EICOSAPENTAENOIC ACID (EPA)

OTHER NAME(S):

Acide Eicosapentaénoïque, Acide Éthyle-Eicosapentaénoïque, Acide Gras Essentiel, Acide Gras d’Huile de Poisson, Acide Gras N-3, Acide Gras Omega, Acide Gras Oméga 3, Acide Gras Polyinsaturé, Acide Gras W3, Acido Eicosapentaenoico, EPA, E-EPA, Eicosapentanoic Acid, Essential Fatty Acid, Ethyl Eicosapentaenoic Acid, Ethyl-Eicosapentaenoic Acid, Ethyl-EPA, Fish Oil Fatty Acid, N-3 Fatty Acid, Omega Fatty Acid, Omega 3, Oméga 3, Omega-3, Omega 3 Fatty Acids, Omega-3 Fatty Acids, Polyunsaturated Fatty Acid, PUFA, W-3 Fatty Acid.<br/><br/>

Overview

Overview Information

Eicosapentaenoic acid (EPA) is an omega-3 fatty acid. It's found in the flesh of cold-water fish, including mackerel, herring, tuna, halibut, salmon, cod liver, whale blubber, or seal blubber.

EPA is used as a prescription medicine to reduce triglyceride levels. As a supplement, EPA is most commonly used for heart disease, preventing adverse events after a heart attack, depression, and menopause. It is also used for chemotherapy-related side effects, recovery after surgery, memory and thinking skills, and many other conditions, but there is no good scientific evidence to support many of these uses.

Don't confuse EPA with similar fatty acids, such as alpha-linolenic acid and docosahexaenoic acid (DHA), as well as with oils like krill or fish oils, which contain both eicosapentaenoic acid and DHA. Most available data involving eicosapentaenoic acid are from research and clinical experience with fish oil products containing variable combinations of EPA and DHA. See the separate listings for alpha-linolenic acid, DHA, fish oil, and krill oil.

How does it work?

EPA can prevent the blood from clotting easily. These fatty acids also reduce pain and swelling.

Uses

Uses & Effectiveness?

Effective for

  • High levels of fats called triglycerides in the blood (hypertriglyceridemia). Research shows that taking a prescription drug called Vascepa, which contains pure eicosapentaenoic acid, helps lowers triglycerides levels by 33% in people with very high levels. This prescription product also lowers triglyceride levels by about 22% and cholesterol levels by 6% in most people taking cholesterol-lowering drugs called "statins" who continue to have high triglyceride levels. Taking this prescription drug also reduces the risk of major heart-related adverse events by about 25% in people taking statins with persistent high triglyceride levels and other heart-related risk factors.

Likely Effective for

  • High levels of blood fats called triglycerides (hypertriglyceridemia). Research shows that taking a specific product containing eicosapentaenoic acid as ethyl eicosapentaenoic acid (Vascepa by Amarin) by mouth along with dieting and cholesterol-lowering drugs called "statins" reduces levels of triglycerides in people with very high levels. It might also improve cholesterol levels. This product is FDA-approved in adults with very high triglyceride levels.

Possibly Effective for

  • A mental disorder marked by unstable mood and behavior (borderline personality disorder). Taking eicosapentaenoic acid seems to slightly lower aggressiveness and slightly relieve depression in women with this mood disorder.
  • Heart disease (cardiovascular disease). In people with high triglycerides and heart disease or a high risk of heart disease, research shows that taking a prescription drug called Vascepa reduces complications of such as heart attack and stroke.
  • Heart disease (coronary heart disease) . People with coronary artery disease who consume more eicosapentaenoic acid as part of their diet seem to have a slightly reduced risk of death. Early research shows that taking 1800 mg of eicosapentaenoic acid daily reduces the risk of heart-related adverse events such as heart attacks in people with high cholesterol and coronary artery disease.
  • Depression. Research suggests that taking pure eicosapentaenoic acid or fish oil containing at least 60% eicosapentaenoic acid reduces symptoms of depression. It might work best when used along with antidepressant drugs.
  • Symptoms of menopause. Research shows that taking eicosapentaenoic acid reduces how often hot flashes occur. But eicosapentaenoic acid does not seem to reduce the intensity of the hot flashes or improve overall quality of life.
  • Heart attack. After a heart attack, people may undergo a procedure called percutaneous coronary intervention (PCI) to improve blood flow to the heart. Taking eicosapentaenoic acid by mouth along with a drug called a "statin" within 24 hours of PCI reduces the risk of heart-related adverse events such as an irregular heart beat (arrhythmia) or death after the procedure compared to taking the "statin" alone. Also, taking eicosapentaenoic acid by mouth along with "statins" before undergoing PCI for chest pain reduces the risk of having a heart attack after the procedure.

