EPA (EICOSAPENTAENOIC ACID)
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 InformationEPA (eicosapentaenoic acid) is a fatty acid found in the flesh of coldwater fish, including mackerel, herring, tuna, halibut, salmon, cod liver, whale blubber, or seal blubber.
EPA is used for high blood pressure in high-risk pregnancies (eclampsia), age-related macular degeneration (AMD), heart disease, schizophrenia, personality disorder, cystic fibrosis, Alzheimer’s disease, depression, and diabetes.
EPA is used in combination with docosahexaenoic acid (DHA) in fish oil preparations for a variety of conditions, including preventing and reversing heart disease, and decreasing irregular heartbeats; as well as asthma, cancer, menstrual problems, hot flashes, hay fever, lung diseases, lupus erythematosus, and kidney disease. EPA and DHA are also used in combination for migraine headache prevention in adolescents, skin infections, Behçet’s syndrome, high cholesterol, high blood pressure, psoriasis, Raynaud’s syndrome, rheumatoid arthritis, Crohn's disease, and ulcerative colitis.
EPA is also used in combination with RNA and L-arginine after surgery to reduce infections, improve wound healing, and shorten recovery time.
Don’t confuse EPA with DHA (docosahexaenoic acid) and fish oils, which contain EPA and DHA. Most available data involving EPA are from research and clinical experience with fish oil products containing variable combinations of EPA and DHA. For more information, see the separate listings for Fish Oil and DHA.
How does it work?EPA can prevent the blood from clotting easily. These fatty acids also reduce pain and swelling.
Uses & Effectiveness
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
- Treating depression, when used with conventional antidepressants.
- For healing wounds after surgery and shortening recovery time, when used with RNA and L-arginine.
- Treating borderline personality disorder, a mood disorder. EPA seems to lower aggressiveness and to relieve depression somewhat in women with this disorder.
- Reducing the risk of heart attack, stroke, and death in people with coronary artery disease (clogged heart arteries). The reduction of the risk of death is small unless high cholesterol is present in addition to coronary artery disease. In that case, taking EPA can reduce the risk of having a heart attack or other major event by up to 19%. However, taking EPA doesn’t seem to reduce the risk of sudden cardiac death, which is due to an electrical malfunction in the heart.
- Symptoms of menopause such as hot flashes.
Possibly Ineffective for
- Treatment of type 2 diabetes.
- Treating symptoms of cystic fibrosis.
- Pregnancy-related high blood pressure (eclampsia).
- High blood pressure.
- Treating asthma.
- Relieving hayfever symptoms including wheezing, cough, and nasal symptoms.
- Preventing an eye disease called AMD (age-related macular degeneration), when EPA is consumed as part of the diet.
- Reducing growths in the uterus.
Insufficient Evidence for
- Prostate cancer. It appears that a higher level of EPA in the blood is linked with a lower risk of getting prostate cancer.
- Attention deficit-hyperactivity disorder (ADHD). Some research shows that low blood levels of EPA and other fatty acids are linked with ADHD in children. However, it’s not known yet if taking EPA supplements can treat or prevent ADHD.
- Schizophrenia. Studies to date show conflicting results about the effectiveness of EPA in treating schizophrenia.
- Alzheimer’s disease. Research so far suggests that EPA doesn’t help to prevent Alzheimer’s disease.
- Menstrual disorders.
- Lung diseases.
- Other conditions.
Side Effects & SafetyEPA is LIKELY SAFE for most people when taken appropriately. It is usually well tolerated. Some people, however, can experience side effects such as nausea; diarrhea; heartburn; skin rash; itching; nosebleed; and joint, back, and muscle pain. Fish oils containing EPA can cause fishy taste, belching, nosebleeds, nausea, and loose stools. Taking EPA with meals can often decrease these side effects.
When used in amounts greater than 3 grams per day, EPA is POSSIBLY UNSAFE, and can thin the blood and increase the risk for bleeding.
Special Precautions & Warnings:Pregnancy and breast-feeding: Not enough is known about using of EPA during pregnancy and breast-feeding. Stay on the safe side and avoid use.
Aspirin-sensitivity: If you are sensitive to aspirin, EPA might affect your breathing.
