Home > Blog > Vascepa – A New Prescription Fish Oil Drug for Triglycerides

Vascepa – A New Prescription Fish Oil Drug for Triglycerides

by Vin Kutty on September 29, 2013

Why many doctors are switching patients from Lovaza to Vascepa.

Vascepa is a new second-generation fish oil-based drug for treating high triglycerides.

Vascepa significantly reduces triglycerides, VLDL and non-HDL cholesterol.

Vascepa improves multiple lipid parameters Vascepa significantly reduces triglyceride levels without increasing LDL Cholesterol

 

Lovaza and Vascepa have very similar effect on blood lipids, except for LDL-C. Lovaza and Vascepa have very similar effect on blood lipids, except for LDL-C.

 

Vascepa vs Lovaza The DHA is believed to be responsible for this effect on LDL-cholesterol.

 

Until recently, the only drug available to Americans for triglycerides has been Lovaza, also marketed as Omacor in several countries.

Both Vascepa and Lovaza are made from fish oil but there are a couple of key differences – see table below for a summary of differences.

Vascepa Cost

Without insurance, Vascepa costs around $7 per day – dosage is 4 pills per day.

Vascepa – will half-dose work?

If you decide to save a few pennies and reduce your dosage from 4 Vascepa pills a day, down to 2 a day, then you’ll notice less triglyceride reduction. Talk to your doctor about this! At half-dose, patients noticed only a 20% drop compared to 33% drop at full dose. Higher your starting triglyceride level, the bigger the drop.

Vascepa vs Lovaza – key differences

  1. EPA to DHA Ratio.
    • As you may know, EPA and DHA are the two key Omega-3 fatty acids in fish oil.
    • Lovaza contains both EPA and DHA, while Vascepa contains only EPA. There is no DHA in Vascepa.

     

  2. DHA increases LDL (or ‘bad’) cholesterol

     

  3. ‘Off-label’ use for depression

Lovaza can increase LDL by up to 45%

The fact that Vascepa has no ‘LDL issues’ is the #1 reason why doctors are switching their patients over from Lovaza to Vascepa.

Clinicians argue whether an increase in LDL is as predictive for future heart disease risk as a decrease in HDL. Studies show that low HDL is 4-times better at predicting future risk than high LDL. Some doctors believe that LDL is “pretty much useless” in predicting risk, instead preferring to focus on the overlooked Triglyceride to HDL ratio.

From this more progressive stance, Lovaza still does a bang up job of reducing triglycerides – by 44% – and your overall heart disease risk.

This eye-opening study shows that CRP is a much better predictor of ‘cardiac events’ than LDL and that women with low LDL levels get just as many heart attacks. There are no drugs available to reduce CRP, so this marker is ignored.

Experimental drugs that increase HDL tend to, well, unanticiapted side effects. Look up Torcetrapib. So there are no HDL-upper drugs, other than Niacin. Consequently, HDL gets ignored too.

Regardless, watching Total Cholesterol and LDL numbers have become a pastime for the over-50 crowd.

(My personal opinion: I’m extremely concerned about my heart health, so I watch my triglycerides, HDL, TG/HDL ratio, A1C, blood glucose, CRP, Apo B, homocysteine, insulin, LDL particle size/number and thyroid levels. I could rattle off all these numbers if you woke me up in the middle of the night, but I honestly don’t know (or care about) my total cholesterol or LDL-C number.
Just my 2 cents.)

Here’s a video by Dr. Mark Hyman to put things in perspective:

Compare Vascepa to Lovaza:

LOVAZA

VASCEPA

Cost (without insurance) $8.60/day About $7/day
Prescription Required Yes Yes
Dosage 4 Pills Per Day 4 Pills Per Day
Omega-3 Per Pill 840 mg 960 mg
Active Ingredients EPA and DHA Omega-3 EPA only
Made from Fish Oil Fish Oil
Omega-3 Content 85% 96%
FDA Approved Drug Yes Yes
Side Effects Low Low
Fatty Acid Form Ethyl Ester Ethyl Ester
EPA Omega-3 Content 465 mg 960 mg
DHA Omega-3 Content 375 mg 0 mg
Triglyceride Reduction Yes Yes
Cholesterol Free Yes Yes
Purification Method Molecular distillation Chromatography
Enteric Coated No No
Fishy Burps Likely Likely
Mercury and Heavy Metals Purified – passes all standards Purified – passes all standards
Certificate of Analysis Availability No No

 

DISCLAIMER: This website is for your education and general health information only. The ideas, opinions and suggestions contained on this website are not to be used as a substitute for medical advice, diagnosis or treatment from your doctor for any health condition or problem. Users of this website should not rely on information provided on this website for their own health problems. Any questions regarding your own health should be addressed to your own physician.