Possibly Ineffective for

  • An eye disease that leads to vision loss in older adults (age-related macular degeneration or AMD). Eating more eicosapentaenoic acid as part of the diet does not seem to prevent AMD.
  • Hay fever. Taking eicosapentaenoic acid by mouth does not seem to relieve hay fever symptoms such as wheezing, cough, and nasal symptoms.
  • Asthma. Taking eicosapentaenoic acid by mouth does not seem to reduce asthma symptoms.
  • Cystic fibrosis. Taking eicosapentaenoic acid by mouth does not seem so to improve symptoms of cystic fibrosis.
  • Diabetes. Taking eicosapentaenoic acid by mouth does not seem to reduce blood sugar or cholesterol levels in people with type 2 diabetes.
  • High blood pressure. Taking eicosapentaenoic acid by mouth with another fatty acid, gamma-linolenic acid, does not seem to reduce blood pressure in people with high blood pressure.
  • Infants with birth weight below the 10th percentile due to inadequate nutrition. Taking eicosapentaenoic acid by mouth does not seem to reduce the risk of an infant having delayed growth while still in the uterus.
  • High blood pressure during pregnancy. Taking eicosapentaenoic acid by mouth does not seem to reduce high blood pressure in women with high-risk pregnancies.

Insufficient Evidence for

  • Alzheimer disease. Early research suggests that increased intake of eicosapentaenoic acid in the diet doesn't help prevent Alzheimer disease.
  • Attention deficit-hyperactivity disorder (ADHD). Some research shows that low blood levels of eicosapentaenoic acid and other fatty acids are linked with ADHD in children. However, it's not known yet if taking eicosapentaenoic acid supplements can treat or prevent ADHD.
  • Involuntary weight loss in people who are very ill (cachexia or wasting syndrome). Early research shows that taking a nutritional supplement containing eicosapentaenoic acid (ProSure by Abbott Nutrition) by mouth while undergoing chemotherapy to treat lung cancer helps prevent the loss of lean body mass better than a nutritional supplement without eicosapentaenoic acid. However, taking eicosapentaenoic acid along with a special diet doesn't seem to prevent the loss of lean body mass any more than the special diet alone in people with head and neck cancer when started before treatment.
  • Diarrhea caused by cancer drug treatment. Taking a nutritional supplement containing eicosapentaenoic acid doesn't seem to prevent diarrhea caused by cancer drug treatment for lung cancer.
  • Nausea and vomiting caused by cancer drug treatment. Taking a nutritional supplement containing eicosapentaenoic acid doesn't seem to prevent nausea or vomiting caused by cancer drug treatment for lung cancer.
  • Nerve damage in the hands and feet caused by cancer drug treatment. Taking a nutritional supplement containing eicosapentaenoic acid during cancer drug treatment for lung cancer prevents nerve pain by a small amount.
  • Tiredness in people treated with cancer drugs. Taking a nutritional supplement containing eicosapentaenoic acid during cancer drug treatment for lung cancer prevents tiredness by a small amount.
  • Lung cancer. Early research shows that taking a nutritional supplement containing eicosapentaenoic acid (ProSure by Abbott Nutrition) by mouth while undergoing cancer drug treatment for lung cancer doesn't improve response rate or increase survival compared to taking a nutritional supplement without eicosapentaenoic acid.
  • Infection after surgery. Early research shows that giving eicosapentaenoic acid, RNA, and L-arginine as part of "tube feeding" after surgery reduces the potential for infections and improves recovery time compared to standard "tube feeding."
  • Recovery after surgery. Weight loss and malnutrition are common after surgery to the esophagus. Early research shows that giving eicosapentaenoic acid as part of "tube feeds" after surgery to the esophagus doesn't prevent weight loss or loss of lean body mass compared to "tube feeds" without eicosapentaenoic acid.
  • Prostate cancer. It is not known if levels of eicosapentaenoic acid in the blood affect the risk of getting prostate cancer. Some research shows that a higher blood level of eicosapentaenoic acid is linked with a lower risk of getting prostate cancer. But other research shows there's no link. In men with normal levels of prostate specific antigen (PSA), which may be elevated in prostate cancer, early research shows that eicosapentaenoic acid may reduce PSA levels.
  • Scaly, itchy skin (psoriasis). Early research shows that taking eicosapentaenoic acid by mouth or giving eicosapentaenoic acid intravenously (by IV) along with a drug called etretinate improves psoriasis symptoms better than etretinate alone.
  • Schizophrenia. Research to date shows conflicting results about the effectiveness of eicosapentaenoic acid in treating schizophrenia.
  • A type of inflammatory bowel disease (ulcerative colitis). Some research shows that a higher intake of eicosapentaenoic acid and other fatty acids in the diet is associated with a reduced risk of having ulcerative colitis. Early research also shows that taking eicosapentaenoic acid for 6 months might reduce markers of bowel inflammation and the risk of worsening ulcerative colitis.
  • Lung diseases.
  • Lupus.
  • Menstrual disorders.
  • Other conditions.
More evidence is needed to rate eicosapentaenoic acid for these uses.

