omega 3 fatty acids (Rx)

Brand and Other Names:Lovaza, Vascazen, more...Omtryg, Omega-3-acid ethyl esters
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

capsule

  • Lovaza: 1g; 900mg of ethyl esters; includes eicosapentaenoic acid (EPA ~465mg) and docosahexaenoic acid (DHA ~375mg)
  • Omtryg: 1.2g; 900mg of ethyl esters; includes eicosapentaenoic acid (EPA ~465mg) and docosahexaenoic acid (DHA ~375mg)
  • Vascazen: 1g; 900mg of ethyl esters; includes eicosapentaenoic acid (EPA ~680mg) and docosahexaenoic acid (DHA ~110mg)

Hypertriglyceridemia (Lovaza, Omtryg)

Adjunct to diet in patients with triglycerides ≥500 mg/dL

Lovaza: 4 g (4 capsules) PO qDay or 2 g (2 capsules) PO BID

Omtryg: 4.8 g (4 capsules) PO qDay or 2.4 g (2 capsules) PO BID

Omega-3 Fatty Acid Deficiency (Vascazen)

Prescription medical food specifically formulated to correct an omega-3 deficiency in cardiovascular patients

Vascazen: 4 g/day PO qDay or divided BID

<18 years: Safety and efficacy not established

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Interactions

Interaction Checker

and omega 3 fatty acids

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      Serious - Use Alternative

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                Monitor Closely (25)

                • alteplase

                  omega 3 fatty acids, alteplase. Other (see comment). Use Caution/Monitor. Comment: Patients taking omega-3-fatty acids and an anticoagulant or other drug affecting coagulation should be monitored periodically due to potential increased risk of bleeding. .

                • anagrelide

                  omega 3 fatty acids, anagrelide. Other (see comment). Use Caution/Monitor. Comment: Patients taking omega-3-fatty acids and an anticoagulant or other drug affecting coagulation should be monitored periodically due to potential increased risk of bleeding. .

                • antithrombin alfa

                  omega 3 fatty acids, antithrombin alfa. Other (see comment). Use Caution/Monitor. Comment: Patients taking omega-3-fatty acids and an anticoagulant or other drug affecting coagulation should be monitored periodically due to potential increased risk of bleeding. .

                • antithrombin III

                  omega 3 fatty acids, antithrombin III. Other (see comment). Use Caution/Monitor. Comment: Patients taking omega-3-fatty acids and an anticoagulant or other drug affecting coagulation should be monitored periodically due to potential increased risk of bleeding. .

                • argatroban

                  omega 3 fatty acids, argatroban. Other (see comment). Use Caution/Monitor. Comment: Patients taking omega-3-fatty acids and an anticoagulant or other drug affecting coagulation should be monitored periodically due to potential increased risk of bleeding. .

                • aspirin

                  omega 3 fatty acids, aspirin. Other (see comment). Use Caution/Monitor. Comment: Patients taking omega-3-fatty acids and an anticoagulant or other drug affecting coagulation should be monitored periodically due to potential increased risk of bleeding. .

                • aspirin/citric acid/sodium bicarbonate

                  omega 3 fatty acids, aspirin/citric acid/sodium bicarbonate. Other (see comment). Use Caution/Monitor. Comment: Patients taking omega-3-fatty acids and an anticoagulant or other drug affecting coagulation should be monitored periodically due to potential increased risk of bleeding. .

                • betrixaban

                  omega 3 fatty acids, betrixaban. Either increases levels of the other by anticoagulation. Use Caution/Monitor.

                • bivalirudin

                  omega 3 fatty acids, bivalirudin. Other (see comment). Use Caution/Monitor. Comment: Patients taking omega-3-fatty acids and an anticoagulant or other drug affecting coagulation should be monitored periodically due to potential increased risk of bleeding. .

                • clopidogrel

                  omega 3 fatty acids, clopidogrel. Other (see comment). Use Caution/Monitor. Comment: Patients taking omega-3-fatty acids and an anticoagulant or other drug affecting coagulation should be monitored periodically due to potential increased risk of bleeding. .

