During the past decade, omega-3 fatty acids from fish oil have garnered a great deal of scientific interest. The anti-tumor, anti-inflammatory, immunomodulating and cardioprotective properties attributed to omega-3 fatty acids have caught the attention of pharmaceutical companies, too, and their efforts have spawned prescription formulations of omega-3. Prescription-strength omega-3s lower triglycerides and reduce your risk for heart disease. Although there are general recommendations for dosing, your doctor is the best source of information about prescription fish oil.
Distinctions
The omega-3 fatty acids found in the tissues of oily fish and in over-the-counter fish oil supplements differ from those in prescription formulations of omega-3s. Prescription omega-3s, or P-OM3s, contain highly purified esters of eicosapentaenoic acid and docosahexaenoic acid, or EPA and DHA, respectively. The March 2008 "Expert Review of Cardiovascular Therapy" explains that this allows manufacturers to pack 900 mg of omega-3s into each 1-g capsule, or 1.5 to 3 times the amount found in most supplements. Furthermore, the purification process provides a means to certify the contents of each P-OM3 capsule and to guarantee its quality.
Mechanism
High triglyceride levels -- over 150 mg/dL -- increase your risk for heart disease. Levels above 1,000 mg/dL dramatically increase your risk for pancreatitis, or inflammation of the pancreas. The U.S. Food and Drug Administration has approved P-OM3s for treating triglyceride levels above 500 mg/dL. The FDA believes P-OM3s reduce your triglyceride level by enhancing triglyceride clearance from your bloodstream, interfering with fatty acid synthesis in your liver and accelerating fatty acid degradation.
Dosage
The FDA-approved dosage of P-OM3 is four capsules -- roughly 4 g -- daily. According to the March 2011 issue of "International Journal of Women's Health," this dose can lower triglyceride levels by up to 45 percent. It also helps lower total and LDL cholesterol levels. You might not observe the benefits of P-OM3s for up to six weeks. The most common side effects of fish oil preparations include stomach upset and the "fishy burp." However, these unpleasant effects are supposedly less prominent in P-OM3s than in over-the-counter formulations.
Considerations
The goal of treatment with prescription omega-3 fatty acid esters is to lower your triglyceride level to 150 mg/dL or less, thus reducing your risk for heart disease. If your triglycerides are extremely high, the recommended 4-g dose of P-OM3s may not be sufficient to reach this treatment goal. You might require the addition of other medications, such as statins or niacin, to attain optimal lipid control. Your physician will help you decide which approach is best for you.
References
- "Expert Review of Cardiovascular Therapy"; Prescription Omega-3 Fatty Acids and Their Lipid Effects: Physiologic Mechanisms of Action and Clinical Implications; H.E. Bays, et al.; March 2008
- "International Journal of Women's Health"; Understanding Hypertriglyceridemia in Women: Clinical Impact and Management with Prescription Omega-3-Acid Ethyl Esters; T.D. Dayspring; March 2011
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