omega 3 fatty acids

Omega 3 fatty acids are types of fatty acids known as polyunsaturated fatty acids (PUFAs) used as an adjunct to diet in adult patients with high triglyceride levels in the blood (hypertriglyceridemia). Omega 3 fatty acids help reduce triglyceride levels and the associated risk of cardiovascular disease.

Omega 3 fatty acids are also prescription medical food specifically formulated to supplement omega 3 deficiency in patients with cardiovascular disease, and are used off-label to reduce the progression of disease in IgA nephropathy, a kidney disorder.

The three primary clinically relevant types of omega 3 fatty acids are alpha-linoleic acid (ALA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA). The FDA approved medication omega 3 fatty acids are ethyl esters that contain EPA and DHA derived from fish oils. Natural sources of omega 3 fatty acids include fish, fish products, nuts, seeds, beans, and green leafy vegetables.

Omega 3 reduce triglyceride levels by inhibiting acyl-CoA:1,2-diacylglycerol acyltransferase (DGAT), a protein essential for triglyceride synthesis in the liver. Omega-3 fatty acids also increase the breakdown of fats in the liver in a process known as beta oxidation, and increase the activity of lipoprotein lipase, the enzyme that degrades triglyceride in the bloodstream.

• Do not take omega 3 fatty acid supplements if you are hypersensitive to fish or any of the components in the formulation.
• Discontinue medications that exacerbate hypertriglyceridemia.
• Do not use omega 3 fatty acids in the treatment of atrial fibrillation (AF) or flutter. Recurrent AF or flutter was observed in studies when initial high dose was administered.
• Omega 3 fatty acids may increase low-density lipoprotein (LDL) cholesterol, monitor levels periodically.
• May increase liver enzyme ALT without corresponding AST increase, monitor patients with liver function impairment.
• May increase bleeding time, use with caution.

Common side effects of omega 3 fatty acids include:

• Belching (eructation)
• Taste perversion
• Indigestion (dyspepsia)
• Constipation
• Vomiting
• Gastrointestinal disorders
• Elevation of liver enzymes ALT and AST
• Increase in LDL cholesterol
• Rash
• Hives (urticaria)
• Itching (pruritus)
• Severe allergic reaction (anaphylaxis)
• Pain
• Back pain
• Chest pain (angina pectoris)
• Flu-like syndrome
• Infection
• Bleeding tendency disorder (hemorrhagic diathesis)

Call your doctor immediately if you experience any of the following symptoms or serious side effects while using this drug:

• Serious heart symptoms include fast or pounding heartbeats, fluttering in your chest, shortness of breath, and sudden dizziness;
• Severe headache, confusion, slurred speech, severe weakness, vomiting, loss of coordination, feeling unsteady;
• Severe nervous system reaction with very stiff muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, and feeling like you might pass out; or
• Serious eye symptoms include blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights.

This is not a complete list of all side effects or adverse reactions that may occur from the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may also report side effects or health problems to the FDA at 1-800-FDA-1088.

Capsule

• Lovaza: 1 g capsule contains at least 900 mg of ethyl esters of omega-3 fatty acids sourced from fish oils and includes eicosapentaenoic acid (EPA approximately 465 mg) and docosahexaenoic acid (DHA approximately 375 mg)
• Omtryg: 1.2 g capsule contains at least 900 mg of ethyl esters of omega-3 fatty acids sourced from fish oils and includes eicosapentaenoic acid (EPA approximately 465 mg) and docosahexaenoic acid (DHA approximately 375 mg)
• Vascazen: 1 g capsule contains at least 900 mg of ethyl esters of omega-3 fatty acids sourced from fish oils and includes eicosapentaenoic acid (EPA approximately 680 mg) and docosahexaenoic acid (DHA approximately 110 mg)

Adult:

Hypertriglyceridemia (Lovaza, Omtryg)

• Adjunct to diet in patients with triglycerides 500 mg/dL or greater
• Lovaza: 4 g (4 capsules) orally once/day or 2 g (2 capsules) orally twice daily
• Omtryg: 4.8 g (4 capsules) orally once/day or 2.4 g (2 capsules) orally twice daily

Omega-3 Fatty Acid Deficiency (Vascazen)

• Prescription medical food specifically formulated to correct an omega-3 deficiency in cardiovascular patients
• Vascazen: 4 g/day orally once/day or divided twice daily

Pediatric:

• Safety and efficacy not established

Omega 3 fatty acids overdose may cause vomiting, constipation, skin reactions, and metabolic disorders. If symptoms do not resolve with discontinuation of omega 3 fatty acids, seek medical help or contact Poison Control.

Inform your doctor of all medications you are currently taking, who can advise you on any possible drug interactions. Never begin taking, suddenly discontinue, or change the dosage of any medication without your doctor’s recommendation.

• Omega 3 fatty acids have no known severe or serious interactions with other drugs.
• Omega 3 fatty acids have moderate interactions with at least 25 different drugs.
• Omega 3 fatty acids have no known mild interactions with other drugs.

The drug interactions listed above are not all of the possible interactions or adverse effects. For more information on drug interactions, visit the RxList Drug Interaction Checker.

It is important to always tell your doctor, pharmacist, or health care provider of all prescription and over-the-counter medications you use, as well as the dosage for each, and keep a list of the information. Check with your doctor or health care provider if you have any questions about the medication.

• There are no adequate and well-controlled studies on the use of omega 3 fatty acids during pregnancy, and their effects on reproductive capacity and fetal development is not known. Use in pregnancy only if maternal benefits justify potential fetal risks.
• Omega 3 fatty acids are present in breast milk and there are no data on their effects on milk production or on the breastfed infant. Use with caution in nursing mothers.

• Take omega 3 fatty acids exactly as prescribed.
• It is important to adhere to the prescribed diet also while taking omega 3 fatty acids.
• Store safely out of reach of children.