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

Vascepa – A New Prescription Fish Oil Drug for Triglycerides

by Vin Kutty, MS 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. Please do not start or stop any medications without consulting with your doctor. We neither encourage you to do so, nor can we be held responsible for the fall out of failing to seek the counsel of a medical health practitioner.

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.

Share this:
Share this page via Email Share this page via Stumble Upon Share this page via Digg this Share this page via Facebook Share this page via Twitter

{ 39 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

fas June 12, 2014 at 8:31 am

thank you for this invaluable article . I’m 63, known hypertensive subject , on Natrilix SR, my TG value is 200 mg , LDL and HDL are within normal ranges . since last thursday I stopped taken Natrilix due to its adverse side effects ( good control of BP but with severe dibility). I stopped eating bread , milk products and concentrated on beans , nuts( peanuts) , with omega 3. I’m monotring my blood pressure regularly and it is still OK.
please advise.

Reply

Vin Kutty, MS June 12, 2014 at 5:26 pm

Hi fas – please make sure you consult with your doctor about stopping or adding prescription medication. Removing bread and sugar from you diet is always a good idea, but again, work with a nutritionist to customize your diet for your health goals.

Reply

James Ehrlich July 6, 2014 at 4:02 am

The entire premise behind developing vascepa and their entire marketing plan depends on a fallacy that any lipidologist understands but sadly few internists appreciate. It does not matter if LDL C is elevated with lovaza as long as apoB or LDL P or particle number is lowered by fish oils. Remnant lipoproteins, size density and # of atherogenic particles are nicely controlled by lovaza so the success of vascepa in the marketplace depends on the prevalence of ignorant docs who care about LDL C and have never ordered advanced testing. Amarin apparently believes its own nonsense and is living a lie. I hate products that look worse the more you understand the field… Vascepa falls apart on scrutiny and appeals only to dumb docs

Reply

Vin Kutty, MS July 6, 2014 at 11:05 am

Well put. Vascepa may be a solution in search of a problem…?

Reply

Gary Head July 20, 2014 at 6:16 am

Well Vin , apparently you and James Ehrlich have never heard of Dr Nissen ..Chair of Cardiology at the Cleveland Clinic ..I guess he is what you two refer to as just another ” ignorant doc who cares about LDL-C ”

If you consider Vascepa ( Rx EPA ) ” a solution in search of a problem ” then does that apply to your Omegia Via EPA 500 as well ?
After all , since I take /taken both I’d like to know .

Vascepa and your Omegia Via EPA are ideal for patients ( of which I am one ) with hetero familia hypercholestremia and who still have elevated TG’s levels despite max dose Statins . Perhaps Mr Ehrich can enlighten you on why Lovaza is not recommended for patients such as myself or those at risk of A Fib..
You correctly identified the role of inflammation in cardiovascular disease …care to compare the effects of Lovaza and Vascepa on lowering hsCrp ( inflammation )

The chart you linked to shows the drop in Amarins stock price when the FDA Adcom voted against approving Vascepa for the mixed dyslipidemia indication . While the FDA usually follows the Adcom recommendations , in this case they have not yet issued a final decision and are in fact reviewing complex issues relating to the 3 outcome trials cited during Adcom.

Omegia Via EPA is a viable alternative for those denied insurance coverage for Vascepa. Thank you for developing it and bringing it to the market place . For patients taking it at 4 gm daily dose please ensure the quality and quantity of EPA is maintained at the highest standard as after all ..its FDA regulated as a food not as a drug …and some of us are using it as a drug.
Gary

Reply

Vin Kutty, MS July 20, 2014 at 9:44 pm

Hi Gary – just to be clear, I don’t and won’t refer to any doctor as ‘ignorant doc who cares about LDL-C.’ Mostly because that would be rude. Others are, of course, welcome to say what they wish. If it is not too offensive/combative, it will get posted here. Having said that, in the spectrum of LDL-C deniers to LDL-C phobes who beat it down any time it approaches 75, I am somewhere in the middle. I think there is definitely a need for understanding LDL particle number and size/density in people with elevated risk. However, I understand the concern expressed by Dr. Ehrlich that there is disproportionate attention paid to LDL-C and that marketing any EPA-only drug (while vilifying DHA) without truly understanding DHA’s effect on LDL-P and size/density is at best premature or at worst entrepreneurial (a solution in search of a problem?). I understand that nuance does not sell. Ask any politician. So why can’t a pharma company take a hint. Amarin is not wrong when they say Lovaza raises LDL. And completely ignoring LDL-C is probably not wise even if it is not the most telling of indicators.

So why did we introduce our EPA 500 product? Inflammation and mood primarily. DHA above and beyond what is required for daily sustenance is contraindicated for depression. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3534764/
And, of course, triglyceride reduction. It’s a great option for those with familial hypercholesterolemia too.

Thank you for using OmegaVia EPA 500. We will continue to maintain or improve the quality and quantity of EPA while keeping the price accessible.

Reply

james ehrlich July 20, 2014 at 10:03 pm

This will be my last post here. I am reasonably confident, after speaking with staff at Amarin that they will be able to better articulate why it is desirable to lower LDL-C in addition to LDL-P and ApoB. I provided their medical staff with a very strong rationale for lowering all 3 biomarkers—-they just had not thought it out well enough, in my opinion.

