Omega-3-acid ethyl esters
Identification
- Summary
Omega-3-acid ethyl esters is a mixture of fatty acids used as an adjunct to diet to reduce triglyceride (TG) levels in adult patients with severe hypertriglyceridemia.
- Brand Names
- Lovaza, Omtryg
- Generic Name
- Omega-3-acid ethyl esters
- DrugBank Accession Number
- DB09539
- Background
Omega-3-acid ethyl esters are prescription drugs that contain eicosapentaenoic acid-ethyl ester (EPA) and docosahexaenoic acid-ethyl ester (DHA) that are used in combination with changes in diet to lower triglyceride levels in adults with severe (≥ 500 mg/dL) hypertriglyceridemiaLabel2. Omega-3-acid ethyl esters are currently marketed in the US, EU, and many other regions under the brand name LovazaLabel4.
- Type
- Small Molecule
- Groups
- Approved, Investigational
- Synonyms
- Omega-3 fatty acid ethyl esters
- Omega-3-acid ethyl esters
- External IDs
- K-85
- K85
- TAK-085
Pharmacology
- Indication
Omega-3-Acid Ethyl Esters capsules, USP are indicated as an adjunct to diet to reduce triglyceride (TG) levels in adult patients with severe (≥500 mg/dL) hypertriglyceridemia (HTG)Label2.
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Indication Type Indication Combined Product Details Approval Level Age Group Patient Characteristics Dose Form Management of Severe hypertriglyceridemia •••••••••••• - Contraindications & Blackbox Warnings
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- Pharmacodynamics
Omega-3-acid ethyl esters reduce triglyceride production, increase fatty acid metabolism, inhibit the release of fatty acids, increase triglyceride clearance, and decrease production of very low density lipoprotein cholesterol(VLDL-C)2.
- Mechanism of action
Omega-3-acid ethyl esters reduce triglyceride production by the liver but this mechanism is not well understood2. Omega-3-acid ethyl esters inhibit acyl-CoA:1,2-diacylglycerol acyltransferase, reducing triglyceride synthesis and increasing paroxysmal beta-oxidation, which increases fatty aside metabolism2. Omega-3-acid ethyl esters also inhibit the release of fatty acids by competing for enzymes involved in the synthesis of triglycerides, increase triglyceride clearance by increasing the activity of lipoprotein lipase, and decrease production of VLDL-C2.
Target Actions Organism USterol regulatory element-binding protein 1 inhibitorHumans - Absorption
Omega-3-acid ethyl esters are rapidly hydrolysed to free fatty acids in the intestinal lumen which then become incorporated into phospholipids, cholesterol, and triglycerides so determination of bioavailability by serum concentration is not possible5,3.
- Volume of distribution
82 ± 56L1
- Protein binding
Because omega-3-acid ethyl esters are rapidly hydrolysed and incorporated into other processes and structures, protein binding data is scarceLabel5. However, most of EPA is bound to plasma protein6.
- Metabolism
Omega-3-acid ethyl esters are hydrolysed to free fatty acids in the intestinal lumen by pancreatic lipase3. Once in enterocytes, the free fatty acids are packaged in chylomicrons which are released from cells into the circulation3. Fatty acids then enter the liver where they can be incorporated into liver stores, incorporated into lipoprotein phospholipids, or oxidised for energy5.
- Route of elimination
Includes oxidative catabolism to carbon dioxide and water
- Half-life
79 hours ± 47 hours1.
- Clearance
757 mL/h ± 283mL/h1.
- Adverse Effects
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- Toxicity
In rats, omega-3-acid ethyl esters are not mutagenic or clastogenic and do not lead to impairment of fertilityLabel.
Safety in human pregnancy have not been performed, however an embryocidal effect was seen in rats force fed 7 times the maximum recommended human doseLabel. The risk and benefit of treatment during pregnancy should be weighed before deciding on treatmentLabel.
