Role of prescription omega-3 fatty acids in the treatment of
hypertriglyceridemia.
   McKenney JM, Sica D.

   School of Pharmacy, Virginia Commonwealth University, Richmond,
Virginia, USA. jmckenney@ncrinc.net

   A prescription form of omega-3 fatty acids has been approved by
the United States Food and Drug Administration as an adjunct to diet
for the treatment of very high triglyceride levels. The active
ingredients of omega-3 fatty acids are eicosapentaenoic acid (EPA) and
docosahexaenoic acid (DHA), which are responsible for the triglyceride
lowering. The prescription product contains a total of 0.84 g of these
two active ingredients in every 1-g capsule of omega-3 fatty acids.
The total EPA and DHA dose recommended for triglyceride lowering is
approximately 2-4 g/day. Fish oil products containing EPA and DHA are
available without a prescription, but the American Heart Association
advises that therapy with EPA and DHA to lower very high triglyceride
levels should be used only under a physician's care. In patients with
triglyceride levels above 500 mg/dl, approximately 4 g/day of EPA and
DHA reduces triglyceride levels 45% and very low-density lipoprotein
cholesterol levels by more than 50%. Low-density lipoprotein
cholesterol levels may increase depending on the baseline triglyceride
level, but the net effect of EPA and DHA therapy is a reduction in non-
high-density lipoprotein cholesterol level. Alternatively, patients
may receive one of the fibrates (gemfibrozil or fenofibrate) or niacin
for triglyceride lowering if their triglyceride levels are higher than
500 mg/dl. In controlled trials, prescription omega-3 fatty acids were
well tolerated, with a low rate of both adverse events and treatment-
associated discontinuations. The availability of prescription omega-3
fatty acids, which ensures consistent quality and purity, should prove
to be valuable for the medical management of hypertriglyceridemia.

   PMID: 17461707 [PubMed - indexed for MEDLINE]