Share on PinterestA prescription fish oil can be the equivalent of 10 to 40 capsules of over-the-counter fish oil. Getty Images
- An FDA advisory panel recommended that more people be eligible for prescription fish oil.
- The prescription drug has been shown to lower triglyceride levels and reduce the risk of heart attack.
- Side effects can occur, including an irregular heartbeat and excessive bleeding.
Should You Take Prescription Fish Oil?
If you have high triglycerides, you may be able to do so soon.
An advisory panel to the Food and Drug Administration (FDA) has recommended changing the standards for prescription fish oil to help more people reduce their risk of heart attack and stroke.
The panel’s unanimous recommendation was sparked by a recent clinical study that showed that consuming prescription strength fish oil can lower the risk of heart attacks, clogged arteries, and other cardiovascular health problems by about 25 percent.
The clinical trial was sponsored by Amarin, the makers of Vascepa (icosapent ethyl).
According to the company, Vascepa is the first and only FDA-approved prescription strength fish oil on the market that reduces high levels of triglycerides without increasing levels of bad cholesterol (LDL-C).
Triglycerides are a type of blood fat that has been linked to an increased risk of heart disease, the leading cause of death in the United States.
Triglyceride levels can be increased from excessive calorie consumption, alcohol consumption, and untreated diabetes.
Prescription strength fish oil is currently only available to those with abnormally high levels of triglycerides.
However, if the FDA approves its panel’s recommendation, the new rules would mean people with lower blood fat levels would be eligible for prescription fish oil.
How does prescription fish oil differ from the products you buy over the counter?
It’s mainly about omega-3 fatty acids.
“The main difference has to do with the amount of omega-3s,” Andy De Santis, a registered dietitian and weight loss specialist, told Healthline.
“Prescription fish oil contains more marine-based omega-3s, namely DHA and EPA,” added Kristin Kirkpatrick, nutritionist and author of “Skinny Liver: A Proven Program to Prevent and Reverse the New Silent Fatty Liver Disease.”
“The focus is also greater,” said Kirkpatrick.
Amarin’s ad says that 4 of their pure capsules contain 10 to 40 over-the-counter capsules of fish oil and omega-3 supplements.
The second difference is the amount of data demonstrating the effectiveness and safety of prescription strength fish oils as opposed to complementary varieties.
“Studies have shown that prescription fish oil helps treat and reduce triglycerides and can be helpful in preventing cardiovascular events,” Kirkpatrick told Healthline.
In contrast, “supplemental, over-the-counter omega-3 has mixed data with some studies showing minimal effects on cardiovascular health, depression and anxiety, or cognitive health,” she said.
There is another difference.
Vascepa currently costs around $ 300 per month without insurance. Over-the-counter fish oils and omega-3 supplements make up a fraction of that cost.
Additional fish oil labels recommend consuming 1 gram per day. Vascepa is 4 grams per day.
“This is considered a high dose and carries some risks,” said De Santis.
Irregular heartbeat, blood thinning, and excessive bleeding are some of the most common problems.
“That’s why it’s regulated as a recipe. If you take that much, you must do so under medical supervision, ”explained De Santis.
The FDA advisory panel looked at the known side effects of prescription strength fish oil, including internal bleeding.
Panelists concluded that the perceived health benefits outweigh any potential risks.
According to the Centers for Disease Control and Prevention (CDC), approximately 25 percent of adults aged 20 and over had elevated triglyceride levels from 2009 to 2012.
Lifestyle factors that contribute to this include smoking, poor diet, and little physical activity.
“In patients with high blood triglycerides, omega-3 supplementation can help lower them,” said De Santis.
However, whether or not to take prescription fish oil should be decided by you and your healthcare team.
“Because both over-the-counter fish oil and prescription fish oil can thin the blood, it may be a contraindication for people taking blood-thinning medications or taking them prior to surgery,” noted Kirkpatrick.
“For the most part, I recommend eating as the first option to get all of the nutrients you need,” she added.
De Santis said that people can naturally increase their omega-3 fatty acids by regularly consuming various types of fish, as well as walnuts, chia seeds, flax seeds, and hemp seeds.
“However, for those who do not consume foods rich in omega-3s, a fish oil supplement may offer cardiovascular benefits by filling the omega-3 void,” said De Santis.
If your doctor suggests an over-the-counter fish oil, Kirkpatrick looks for “marine options that do not require switching and that contain a combination of DHA and EPA”.
“Then you check the third party certification that ensures the quality of the ingredients,” she said.
US Pharmacopeia and ConsumerLab.com are two resources that report on nutritional supplements.