Animal studies in lactating rats have shown excretion of omega-3-acid ethyl esters at concentrations 6 to 14 times higher than in the serum of the mother, however the effects of this excretion on a mother or child have not been establishedLabel.
Safety and effectiveness in pediatric patients has not been establishedLabel.
There appear to be no differences in the safety and efficacy in patients above or below 60 years of age based on limited dataLabel.
- Pathways
- Not Available
- Pharmacogenomic Effects/ADRs Browse all" title="About SNP Mediated Effects/ADRs" id="snp-actions-info" class="drug-info-popup" href="javascript:void(0);">
- Not Available
Interactions
- Drug Interactions Learn More" title="About Drug Interactions" id="structured-interactions-info" class="drug-info-popup" href="javascript:void(0);">
- This information should not be interpreted without the help of a healthcare provider. If you believe you are experiencing an interaction, contact a healthcare provider immediately. The absence of an interaction does not necessarily mean no interactions exist.
Drug Interaction Integrate drug-drug
interactions in your softwareAbciximab The risk or severity of bleeding can be increased when Omega-3-acid ethyl esters is combined with Abciximab. Acenocoumarol The risk or severity of bleeding can be increased when Omega-3-acid ethyl esters is combined with Acenocoumarol. Acetylsalicylic acid The risk or severity of bleeding can be increased when Omega-3-acid ethyl esters is combined with Acetylsalicylic acid. Alteplase The risk or severity of bleeding can be increased when Omega-3-acid ethyl esters is combined with Alteplase. Anagrelide The risk or severity of bleeding can be increased when Omega-3-acid ethyl esters is combined with Anagrelide. - Food Interactions
- Take with a full glass of water.
- Take with food. Take with food to reduce gastrointestinal disturbance.
Products
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- Active Moieties
Name Kind UNII CAS InChI Key Omega-3 fatty acids unknown 71M78END5S 329042-31-1 Not applicable - Product Images
- Brand Name Prescription Products
- Generic Prescription Products
Name Dosage Strength Route Labeller Marketing Start Marketing End Region Image Lovaza Capsule, liquid filled 1 g/1 Oral Woodward Pharma Services Llc 2015-11-30 Not applicable US Omega-3-Acid Ethyl Ester Capsule, liquid filled 900 mg/1 Oral Bionpharma Inc. 2017-01-15 Not applicable US Omega-3-Acid Ethyl Ester Capsule, liquid filled 900 mg/1 Oral bryant ranch prepack 2017-01-15 Not applicable US Omega-3-acid ethyl esters Capsule, liquid filled 1 g/1 Oral American Health Packaging 2016-10-13 Not applicable US Omega-3-acid Ethyl Esters Capsule, liquid filled 1 g/1 Oral Lifestar Pharma Llc 2021-11-16 Not applicable US - Mixture Products
