omega 3 carboxylic acids (Rx)

Brand and Other Names:Epanova
  • Print

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

capsule

  • 1g
  • Note: 1g capsule free fatty acids derived from fish oil contains at least 850mg of polyunsaturated fatty acids, including omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) being the most abundant

Hypertriglyceridemia

Indicated as an adjunct to diet in patients with severe hypertriglyceridemia (ie, TG ≥500 mg/dL)

2-4 g PO qDay

Individualize dose according to response and tolerability

Dosing Considerations

Effect on risk of pancreatitis has not been determined

Effect on cardiovascular mortality and morbidity has not been determined

Safety and efficacy not established

Next:

Interactions

Interaction Checker

and omega 3 carboxylic acids

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

            All Interactions Sort By:
             activity indicator 
            Previous
            Next:

            Adverse Effects

            >10%

            Diarrhea (7-15%)

            1-10%

            Nausea (4-6%)

            Abdominal pain/discomfort (3-5%)

            Eructation (3%)

            Postmarketing Reports

            Vomiting

            Flatulence

            Dysgeusia

            Previous
            Next:

            Warnings

            Contraindications

            Hypersensitivity (eg, anaphylaxis)

            Cautions

            May increase LDL-C levels, monitor periodically

            Monitor ALT and AST levels periodically in patients with hepatic impairment

            Contains polyunsaturated free fatty acids derived from fish oils; caution in patients with known allergies to fish and/or shellfish

            Prolonged bleeding time reported with omega- 3 fatty acids; caution if coadministered with anticoagulants or antiplatelet agents

            Previous
            Next:

            Pregnancy & Lactation

            Pregnancy: There are no studies in pregnant women and the limited available data are not sufficient to inform a drug-associated risk for major birth defects or miscarriages

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

            Pregnant or breastfeeding patients should seek advice of health professional before using OTC drugs

            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.

            Previous
            Next:

            Pharmacology

            Mechanism of Action

            Omega-3 fatty acids reduce hepatic production of triglyceride (TG)-rich very low density lipoproteins (VLDL) and may increase the removal rate of TG-rich lipoproteins by increasing lipoprotein lipase activity, in humans

            Some potential cellular mechanisms of action include inhibition of acyl-CoA:1,2-diacylglycerol acyltransferase, increased mitochondrial and peroxisomal beta-oxidation in the liver, and decreased lipogenesis in the liver

            Absorption

            Peak plasma time: 5-9 hr

            Steady state (EPA, DHA) achieved: 2 weeks

            Directly absorbed in small intestine, then enters systemic circulation mainly via the thoracic duct lymphatic system

            Distribution

            Majority of EPA and DHA in plasma incorporated in phospholipids, triglycerides, and cholesteryl esters

            Metabolism

            Mainly oxidized in liver to fatty acids derived from dietary sources

            Elimination

            Half-life: 37 hr (EPA); 46 hr (DHA)

            Plasma clearance: 548 mL/hr (EPA); 518 mL/hr (DHA)

            Does not undergo renal excretion

            Previous
            Next:

            Administration

            Oral Administration

            May take with or without food

            Swallow capsule whole; do not break open, crush, dissolve, or chew

            Storage

            Store at 25°C (77°F); excursions permitted to 15-30°C (59-86°F)

            Do not freeze

            Previous
            Next:

            Images

            Previous
            Next:

            Formulary

            FormularyPatient Discounts

            Adding plans allows you to compare formulary status to other drugs in the same class.

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

            Adding plans allows you to:

            • View the formulary and any restrictions for each plan.
            • Manage and view all your plans together – even plans in different states.
            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            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
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
            Additional Offers
            Email to Patient

            From:

            To:

            The recipient will receive more details and instructions to access this offer.

            By clicking send, you acknowledge that you have permission to email the recipient with this information.

            Email Forms to Patient

            From:

            To:

            The recipient will receive more details and instructions to access this offer.

            By clicking send, you acknowledge that you have permission to email the recipient with this information.

            Previous
            Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.