Top 300 Pharmacy Drug Cards

OMEGA-3-ACID ETHYL ESTERS: Lovaza, Various

Class: Antihyperlipidemic

Dosage Forms. Capsule, Liquid Filled: 1 g

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Common FDA Label Indication, Dosing, and Titration.

1. Hypertriglyceridemia, adjunct to diet in adults with triglyceride levels 500 mg/dL or higher: 4 g po daily or divided into 2 doses

Off-Label Uses.

1. Coronary arteriosclerosis, hypertriglyceridemia: 4 g po daily or divided into 2 doses

2. Familial combined hyperlipidemia: 4 g po daily or divided into 2 doses

3. Heart failure: 4 g po daily or divided into 2 doses

4. Hyperlipidemia, hypertriglyceridemia, triglyceride levels less than 500 mg/dL: 4 g po daily or divided into 2 doses

MOA. Potential mechanisms of action include inhibition of acyl-CoA:1,2-diacylglycerol acyltransferase, increased mitochondrial and peroxisomal β-oxidation in the liver, decreased lipogenesis in the liver, and increased plasma lipoprotein lipase activity. Lovaza may reduce the synthesis of triglycerides in the liver because EPA and DHA are poor substrates for the enzymes responsible for TG synthesis, and EPA and DHA inhibit esterification of other fatty acids.

Drug Characteristics: Omega-3-Acid Ethyl Esthers

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Medication Safety Issues: Omega-3-Acid Ethyl Esthers

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Drug Interactions: Omega-3-Acid Ethyl Esthers. None known

Adverse Reactions: Omega-3-Acid Ethyl Esthers

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Efficacy Monitoring Parameters. Reduction in triglyceride levels to <150 mg/dL.

Toxicity Monitoring Parameters. LDL levels may increase, LFTs.

Key Patient Counseling Points. Swallow the whole capsule; take with food. If you are unable to swallow the whole capsule, you may puncture the capsule and squeeze the contents into a glass or porcelain cup. Do not use a plastic cup; this may cause foaming. Seek medical attention if severe rash, chest pain, heart palpitations, or shortness of breath.

Clinical Pearls. Ten to eighteen OTC fish oil concentrate capsules are equivalent to 3 Lovaza capsules. Treatment of hypertriglyceridemia with omega-3-acid ethyl esters offers a better tolerability profile for patients as compared with other drugs, such as gemfibrozil and nicotinic acid, and has shown to be equivalent to gemfibrozil in efficacy.