High blood pressure: EPA might lower blood pressure. In people who are already taking medications to lower their blood pressure, adding EPA might make blood pressure drop too low. If you have high blood pressure, discuss using EPA with your healthcare provider, before you start taking it.
Be cautious with this combination
Medications for high blood pressure (Antihypertensive drugs) interacts with EPA (EICOSAPENTAENOIC ACID)
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 EPA (EICOSAPENTAENOIC ACID)
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.
EPA is usually administered with DHA (docosahexaenoic acid) as fish oil. A wide range of doses have been used. A typical dose is 5 grams of fish oil containing 169-563 mg of EPA and 72-312 mg of DHA.
- For depression: 1 gram EPA twice daily.
- For borderline personality disorder: 1 gram of EPA daily (as ethyl eicosapentaenoic acid) has been used for up to 8 weeks.
- For symptoms of menopause such as hot flashes: 500 mg ethyl-EPA three times daily has been used for up to 8 weeks.
- Kris-Etherton, P. M., Taylor, D. S., Yu-Poth, S., Huth, P., Moriarty, K., Fishell, V., Hargrove, R. L., Zhao, G., and Etherton, T. D. Polyunsaturated fatty acids in the food chain in the United States. Am J Clin Nutr 2000;71(1 Suppl):179S-188S. View abstract.
- Sanders, T. A. Polyunsaturated fatty acids in the food chain in Europe. Am J Clin Nutr 2000;71(1 Suppl):176S-178S. View abstract.
- Simopoulos, A. P. Human requirement for N-3 polyunsaturated fatty acids. Poult.Sci 2000;79(7):961-970. View abstract.
- Sublette, M. E., Ellis, S. P., Geant, A. L., and Mann, J. J. Meta-analysis of the effects of eicosapentaenoic acid (EPA) in clinical trials in depression. J.Clin.Psychiatry 2011;72(12):1577-1584. View abstract.
- Akedo I, Ishikawa H, Nakamura T, et al. Three cases with familial adenomatous polyposis diagnosed as having malignant lesions in the course of a long-term trial using docosahexanoic acid (DHA)-concentrated fish oil capsules (abstract). Jpn J Clin Oncol 1998;28:762-5. View abstract.
- Ballantyne CM, Bays HE, Kastelein JJ, Stein E, Isaacsohn JL, Braeckman RA, Soni PN. Efficacy and safety of eicosapentaenoic acid ethyl ester (AMR101) therapy in statin-treated patients with persistent high triglycerides (from the ANCHOR study). Am J Cardiol. 2012 Oct 1;110(7):984-92. View abstract.
- Bays HE, Ballantyne CM, Kastelein JJ, Isaacsohn JL, Braeckman RA, Soni PN. Eicosapentaenoic acid ethyl ester (AMR101) therapy in patients with very high triglyceride levels (from the Multi-center, plAcebo-controlled, Randomized, double-blINd, 12-week study with an open-label Extension [MARINE] trial). Am J Cardiol. 2011 Sep 1;108(5):682-90. View abstract.
- Braeckman RA, Stirtan WG, Soni PN. Pharmacokinetics of Eicosapentaenoic Acid in Plasma and Red Blood Cells After Multiple Oral Dosing With Icosapent Ethyl in Healthy Subjects. Clin Pharmacol Drug Dev. 2014 Mar;3(2):101-108. View abstract.
- Bulstra-Ramakers MT, Huisjes HJ, Visser GH. The effects of 3g eicosapentaenoic acid daily on recurrence of intrauterine growth retardation and pregnancy induced hypertension. Br J Obstet Gynaecol 1995;102:123-6. View abstract.
- Calder PC. N-3 polyunsaturated fatty acids, inflammation and immunity: pouring oil on troubled waters or another fishy tale? Nutr Res 2001;21:309-41.
- Cawood AL, Ding R, Napper FL, et al. Eicosapentaenoic acid (EPA) from highly concentrated n-3 fatty acid ethyl esters is incorporated into advanced atherosclerotic plaques and higher plaque EPA is associated with decreased plaque inflammation and increased stability. Atherosclerosis. 2010;212(1):252-9. View abstract.