Name Ingredients Dosage Route Labeller Marketing Start Marketing End Region Image Omega-3 Rx Complete Omega-3-acid ethyl esters (1 g/1) + Ascorbic acid (60 mg/1) + Biotin (.075 mg/1) + Calcium (210 mg/1) + Chromium nicotinate (.12 mg/1) + Copper (2 mg/1) + Cyanocobalamin (.018 mg/1) + Folic acid (.4 mg/1) + Lycopene (.3 mg/1) + Magnesium (140 mg/1) + Magnesium oxide (140 mg/1) + Nicotinamide (18 mg/1) + Pantothenic acid (.016 mg/1) + Phylloquinone (.020 mg/1) + Riboflavin (1.7 mg/1) + Selenium (.11 mg/1) + Thiamine chloride (1.35 mg/1) + Vitamin A (3500 [iU]/1) + Vitamin D (700 [iU]/1) + Vitamin E (22.5 [iU]/1) + Zinc oxide (15 mg/1) Kit Oral Tmig, Inc. 2015-09-01 Not applicable US Omega-3 Well Pack Omega-3-acid ethyl esters (1 g/1) + Vitamin D (1000 [iU]/1) Kit Oral Tmig, Inc. 2015-09-01 Not applicable US Omega-3 Well Pack Omega-3-acid ethyl esters (1 g/1) + Vitamin D (1000 [iU]/1) Kit Oral Cloverleaf Pharma Llc 2015-09-01 Not applicable US Sure Result O3D3 System Omega-3-acid ethyl esters (1 g/1g) + Vitamin D (1000 [iU]/1) Kit Oral International Brand Management, Llc 2016-03-05 Not applicable US - Unapproved/Other Products
Name Ingredients Dosage Route Labeller Marketing Start Marketing End Region Image Concept DHA Omega-3-acid ethyl esters (200 mg/1) + Ascorbic acid (25 mg/1) + Biotin (300 ug/1) + Cupric sulfate pentahydrate (2 mg/1) + Cyanocobalamin (12.5 ug/1) + Ferrous fumarate (17.5 mg/1) + Folic acid (1 mg/1) + Iron (17.5 mg/1) + Magnesium sulfate (5 mg/1) + Niacin (1.8 mg/1) + Calcium pantothenate (5 mg/1) + Pyridoxine hydrochloride (25 mg/1) + Riboflavin (3 mg/1) + Thiamine mononitrate (2 mg/1) + Zinc sulfate, unspecified form (10 mg/1) Capsule, liquid filled Oral U.S. Pharmaceutical Corporation 2009-06-24 Not applicable US Divista Omega-3-acid ethyl esters (300 mg/1) + Biotin (2 mg/1) + Chromium picolinate (1000 ug/1) + Cyanocobalamin (15 ug/1) + Folic acid (1 mg/1) + Pyridoxine (25 mg/1) Capsule Oral Us Pharmaceutical Corporation 2010-07-10 2011-09-30 US Luvira Omega-3-acid ethyl esters (1220 mg/1) + (12R)-12-hydroxyeicosapentaenoic acid (465 mg/1) + Doconexent (375 mg/1) Capsule Oral Sterling-Knight Pharmaceuticals, LLC 2019-11-07 2020-01-17 US Mi-Omega NF Omega-3-acid ethyl esters (500 mg/1) + Cyanocobalamin (500 ug/1) + Folic acid (1 mg/1) + Pyridoxine hydrochloride (12.5 mg/1) + beta-Sitosterol (200 mg/1) Capsule Oral Mayne Pharma 2009-01-01 2016-05-31 US Multinate DHA Omega-3-acid ethyl esters (430 mg/1) + Ascorbic acid (120 mg/1) + Beta carotene (3000 [iU]/1) + Calcium carbonate (200 mg/1) + Cholecalciferol (400 [iU]/1) + Cupric oxide (2 mg/1) + Cyanocobalamin (12 ug/1) + Doconexent (295 mg/1) + Folic acid (1 mg/1) + Iron (29 mg/1) + Magnesium oxide (25 mg/1) + Nicotinamide (20 mg/1) + Pyridoxine hydrochloride (25 mg/1) + Riboflavin (4 mg/1) + Thiamine mononitrate (1.8 mg/1) + Vitamin E (30 mg/1) + Zinc oxide (25 mg/1) Kit Oral River's Edge Pharmaceuticals, LLC 2009-09-01 2011-04-20 US
Categories
- Drug Categories
- Classification
- Not classified
- Affected organisms
- Humans and other mammals
Chemical Identifiers
- UNII
- D87YGH4Z0Q
- CAS number
- 308081-97-2
References
- General References
- Braeckman RA, Stirtan WG, Soni PN: Pharmacokinetics of Eicosapentaenoic Acid in Plasma and Red Blood Cells After Multiple Oral Dosing With Icosapent Ethyl in Healthy Subjects. Clin Pharmacol Drug Dev. 2014 Mar;3(2):101-108. Epub 2013 Oct 22. [Article]
- Koski R: Omega-3-acid Ethyl Esters (Lovaza) For Severe Hypertriglyceridemia Pharmacy and Therapeutics. 2008 May;33(5):271-303. [Article]