                • dabigatran

                  omega 3 fatty acids, dabigatran. Other (see comment). Use Caution/Monitor. Comment: Patients taking omega-3-fatty acids and an anticoagulant or other drug affecting coagulation should be monitored periodically due to potential increased risk of bleeding. .

                • dalteparin

                  omega 3 fatty acids, dalteparin. Other (see comment). Use Caution/Monitor. Comment: Patients taking omega-3-fatty acids and an anticoagulant or other drug affecting coagulation should be monitored periodically due to potential increased risk of bleeding. .

                • desirudin

                  omega 3 fatty acids, desirudin. Other (see comment). Use Caution/Monitor. Comment: Patients taking omega-3-fatty acids and an anticoagulant or other drug affecting coagulation should be monitored periodically due to potential increased risk of bleeding. .

                • dipyridamole

                  omega 3 fatty acids, dipyridamole. Other (see comment). Use Caution/Monitor. Comment: Patients taking omega-3-fatty acids and an anticoagulant or other drug affecting coagulation should be monitored periodically due to potential increased risk of bleeding. .

                • enoxaparin

                  omega 3 fatty acids, enoxaparin. Other (see comment). Use Caution/Monitor. Comment: Patients taking omega-3-fatty acids and an anticoagulant or other drug affecting coagulation should be monitored periodically due to potential increased risk of bleeding. .

                • fondaparinux

                  omega 3 fatty acids, fondaparinux. Other (see comment). Use Caution/Monitor. Comment: Patients taking omega-3-fatty acids and an anticoagulant or other drug affecting coagulation should be monitored periodically due to potential increased risk of bleeding. .

                • heparin

                  omega 3 fatty acids, heparin. Other (see comment). Use Caution/Monitor. Comment: Patients taking omega-3-fatty acids and an anticoagulant or other drug affecting coagulation should be monitored periodically due to potential increased risk of bleeding. .

                • prasugrel

                  omega 3 fatty acids, prasugrel. Other (see comment). Use Caution/Monitor. Comment: Patients taking omega-3-fatty acids and an anticoagulant or other drug affecting coagulation should be monitored periodically due to potential increased risk of bleeding. .

                • reteplase

                  omega 3 fatty acids, reteplase. Other (see comment). Use Caution/Monitor. Comment: Patients taking omega-3-fatty acids and an anticoagulant or other drug affecting coagulation should be monitored periodically due to potential increased risk of bleeding. .

                • tenecteplase

                  omega 3 fatty acids, tenecteplase. Other (see comment). Use Caution/Monitor. Comment: Patients taking omega-3-fatty acids and an anticoagulant or other drug affecting coagulation should be monitored periodically due to potential increased risk of bleeding. .

                • ticlopidine

                  omega 3 fatty acids, ticlopidine. Other (see comment). Use Caution/Monitor. Comment: Patients taking omega-3-fatty acids and an anticoagulant or other drug affecting coagulation should be monitored periodically due to potential increased risk of bleeding. .

                • vorapaxar

                  omega 3 fatty acids, vorapaxar. Either increases effects of the other by anticoagulation. Use Caution/Monitor. Coadministration of anticoagulants, antiplatelets, or other drug affecting coagulation should be monitored periodically due to potential increased risk of bleeding.

                • vortioxetine

                  omega 3 fatty acids, vortioxetine. Either increases effects of the other by anticoagulation. Use Caution/Monitor.

                • warfarin

                  omega 3 fatty acids, warfarin. Other (see comment). Use Caution/Monitor. Comment: Patients taking omega-3-fatty acids and an anticoagulant or other drug affecting coagulation should be monitored periodically due to potential increased risk of bleeding. Monitor for changes in INR.

                • zanubrutinib

                  omega 3 fatty acids, zanubrutinib. Either increases effects of the other by anticoagulation. Modify Therapy/Monitor Closely. Zanubrutinib-induced cytopenias increases risk of hemorrhage. Coadministration of zanubritinib with antiplatelets or anticoagulants may further increase this risk.