- Chavarro JE, Stampfer MJ, Li H, et al. A prospective study of polyunsaturated fatty acid levels in blood and prostate cancer risk. Cancer Epidemiol Biomarkers Prev 2007;16:1364-70. View abstract.
- Cho E, Hung S, Willet W, et al. Prospective study of dietary fat and the risk of age-related macular degeneration. Am J Clin Nutr 2001;73:209-18.. View abstract.
- Daly JM, Lieberman MD, Goldfine J, et al. Enteral nutrition with supplemental arginine, RNA, and omega-3 fatty acids in patients after operation: immunologic, metabolic and clinical outcome. Surgery 1992;112:56-67. View abstract.
- Doi M, Nosaka K, Miyoshi T, Iwamoto M, Kajiya M, Okawa K, Nakayama R, Takagi W, Takeda K, Hirohata S, Ito H. Early eicosapentaenoic acid treatment after percutaneous coronary intervention reduces acute inflammatory responses and ventricular arrhythmias in patients with acute myocardial infarction: a randomized, controlled study. Int J Cardiol. 2014 Oct 20;176(3):577-82. View abstract.
- Dokholyan RS, Albert CM, Appel LJ, et al. A trial of omega-3 fatty acids for prevention of hypertension. Am J Cardiol 2004;93:1041-3. View abstract.
- Emsley R, Myburgh C, Oosthuizen P, van Rensburg SJ. Randomized, placebo-controlled study of ethyl-eicosapentaenoic acid as supplemental treatment in schizophrenia. Am J Psychiatry 2002;159:1596-8. View abstract.
- Erkkila AT, Lehto S, Pyorala K, Uusitupa MI. n-3 Fatty acids and 5-y risks of death and cardiovascular disease events in patients with coronary artery disease. Am J Clin Nutr 2003;78:65-71.. View abstract.
- FDA. Center for Food Safety and Applied Nutrition. Letter regarding dietary supplement health claim for omega-3 fatty acids and coronary heart disease. Available at: http://www.fda.gov/ohrms/dockets/dockets/95s0316/95s-0316-Rpt0272-38-Appendix-D-Reference-F-FDA-vol205.pdf. (Accessed February 7, 2017).
- Fenton WS, Dickerson F, Boronow J, et al. A placebo-controlled trial of omega-3 fatty acid (ethyl eicosapentaenoic acid) supplementation for residual symptoms and cognitive impairment in schizophrenia. Am J Psychiatry 2001;158:2071-4. View abstract.
- Finnegan YE, Howarth D, Minihane AM, et al. Plant and marine derived (n-3) polyunsaturated fatty acids do not affect blood coagulation and fibrinolytic factors in moderately hyperlipidemic humans. J Nutr 2003;133:2210-3.. View abstract.
- Fu YQ, Zheng JS, Yang B, Li D. Effect of individual omega-3 fatty acids on the risk of prostate cancer: a systematic review and dose-response meta-analysis of prospective cohort studies. J Epidemiol. 2015;25(4):261-74. View abstract.
- Grosso G, Pajak A, Marventano S, Castellano S, Galvano F, Bucolo C, Drago F, Caraci F. Role of omega-3 fatty acids in the treatment of depressive disorders: a comprehensive meta-analysis of randomized clinical trials. PLoS One. 2014 May 7;9(5):e96905. View abstract.
- Joy CB, Mumby-Croft R, Joy LA. Polyunsaturated fatty acid supplementation for schizophrenia. Cochrane Database Syst Rev 2006;3:CD001257. View abstract.
- Kemen M, Senkal M, Homann HH, et al. Early postoperative enteral nutrition with arginine-omega-3 fatty acids and ribonucleic acid-supplemented diet vs placebo in cancer patients: an immunologic evaluation of impact. Crit Care Med 1995;23:652-9. View abstract.
- Kris-Ehterton PM, Harris WS, Appel LJ, et al. Fish consumption, fish oil, omega-3 fatty acids, and cardiovascular disease. Circulation 2002;106:2747-57. View abstract.
