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Medication Spotlight [Vascepa]

Vascepa, otherwise known as icosapent ethyl, is indicated as add-on therapy to statins for the reduction of triglycerides to decrease the risk of cardiovascular (CV) events in patients with established cardiac history or diabetes with CV risk.

---------------- Role in Therapy

Statins are effective medications for reducing LDL cholesterol, but have only a moderate effect on triglycerides. Some patients may continue to experience myocardial infarction or stroke despite being on a statin.

In the past, niacin, fenofibrates and low dose omega-3 have not been proven to reduce cardiovascular outcomes when added to statins. Some people may view Vascepa as “expensive omega-3”, but the evidence is interesting because clinical trials have shown that it is able to further reduce triglycerides and cardiovascular risk.


Mechanism of Action

While over-the-counter omega-3 supplements contain both DHA and EPA fatty acids, Vascepa only contains 96% pure EPA, according to the manufacturer. DHA can increase LDL levels, so through an omega-3 purification process, DHA is removed, along with saturated fats, toxins and impurities. Since triglycerides plays a role in the development of athersclerotic plaques in cardiovascular disease, this could be an additional benefit to these patients.

---------------- Dosing

Two 1 gram capsules twice daily with food = 4 grams total daily

---------------- Adverse Effects and Drug Interactions

The most common adverse effects of Vascepa include peripheral edema, constipation and atrial fibrillation. Other potential adverse effects noted from other countries’ data may include extremity pain, arthralgia, gout, and abdominal symptoms.

Vascepa may increase the risk of bleeding, so caution with blood thinners is recommended. Also, be aware of therapeutic duplication with over-the-counter omega-3 supplements because patients may not be aware that Vascepa is a form of omega-3. Be aware of allergies to fish or shellfish products as cross-allergy may be possible.

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