                Minor (0)

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                  Adverse Effects

                  1-10%

                  Eructation (4.9%)

                  Infection (4.4%)

                  Flu-like syndrome (3.5%)

                  Dyspepsia (3.1%)

                  Taste perversion (2.7%)

                  Back pain (2.2%)

                  Pain (1.8%)

                  Rash (1.8%)

                  Angina pectoris (1.3%)

                  Postmarketing Reports

                  Anaphylactic reaction

                  Hemorrhagic diathesis

                  Urticaria

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                  Warnings

                  Contraindications

                  Hypersensitivity

                  Cautions

                  Discontinue medications that exacerbate hypertriglyceridemia

                  Use caution in patients allergic to fish

                  May increase liver ALT without increasing AST (monitor)

                  May increase LDL levels (monitor)

                  May prolong bleeding time (use caution)

                  Recurrent AF or flutter observed when initial high dose of Lovaza administered (ie, 8 g/day x1 week, then 4 g/day thereafter)

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                  Pregnancy & Lactation

                  Pregnancy

                  Available data from published case reports and pharmacovigilance database on use in pregnant women are insufficient to identify a drug-associated risk for major birth defects, miscarriage, or adverse maternal or fetal outcomes

                  Animal data

                  • In animal studies, omega-3-acid ethyl esters given orally to female rats prior to mating through lactation did not have adverse effects on reproduction or development when given at doses 5 times maximum recommended human dose (MRHD) of 4 grams/day, based on a body surface area comparison; omega-3-acid ethyl esters given orally to rats and rabbits during organogenesis was not teratogenic at clinically relevant exposures, based on body surface area comparison

                  Lactation

                  Published studies have detected omega-3 fatty acids, including EPA and DHA, in human milk

                  Lactating women receiving oral omega-3 fatty acids for supplementation have resulted in higher levels of omega-3 fatty acids in human milk

                  There are no data available on effects of omega- 3 fatty acid ethyl esters on breastfed infant or on milk production

                  Developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for therapy and any potential adverse effects on breastfed child from drug or from underlying maternal condition

                  Pregnancy Categories

                  A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

                  B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

                  C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

                  D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

                  X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

                  NA: Information not available.

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                  Pharmacology

                  Mechanism of Action

                  Possibly inhibits acyl CoA: 1,2-diacylglycerol acyltransferase, increases peroxisomal beta-oxidation in liver; may decrease hepatic triglyceride synthesis; plasma lipoprotein lipase activity may increase

                  Absorption

                  Rapid

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                  Administration

                  Instructions

                  Swallow capsules whole; do not chew, crush, break, or dissolve

                  Lovaza, Vascazen: May take with or without food

                  Omtryg: Take with food

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                  Images

                  BRAND FORM. UNIT PRICE PILL IMAGE
                  omega-3 fatty acids oral
                  -
                  1,000 mg capsule
                  Fish Oil oral
                  -
                  60-90-500 mg capsule
                  Fish Oil oral
                  -
                  360-1,200 mg capsule
                  Fish Oil oral
                  -
                  300-1,000 mg capsule
                  Fish Oil oral
                  -
                  360-1,200 mg capsule
                  Fish Oil oral
                  -
                  300-1,000 mg capsule
                  Fish Oil oral
                  -
                  120-180 mg capsule
                  Fish Oil oral
                  -
                  300-1,000 mg capsule
                  Fish Oil oral
                  -
                  300-1,000 mg capsule
                  Fish Oil oral
                  -
                  340-1,000 mg capsule

                  Copyright © 2010 First DataBank, Inc.

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                  Patient Handout

                  A Patient Handout is not currently available for this monograph.
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                  Formulary

                  FormularyPatient Discounts

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                  Tier Description
                  1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
                  2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
                  3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
                  4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
                  5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
                  6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
                  NC NOT COVERED – Drugs that are not covered by the plan.
                  Code Definition
                  PA Prior Authorization
                  Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
                  QL Quantity Limits
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                  Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
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                  Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.