- Kuhnt K, Fuhrmann C, Köhler M, Kiehntopf M, Jahreis G. Dietary echium oil increases long-chain n-3 PUFAs, including docosapentaenoic acid, in blood fractions and alters biochemical markers for cardiovascular disease independently of age, sex, and metabolic syndrome. J Nutr. 2014 Apr;144(4):447-60. View abstract.
- Kuhnt K, Weiß S, Kiehntopf M, Jahreis G. Consumption of echium oil increases EPA and DPA in blood fractions more efficiently compared to linseed oil in humans. Lipids Health Dis. 2016 Feb 18;15:32. View abstract.
- Kurita A, Takashima H, Ando H, Kumagai S, Waseda K, Gosho M, Amano T. Effects of eicosapentaenoic acid on peri-procedural (type IVa) myocardial infarction following elective coronary stenting. J Cardiol. 2015 Aug;66(2):114-9. View abstract.
- Lucas M, Asselin G, Merette C, et al. Effects of ethyl-eicosapentaenoic acid omega-3 fatty acid supplementation on hot flashes and quality of life among middle-aged women: a double-blind, placebo-controlled, randomized clinical trial. Menopause 2009;16:357-66. View abstract.
- Mayser P, Mrowietz U, Arenberger P, et al. Omega-3 fatty acid-based lipid infusion in patients with chronic plaque psoriasis: results of a double-blind, randomized, placebo-controlled, multicenter trial. J Am Acad Dermatol 1998;38:539-47. View abstract.
- Mischoulon D, Nierenberg AA, Schettler PJ, Kinkead BL, Fehling K, Martinson MA, Hyman Rapaport M. A double-blind, randomized controlled clinical trial comparing eicosapentaenoic acid versus docosahexaenoic acid for depression. J Clin Psychiatry. 2015 Jan;76(1):54-61. View abstract.
- Mori TA, Burke V, Puddey IB, et al. Purified eicosapentaenoic and docosahexaenoic acids have differential effects on serum lipids and lipoproteins, LDL particle size, glucose, and insulin in mildly hyperlipidemic men. Am J Clin Nutr 2000;71:1085-94. View abstract.
- Morris MC, Evans DA, Bienias JL, et al. Consumption of fish and n-3 fatty acids and risk of incident Alzheimer disease. Arch Neurol 2003;60:940-6. View abstract.
- Nemets B, Stahl Z, Belmaker RH. Addition of omega-3 fatty acid to maintenance medication treatment for recurrent unipolar depressive disorder. Am J Psychiatry 2002;159:477-9.. View abstract.
- Peet M, Horrobin DF. A dose-ranging study of the effects of ethyl-eicosapentaenoate in patients with ongoing depression despite apparently adequate treatment with standard drugs. Arch Gen Psychiatry 2002;59:913-9.. View abstract.
- Picado C, Castillo JA, Schinca N, et al. Effects of a fish oil enriched diet on aspirin intolerant asthmatic patients: a pilot study. Thorax 1988;43:93-7. View abstract.
- Prisco D, Paniccia R, Bandinelli B, et al. Effect of medium-term supplementation with a moderate dose of n-3 polyunsaturated fatty acids on blood pressure in mild hypertensive patients. Thromb Res 1998;1:105-12. View abstract.
- Sacks FM, Hebert P, Appel LJ, et al. Short report: the effect of fish oil on blood pressure and high-density lipoprotein-cholesterol levels in phase I of the trials of hypertension prevention. J Hypertens 1994;12:209-13. View abstract.
- Sakakibara H, Hirose K, Matsushita K, et al. Effect of supplementation with eicosapentaenoic acid ethylster MND-21, on generation of leukotrienes by calcium ionophore-activated leukocytes in bronchial asthma. Nihon Kyobu Shikkan Gakkai Zasshi 1995;33:395-402. View abstract.
- Sánchez-Lara K, Turcott JG, Juárez-Hernández E, Nuñez-Valencia C, Villanueva G, Guevara P, De la Torre-Vallejo M, Mohar A, Arrieta O. Effects of an oral nutritional supplement containing eicosapentaenoic acid on nutritional and clinical outcomes in patients with advanced non-small cell lung cancer: randomised trial. Clin Nutr. 2014 Dec;33(6):1017-23. View abstract.
