I suggest you send this to the pharmacist
I am writing today to clarify the appropriate positioning of medications known as OMEGA -3. These medications are often called “fish oil” by people without adequate knowledge. It is important to realize that there are many types of Omega 3 oils but for our purposes we need to only discuss two, DHA and EPA. There are significant differences in how each of these substance react at the biochemical level within the human body. I will not delve into this, for brevity's sake, but suffice it to say that EPA substantially reduces inflammation.
Lovaza (and generic Lovaza) contains DHA and EPA. Lovaza (and its generic) is only approved to reduce triglycerides over 500mg/dl . Lovaza actually increases LDL by a whopping 49%. It is theorized that this is a result of the DHA component.
Vascepa is pure EPA (Isocapent ethyl). In a landmark study called REDUCE IT – Coronary events were reduced by a substantial 25% in individuals already on statins who were prescribed Vascepa . (The reduction would have probably been much more on individuals not taking statins ) Recent analysis of data also suggests CVA reduction by 30% . It is theorized that EPA is achieving this by reduction of inflammation.
Appropriate classification and positioning of Omega 3 medications.
Lovaza (L) and Generic Lovaza (gL)
These are a combinations of EPA and DHA. The only appropriate utilization is for triglycerides > 500 to prevent pancreatitis. You should note that if you have this listed under CARDIOVASCULAR DRUGS – antilipemics ( as you also may have listed fibrates / niacin etc.) that NONE of these drugs have any outcomes study showing any improvement in Cardiovascular outcomes!. The only possible use of these medications is the reduction of triglycerides > 500 for the prevention of pancreatitis. Lovaza may actually induce cardiovascular disease since it increases LDL by 49%. These medications should NOT be listed as cardiovascular medicines.
Vascepa (V) and Generic Vascepa (gV)
These medications contain only EPA – both of these medication can be utilized for Trigs >500mg/dl, however, the fact of the matter is Lovaza (DHA /EPA) works better for pure trig reduction.
The vast majority of prescriptions written for Vascepa are for the REDUCE IT indications (individuals with known CAD or those with Diabetes and two risk factors on statins with trigs > 150 ), meaning it is being utilized to prevent cardiovascular disease. You cannot substitute Lovaza or generic lovaza for these prescriptions - they have NO indication for this and you may actually be harming the patient by increasing their LDL by 49% - Lovaza and Vascepa are DIFFERENT medications and are NOT Interchangeable.
Furthermore if a prescription is written for Vascepa for REDUCE IT indications (95% of use) you cannot substitute generic Vascepa – this is direct patent infringement and law suits are have been filed for such ( Healthnet). Generic Vascepa is ONLY approved for trigs >500 it is NOT approved for reduction of cardiovascular risk and doing so will expose you to liability for direct patent infringement.
In summary:
Omega 3's that can be used for Trigs >500
Lovaza – Generic Lovaza - Vascepa - Generic Vascepa
Omega 3's that can be utilized for cardiovascular risk Reduction
VASCEPA