Author Vin Kutty is an expert on fish oil About the Author: Vin Kutty, M.S., is OmegaVia’s Scientific Advisor and Chief Blogger. He is a nutritionist, author, and Omega-3 expert with over 20 years of experience.

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{ 21 comments… read them below or add one }

Bernadette Adams September 30, 2013 at 12:20 am

Hi,

My 53 yr old husband takes Plavix, Lisinoprol & metyroprol. Can he take OmegaVia EPA 500. Are there dangerous side effects combining these medicines with Fish Oil?

Thank You

Reply

Vin Kutty September 30, 2013 at 6:56 pm

Hi Bernadette – you’ll have to consult with your doctor. Fish oil is considered a food and is compatible with almost all drugs. At extremely high doses, Omega-3 can have a slight blood thinning effect. At suggested doses, you’re very unlikely to notice this. Since Plavix is also a blood thinner, you may want to run this by your doctor, just to be safe.

Reply

Bernadette Adams September 30, 2013 at 12:27 am

Hi,

My 20 yr old daughter is a Div 1 basketball player. Lately her ankle has been diagnosed with severe scar tissue and inflammation which is Anterior Ankle Impingement. She may have to require ankle arthoscopic surgery. Is OmegaVia EPA 500 something she should take for the inflammation she gets after every workout.

Thank You

Reply

Vin Kutty September 30, 2013 at 6:58 pm

Hi Bernadette – EPA works really well for inflammation, especially if you combine with a baby aspirin. This combo would be much safer than taking a lot of pain medications.

Reply

Oneil October 7, 2013 at 11:25 pm

Hey Vin, thanks for all the interesting articles. I’m just wondering if fish oil itself has any vitamin A in it? I know some companies add the extra vitamin D, but that is clearly labeled on the bottle. Thanks!

Reply

Vin Kutty October 8, 2013 at 12:26 am

Hi Oneil – most fish oils don’t. If there is any present, it is purified out, sadly. Another reason to get your nutrients from real food instead of supplements. Some, like traditional or fermented cod liver oils do. The vitamin A in cod liver oil is pre-formed and very well absorbed and that’s a reason why people like it. Vitamin A in carrots and veggies are not the immediately absorbably ‘pre-formed’ kind, so Vitamin A from animal fats is preferable.

I am not a fan of adding Vitamin D to fish oil. I explain why here: http://www.omegavia.com/brenda-watson-omega-3-and-vitamin-d/. Again, MUCH better to get Vitamin D from the sun because skin makes Vit D sulfate and pills are not in the sulfate form. Different things with different benefits.

Reply

Josh Graham October 31, 2013 at 10:57 pm

Does keeping fish oil and multivits in weekly pill box/organizer make them less fresh?

Reply

Vin Kutty November 1, 2013 at 1:26 pm

Hi Josh – no…unless you’re keeping a lot more than a week’s worth and you’re keeping it in bright light. One-week supply, in a pill box in cupboard or cabinet is perfectly fine.

Reply

Randy November 9, 2013 at 4:03 pm

Great info! Vascepa is known NOT to have fishy burps and it is noted on Lovaza’s label that it can cause A-fib. IMO, the anti-inflammatory properties of highly purified EPA with no DHA makes Vascepa the preferred choice in most indications.

Reply

Vin Kutty November 9, 2013 at 6:53 pm

Thank you, Randy. You’re right, there is that note about Lovaza and atrial fibrillation. It is something people report during the first few months…usually. However, there are some studies that support the use of Omega-3 for prevention of a-fib, although the science is inconclusive.

There is no published data on Vascepa causing fishy burps. But I take Vascepa and have noticed fishy burps. So have 3 other users I’ve personally discussed the matter with. So let’s call it an undocumented side effect. This is not a technical property of Vascepa’s active ingredient, EPA ethyl ester. It is simply a combination of several factors: the age of the oil, storage conditions, lack of enteric coating and individual physiology. EPA is highly susceptible to oxidation and when (not if) this occurs with time, some people will experience burping. In that regard, it is not significantly different from DHA.

Reply

Melissa February 1, 2014 at 12:34 am

My grandma always kept her fish oil tablets in the freezer. She said it stopped the “fishy burps”, I do not know if this is a feasible idea but it was a “trick” she used.

