA Prescribing Information
Last Editorial Review: 11/10/2009 2:53:29 PM
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