- Saynor R, Gillott T. Changes in blood lipids and fibrinogen with a note on safety in a long term study on the effects of n-3 fatty acids in subjects receiving fish oil supplements and followed for seven years. Lipids 1992;27:533-8. View abstract.
- Senkal M, Kemen M, Homann HH, et al. Modulation of postoperative immune response by enteral nutrition with a diet enriched with arginine, RNA, and omega-3 fatty acids in patients with upper gastrointestinal cancer. Eur J Surg 1995;161:115-22. View abstract.
- Simopoulos AP. Essential fatty acids in health and chronic disease. Am J Clin Nutr 1999;70:560S-9S. View abstract.
- Stevens LJ, Zentall SS, Deck JL, et al. Essential fatty acid metabolism in boys with attention-deficit hyperactivity disorder. Am J Clin Nutr 1995;62:761-8. View abstract.
- Su KP, Lai HC, Yang HT, Su WP, Peng CY, Chang JP, Chang HC, Pariante CM. Omega-3 fatty acids in the prevention of interferon-alpha-induced depression: results from a randomized, controlled trial. Biol Psychiatry. 2014 Oct 1;76(7):559-66. View abstract.
- Tepaske R, Velthuis H, Oudemans-van Straaten HM, et al. Effect of preoperative oral immune-enhancing nutritional supplement on patients at high risk of infection after cardiac surgery: a randomised placebo-controlled trial. Lancet 2001;358:696-701. View abstract.
- Terano T, Hirai A, Hamazaki T, et al. Effect of oral administration of highly purified eicosapentaenoic acid on platelet function, blood viscosity and red cell deformability in healthy human subjects. Atherosclerosis 1983;46:321-31.. View abstract.
- Thien FC, Mencia-Huerta J, Lee TH. Dietary fish oil effects on seasonal hay fever and asthma in pollen- sensitive subjects. Am Rev Respir Dis 1993;147:1138-43. View abstract.
- Thies F, Nebe-von-Caron G, Powell JR, et al. Dietary supplementation with eicosapentaenoic acid, but not with other long-chain n-3 or n-6 polyunsaturated fatty acids, decreases natural killer cell activity in healthy subjects aged >55 y. Am J Clin Nutr 2001;73:539-48. View abstract.
- Thies N. The effect of 12 months' treatment with eicosapentaenoic acid in five children with cystic fibrosis. J Paediatr Child Health 1997;33:349-51. View abstract.
- Toft I, Bonaa KH, Ingebretsen OC, et al. Effects of n-3 polyunsaturated fatty acids on glucose homeostasis and blood pressure in essential hypertension. A randomized, controlled trial. Ann Intern Med 1995;123:911-8. View abstract.
- Vandongen R, Mori TA, Burke V, et al. Effects on blood pressure of omega 3 fats in subjects at increased risk of cardiovascular disease. Hypertension 1993;22:371-9. View abstract.
- Woodman RJ, Mori TA, Burke V, et al. Effects of purified eicosapentaenoic and docosahexaenoic acids on glycemic control, blood pressure, and serum lipids in type 2 diabetic patients with treated hypertension. Am J Clin Nutr 2002;76:1007-15.. View abstract.
- Yao JK, Magan S, Sonel AF, et al. Effects of omega-3 fatty acid on platelet serotonin responsivity in patients with schizophrenia. Prostaglandins Leukot Essent Fatty Acids 2004;71:171-6. View abstract.
- Yokoyama M, Origasa H, Matsuzaki M, et al. Effects of eicosapentaenoic acid on major coronary events in hypercholesterolaemic patients (JELIS): a randomised open-label, blinded endpoint analysis. Lancet 2007;369:1090-8. View abstract.
- Zanarini MC, Frankenburg FR. Omega-3 Fatty acid treatment of women with borderline personality disorder: a double-blind, placebo-controlled pilot study. Am J Psychiatry 2003;160:167-9.. View abstract.
- Zuijdgeest-Van Leeuwen SD, Dagnelie PC, Wattimena JL, et al. Eicosapentaenoic acid ethyl ester supplementation: in cachectic cancer patients and healthy subjects: effects on lipolysis and lipid oxidation. Clin Nutr 2000;19:417-23. View abstract.