Reply

Vin Kutty February 1, 2014 at 11:13 pm

Hi Melissa – I’ve heard the same trick many times too. I don’t know if it really works, but certainly, the enteric coating found on modern Omega-3 supplements will fix the problem. Other tricks include taking the pill right before falling asleep or just before a meal.

Reply

Munish November 11, 2013 at 12:05 am

Hi Vin,

Is there any instrument out there that will tell the sugar content. I am indian and 95% of the time we are eating simple indian food. Rice, chappati (wheat) and lentils and green vegetales, all cooked in olive oil. The only issue I have is my TG are high and even after working out it is still high.
After reading your article, it is possible it is all the sugar/starch that comes with indian food.

So, in short how can I measure the amount of starch/sugar a chappati or rice has, this way I can control it.

Thanks
Munish

Reply

Vin Kutty November 11, 2013 at 11:34 pm

Hi Munish – if the foundation of your diet is wheat and rice, your triglycerides are going to be high. You don’t need an instrument to for that. But here is another option. Eat whatever you want, but get a glucometer from the local drugstore and test your blood sugar an hour after each meal. You know, the finger pin prick machines…if your blood glucose is higher than 120 – 130, then you’re eating the wrong thing.

If you’re a vegetarian, eat lentils and vegetables, not grains. With a generous amount of olive and coconut oil, of course.

Reply

Nancy November 24, 2013 at 5:44 pm

My grandson was diagnosed for ADHD, can OmegaVia 500 help control his mood and how much he should take daily. He is 13 yrs old .

Thank you

Reply

Vin Kutty November 25, 2013 at 4:28 am

Hi Nancy – it could definitely help if his mood/behavior is a result of Omega-3 deficiency. I’d give him 2 per day and see how he does. But if you want to see dramatic improvements, cut out the soda, processed foods, fast foods, wheat and dairy. Wheat is a biggie. If these constitute most of this calories, then you have the answer to your problem.

Reply

emmett jones November 25, 2013 at 5:55 pm

I have emailed you before, and concerned about what I see on different sites. The latest study I saw, says that HDL is not as thought a protective indicator of heart health. The study says that in studing people that dies from heart attacks, that they most all had healthy levels of HDL. It also said that they know know that small particles of LDL is the main culprit. If this is true, what about the HDL I ahve been hearing about for so many years? Also on another matter, what was the new product you mentioned to me that was coming to compete with Vascepa?

Reply

Vin Kutty November 25, 2013 at 10:49 pm

Hi Emmett – in terms of what is truly indicative of your heart health risk, total cholesterol is pretty poor. LDL is somewhat better, HDL and triglyceride is even better. Many doctor use triglyceride/HDL ratio or total chol/HDL ratio, which are again, even better. Having small dense LDL particles is a high risk indicator. One of the best is oxidized LDL, but that’s difficult to measure. High-sensitivity C-reactive protein (hsCRP) is another very telling one. One thing’s for sure – that total cholesterol is a relatively useless number because it combines numbers that are supposed to be high and low.

So saying that HDL is a poor indicator flies against most of the published science. There is no good drug to increase HDL. Niacin bumps up HDL but it is not without issues. Exercise, activity and increasing consumption of healthy fats (olive oil, coconut oil, grass-fed butter) will all increase HDL.

This product is relatively similar to Vascepa but is half the pill size and half the dosage. SO you’ll have to double up on the pills. http://www.omegavia.com/epa-500/

This company here http://www.shiel.com/themes/site_themes/agile_records/images/uploads/Shiel-Oxidized-LDL-Triple-Marker-Test.pdf combines HDL, oxidized LDL and hsCRP to give you a score that, they claim, is far better predictor of future events.

Reply

vicki nowak February 4, 2014 at 10:30 pm

Hi Emmett,

My Tri’s are very high as well as my Cholesterol! My Dr. perscribed Vascepa and 4000 mg. of one the counter Omega 3 Krill Oil…! My stomach is extremely upset (I have IBS and fibromyalgia). In your opinion, is the Vascepa enough? ps This dr. is known to over-medicate

Reply

John February 25, 2014 at 6:30 pm

Hi Vin,

Is the new EPA only supplement you sell more appropriate for kids than regular Omegavia? My kids (boys age 7 and 9)can take the larger pill just fine, but if EPA only is more appropriate, I can switch them to that. Thanks.

Reply

Vin Kutty February 25, 2014 at 7:58 pm

Hi John – if they can take regular OmegaVia, that’s fine. But if you are concerned about mood, focus, inflammation related conditions like asthma, skin issues etc., a little extra EPA can help.

Reply

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