Omega-3-carboxylic acids

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

Omega-3-Carboxylic Acids may be found in some form under the following brand names:

• Epanova

Tell your doctor if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X - are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

Omega-3-carboxylic acids falls into category C. In animal studies, pregnant animals were given this medication and had some babies born with problems. No well-controlled studies have been done in humans. Therefore, this medication may be used if the potential benefits to the mother outweigh the potential risks to the unborn child.

Take omega-3-carboxylic acids exactly as prescribed.

Omega-3-carboxylic acids comes in capsule form and is taken once daily. Take omega-3-carboxylic acids capsules whole. Do not break open, crush, dissolve, or chew omega-3-carboxylic acids capsules before swallowing. If you cannot swallow omega-3-carboxylic acids capsules whole, tell your doctor. You may need a different medicine.

If you miss a dose, take the missed dose as soon as you remember. If it is almost time for the next dose, skip the missed dose and take your next dose at the regular time. Do not take 2 doses of omega-3-carboxylic acids at the same time.

Your doctor should start you on a diet that is low in saturated fat, cholesterol, carbohydrates, and low in added sugars before giving you omega-3-carboxylic acids. Stay on this diet while taking omega-3-carboxylic acids.

Your doctor will do regular blood tests to check your triglycerides, bad cholesterol, and liver function levels while you take omega-3-carboxylic acids.

Take this medication exactly as prescribed by your doctor. Follow the directions on your prescription label carefully.

The dose your doctor recommends may be based on the following:

• how you respond to this medication

The recommended dose of omega-3-carboxylic acidsfor the treatment of high triglycerides is 2 grams (2 capsules) or 4 grams (4 capsules) once daily, depending on your body's response and how well the medication is tolerated.

If you take too much omega-3-carboxylic acids, call your healthcare provider or local Poison Control Center or seek emergency medical attention right away.

If omega-3-carboxylic acids is administered by a healthcare provider in a medical setting, it is unlikely that an overdose will occur. However, if overdose is suspected, seek emergency medical attention.

In the U.S.

• Epanova

Available Dosage Forms:

• Capsule, Liquid Filled

Therapeutic Class: Antihyperlipidemic

Chemical Class: Omega-3 Fatty Acid