- Davidson MH: Omega-3 fatty acids: new insights into the pharmacology and biology of docosahexaenoic acid, docosapentaenoic acid, and eicosapentaenoic acid. Curr Opin Lipidol. 2013 Dec;24(6):467-74. doi: 10.1097/MOL.0000000000000019. [Article]
- Omega-3-acid ethyl esters 90 (K85EE) [Link]
- Australian Public Assessment Report for Omega-3-acid ethyl esters 90 [Link]
- FDA reports [Link]
- External Links
- PubChem Substance
- 347910460
- 484348
- Wikipedia
- Omega-3_acid_ethyl_esters
- FDA label
- Download (177 KB)
- MSDS
- Download (176 KB)
Clinical Trials
- Clinical Trials Learn More" title="About Clinical Trials" id="clinical-trials-info" class="drug-info-popup" href="javascript:void(0);">
Phase Status Purpose Conditions Count 4 Active Not Recruiting Prevention Diabetes Mellitus 1 4 Completed Other Hyperlipidemias 2 4 Completed Prevention Atrial Fibrillation 1 4 Completed Treatment Acquired Immune Deficiency Syndrome (AIDS) / Dyslipidemia / Human Immunodeficiency Virus (HIV) Infections / Hypertriglyceridemias 1 4 Completed Treatment Atherosclerosis / Type 2 Diabetes Mellitus 1
Pharmacoeconomics
- Manufacturers
- Not Available
- Packagers
- Not Available
- Dosage Forms
Form Route Strength Capsule, liquid filled Oral Capsule Oral 500 mg Capsule, liquid filled Oral 900 mg/1 Capsule Oral Capsule Oral Kit Oral Capsule, liquid filled Oral 1 g/1 Capsule Oral 1 g/1g Capsule Oral 1 g/1 Capsule Oral 900 mg/1 Tablet Oral Capsule Oral 1000 mg - Prices
- Not Available
- Patents
- Not Available
Properties
- State
- Liquid
- Experimental Properties
Property Value Source melting point (°C) <20 [MSDS] boiling point (°C) >400 [MSDS] water solubility Not Soluble [MSDS] - Predicted Properties
- Not Available
- Predicted ADMET Features
- Not Available
Spectra
- Mass Spec (NIST)
- Not Available
- Spectra
- Not Available
- Chromatographic Properties
Collision Cross Sections (CCS)
Not Available
Targets
- Kind
- Protein
- Organism
- Humans
- Pharmacological action
- Unknown
- Actions
- Inhibitor
- General Function
- Transcriptional activator activity, rna polymerase ii core promoter proximal region sequence-specific binding
- Specific Function
- Transcriptional activator required for lipid homeostasis. Regulates transcription of the LDL receptor gene as well as the fatty acid and to a lesser degree the cholesterol synthesis pathway (By sim...
- Gene Name
- SREBF1
- Uniprot ID
- P36956
- Uniprot Name
- Sterol regulatory element-binding protein 1
- Molecular Weight
- 121673.6 Da
References
- Davidson MH: Omega-3 fatty acids: new insights into the pharmacology and biology of docosahexaenoic acid, docosapentaenoic acid, and eicosapentaenoic acid. Curr Opin Lipidol. 2013 Dec;24(6):467-74. doi: 10.1097/MOL.0000000000000019. [Article]
Enzymes
- Kind
- Protein
- Organism
- Humans
- Pharmacological action
- Unknown
- Actions
- Inhibitor
- General Function
- Sterol o-acyltransferase activity
- Specific Function
- Catalyzes the formation of fatty acid-cholesterol esters, which are less soluble in membranes than cholesterol. Plays a role in lipoprotein assembly and dietary cholesterol absorption. In addition ...
- Gene Name
- SOAT1
- Uniprot ID
- P35610
- Uniprot Name
- Sterol O-acyltransferase 1
- Molecular Weight
- 64733.975 Da
Drug created at November 30, 2015 19:10 / Updated at February 21, 2021 18:52