Side Effects

Side Effects & Safety

When taken by mouth: Eicosapentaenoic acid (EPA) is LIKELY SAFE for most adults. It has been used safely in studies for up to 7 years. Most side effects are mild and may include nausea, diarrhea, discomfort in the upper abdomen, or belching. Taking EPA with meals can often decrease these side effects. But people should limit intake of EPA and other omega-3 fatty acids to 3 grams per day, with no more than 2 grams per day from a dietary supplement unless approved by a healthcare provider. Doses of EPA and other omega-3 fatty acids greater than 3 grams per day is POSSIBLY UNSAFE. Taking more than 3 grams per day of omega-3 fatty acids might slow blood clotting and may increase the chance of bleeding.

When given by IV: Eicosapentaenoic acid is POSSIBLY SAFE for most people when given by IV with the approval of a healthcare provider. It is usually well tolerated.

Special Precautions & Warnings:

Pregnancy and breast-feeding: There isn't enough reliable information to know if eicosapentaenoic acid is safe to use when pregnant or breast-feeding. Stay on the safe side and avoid using more than food amounts.

Irregular heartbeat (arrhythmia): In people with a history of arrhythmias, eicosapentaenoic acid may further increase risk of irregular heartbeat. If you have had arrhythmias, talk with your healthcare provider before you start taking eicosapentaenoic acid.

Aspirin-sensitivity: If you are sensitive to aspirin, eicosapentaenoic acid might affect your breathing.

High blood pressure: Eicosapentaenoic acid might lower blood pressure. In people who are already taking medications to lower their blood pressure, adding eicosapentaenoic acid might make blood pressure drop too low. If you have high blood pressure, discuss using eicosapentaenoic acid with your healthcare provider, before you start taking it.

Interactions

Interactions?

Moderate Interaction

Be cautious with this combination

!

  • Medications for high blood pressure (Antihypertensive drugs) interacts with EICOSAPENTAENOIC ACID (EPA)

    EPA can decrease blood pressure. Taking EPA along with medications for high blood pressure might cause you blood pressure to go too low.<br/><br/> Some medications for high blood pressure include captopril (Capoten), enalapril (Vasotec), losartan (Cozaar), valsartan (Diovan), diltiazem (Cardizem), Amlodipine (Norvasc), hydrochlorothiazide (HydroDiuril), furosemide (Lasix), and many others.

  • Medications that slow blood clotting (Anticoagulant / Antiplatelet drugs) interacts with EICOSAPENTAENOIC ACID (EPA)

    EPA (eicosapentaenoic acid) might slow blood clotting. Taking EPA (eicosapentaenoic acid) along with medications that also slow clotting might increase the chances of bruising and bleeding.<br/><br/> Some medications that slow blood clotting include aspirin, clopidogrel (Plavix), diclofenac (Voltaren, Cataflam, others), ibuprofen (Advil, Motrin, others), naproxen (Anaprox, Naprosyn, others), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, warfarin (Coumadin), and others.

Dosing

Dosing

The following doses have been studied in scientific research:

BY MOUTH:

  • For high levels of fats called triglycerides in the blood (hypertriglyceridemia): A specific prescription medicine containing pure eicosapentaenoic acid (Vascepa by Amarin) has been taken in doses of 2 grams twice daily along with dieting an possibly treatment with cholesterol-lowering drugs called "statins."
  • For heart disease (cardiovascular disease): An ethyl eicosapentaenoic acid product (Vascepa, Amarin) 4 grams daily has been used for about 4.9 years.
  • For heart disease (coronary heart disease): 0.6 grams of eicosapentaenoic acid three times daily.
  • For depression: For treating depression, 0.5-1 gram of eicosapentaenoic acid (as ethyl eicosapentaenoic acid) twice daily has been used along with antidepressant medication. In some cases, eicosapentaenoic acid is taken with docosahexaenoic acid. The combination formulas containing at least 60% eicosapentaenoic acid seem to work best. For preventing depression in people receiving interferon-alpha treatment, 3.5 grams of eicosapentaenoic acid per day has been used for 2 weeks.
  • For heart attack: 1.8 grams of eicosapentaenoic acid daily in combination with "statins" has been taken for one month or one year following a procedure called percutaneous coronary intervention (PCI). Taking 1.8 grams daily in combination with "statins" for one month before PCI has also been used.
  • For symptoms of menopause: 500 mg of eicosapentaenoic acid (as ethyl eicosapentaenoic acid) three times daily has been used for up to 8 weeks.
  • For a mental disorder marked by unstable mood and behavior (borderline personality disorder): 1 gram of eicosapentaenoic acid (as ethyl eicosapentaenoic acid) has been used daily for up to 8 weeks.
Many fatty acid preparations such as eicosapentaenoic acid also contain small amounts of vitamin E as an antioxidant to prevent spoilage.

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View References

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