I may have been too strong in characterizing physicians who do not consider advanced lipids……ignorant was not the best choice of words. Having said that, I recognize Dr. Nissen’s contribution to cardiology (IVUS, etc), but also realize he has done a complete disservice in preventive cardiology by dismissing the value of coronary calcium imaging and he has been completely dishonest in this area of medicine. I will not go into details in this forum as this is my last post. I am not a fan of Dr. Nissen although i believe he has made significant contributions in intravascular ultrasound.

Reply

Gary Head July 21, 2014 at 6:00 pm

James
Hopefully that was not your last post .
Vin is smart enough to allow divergent views to be openly aired …allow the light of scrutiny to expose the truth.
We all benefit from the exchange of views, presented respectfully.
Gary

Reply

james ehrlich July 22, 2014 at 3:07 am

thanks….well maybe i will continue to comment. However, I assured people at Amarin that I would not be discussing their product on a website…..but anything related to lipids and preventive cardiology is of interest to me.

Reply

Gary Head July 22, 2014 at 11:22 pm

That is great James .
I’m hetero familia hypercholestremia with a dash of mixed dyslipidemia ( despite max dose Statins ) thrown in ….so its great to have access to MD’s such as yourself ,who work in preventive Cardiology .
Gary

Reply

Gary Head July 24, 2014 at 3:18 pm

Hi James and Vin
Just wondering if you are familiar with the following study

Purified Eicosapentaenoic Acid Reduces Small Dense LDL, Remnant Lipoprotein Particles, and C-Reactive Protein in Metabolic Syndrome

Its in the Journal Diabetes Care and I believe is the first study to demonstrate that purified EPA reduces sdLDL. remnants and CRP , therefore potentially reducing the risk of Cardio Vascular disease in at least these patients .

I believe there are over 10m diabetics in the US …many of which may benefit from your Omegia Via EPA 500 , Vin …if they have been unable to get a script , or been denied insurance coverage , for Vascepa

Gary

Reply

Vin Kutty, MS July 24, 2014 at 6:05 pm

Hi Gary – yes, this paper and the JELIS study from Japan that came out just before this paper were very positive. Tiny, EPA-only Rx pills are widely available in Japan and are subsidized by the govt…despite them being a heavy fish-eating culture.

Reply

Gary Head September 9, 2014 at 3:20 am

Hi Vin
Just an update on my views of Amarins Vascepa , your Omegia Via EPA and the FDA…Sept 9th 2014
Dr Jenkins has convened a council at the FDA to render a judgement on whether Amarins Vascepa should be approved for wider use ( I’m giving you the short version ) .

This decision is likely to be announced within the next 2 weeks.
If the FDA approves an expanded label ( ie approves it use for Diabetics etc ) …which in not certain , but likely . based on recent research published in the New England Journal of Medicine on the role of Triglycerides in heart disease …. there will be an increased demand for purified EPA fish oil .

For those with generous insurance coverage this demand will be met with Rx prescribed Amarins Vascepa.
For those without insurance , your OmegiaVia EPA provides the best dietary supplement alternative.

As an advocate for patients ….may I suggest you prepare yourself for increased demand should the FDA approve wider use of Amarins Vascepa.
Not everyone will have insurance coverage to pay for Vascepa
Many will seek lower cost , dietary supplement alternatives , of which your is the best .

However , it is important that you market Omegia Via EPA for what it is … an FDA approved dietary supplement , not an FDA approved drug …and insure the best quality of product and delivery of product possible .

Heres hoping to a wider use of highly purified EPA fish oil
Gary

Reply

Vin Kutty, MS September 9, 2014 at 10:31 pm

Hi Gary – thank you for this information and your vote of confidence in OmegaVia EPA 500. We will continue to make the best dietary supplement form of EPA Omega-3 we can.

Reply

Gary Head September 12, 2014 at 8:05 pm

My wife had requested some Omegia Via EPA
It was ordered direct from your company , delivered by regular mail…USPS …into our mail box …in perfection condition

This method of delivery works far better in our experience then buying thru Amazon who normally use UPS and the box can end up anywhere on the front of our property.

In other news ..the FDA has unfortunately declined to approve Amarins Vascepa ( Rx EPA ) for wider use , apparently deciding to wait for the results of Amarins Outcome trial before approving for cardiovascular benefit.

Reply

Vin Kutty, MS September 12, 2014 at 8:25 pm

Hi Gary – glad you found a shipping method that works well.

Reply

Larry Stewart October 15, 2014 at 12:58 pm

I wonder if it is cheaper in Europe or Mexico? Odd that anything that really works has to be a script and so darn expensive. Even with my co-pay I can’t do this stuff. Any alternatives?

Reply

Gary Head October 15, 2014 at 7:26 pm

Larry
Noticed your comment .
To my knowledge Vascepa is only available in the US .

Omegia Via EPA is in my experience , the best dietary supplement alternative to Rx Vascepa . ( I’ve had lipid panel /blood tests run comparing 3 months on Omegia Via EPA vs Vascepa and Triglyceride lowering effect are very similar)

Its important to remember tho that if you are taking Omegia Via EPA as a drug ..instead of Vascepa ….that its FDA regulated as a food NOT as a drug …so we depend on Vin and his team to maintain the highest quality possible .
Good luck
Gary

Reply

Leave a Comment

Previous post:

Next post:


ABOUT SSL CERTIFICATES
Innovix Pharma, Inc., Vitamins & Food Supplements, Calabasas, CA
Hassle-free returns and refunds