Prescription Omega-3 Fatty Acid Products and Dietary Supplements Are Not Interchangeable

Daniel Hilleman, Aiman Smer

Research output: Contribution to journalReview article

3 Citations (Scopus)

Abstract

PURPOSE: To provide an overview of prescription and dietary supplement omega-3 fatty acid (OM3-FA) products and considerations for clinical use.

DESIGN: Narrative review.

METHODOLOGY: The PubMed database was searched for cardiovascular-related investigations focused on eicosapentaenoic acid (EPA) and/or docosahexaenoic acid (DHA) (limit: English-only articles). Additional regulatory information on prescription and dietary supplements was obtained from United States Food and Drug Administration online sources.

RESULTS: Prescription QM3-FA products are supported by robust clinical development and safety monitoring programs, whereas dietary supplements are not required to demonstrate safety or efficacy prior to marketing. There are no over-the-counter OM3-FA products available in the United States. Investigations of OM3-FA dietary supplements show that quantities of EPA and DHA are highly variable within and between brands. Dietary supplements also may contain potentially harmful components, including oxidized OM3-FA, other lipids, cholesterol, and toxins. Prescription OM3-FA products may contain DHA and EPA or EPA alone. All prescription OM3-FA products have demonstrated statistically significant triglyceride reduction as monotherapy or in combination with statins in patients with hypertriglyceridemia. Differential effects between products containing EPA and DHA compared with a high-purity EPA product (icosapent ethyl) have clinical implications: Increases in low-density lipoprotein cholesterol associated with DHA have the potential to confound strategies for managing patients with dyslipidemia. Cardiovascular outcomes studies of prescription CM3-FA products are ongoing.

CONCLUSIONS: OM3-FA dietary supplements should not be substituted for prescription products, and prescription OM3-FA products that contain DHA are not equivalent to or interchangeable with high-purity EPA (icosapent ethyl) and should not be substituted for it.

Original languageEnglish (US)
Pages (from-to)46-52
Number of pages7
JournalManaged care (Langhorne, Pa.)
Volume25
Issue number1
StatePublished - Jan 1 2016

Fingerprint

Omega-3 Fatty Acids
Dietary Supplements
Eicosapentaenoic Acid
Prescriptions
Docosahexaenoic Acids
Safety
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Hypertriglyceridemia
United States Food and Drug Administration
Dyslipidemias
Marketing
PubMed
LDL Cholesterol
Triglycerides
Cholesterol
Outcome Assessment (Health Care)
Databases
Lipids

All Science Journal Classification (ASJC) codes

  • Health Policy
  • Public Health, Environmental and Occupational Health

Cite this

Prescription Omega-3 Fatty Acid Products and Dietary Supplements Are Not Interchangeable. / Hilleman, Daniel; Smer, Aiman.

In: Managed care (Langhorne, Pa.), Vol. 25, No. 1, 01.01.2016, p. 46-52.

Research output: Contribution to journalReview article

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