Cod liver oil

Identification

Summary

Cod liver oil is an ingredient found in a variety of nutritional products.

Generic Name

Cod liver oil

DrugBank Accession Number

DB11321

Background

Cod liver oil is extracted from the liver of cod fish and mainly consists of omega-3 fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Also being a rich source of vitamin A and D, cod liver oil can be taken orally as daily supplements. It is used as an adjunct treatment and preventative therapy of rickets, osteomalacia and osteoporosis while meeting the consumption criteria.

Type

Small Molecule

Groups

Nutraceutical, Vet approved

Synonyms

• Cod liver oil
• Cod-liver oil
• Gadus morhua liver oil
• Oils, cod liver
• Oleum morrhuae

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Pharmacology

Indication

Cod liver oil is predominantly manufactured, marketed, and used by the population at large as a general nutraceutical dietary supplement ^1,2,7.

Historically, cod liver oil was often given to children because the vitamin d content in the oil had been shown to prevent or treat vitamin D deficiency and condition of rickets associated with it ². Over time, this common use in children growing up may have conferred upon cod liver oil its identity as a healthy and useful all-purpose dietary supplement.

However, since cod liver oil is a composite of several other nutritional compounds including the omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) as well as vitamin A and vitamin D ^2,7,6, the presence in varying amounts of all of these compounds at once makes it difficult to recommend or use cod liver oil as an appropriate supplement to confer any one particular health effect or for any one particular nutritional deficiency.

Regardless, because it does contain a combination of a number of important and healthy nutritional compounds, cod liver oil has sometimes been recommended in the literature for conferring the health effects of some of these compounds, such as the potential use of cod liver oil supplements in post-heart attack patients for secondary prophylaxis associated with the use of omega-3 fatty acids ⁵.

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Associated Conditions

Indication Type	Indication	Combined Product Details	Approval Level	Age Group	Patient Characteristics	Dose Form
Prevention of	Deficiency, vitamin a		••••••••••••			•••••••
Prevention of	Deficiency, vitamin d		••••••••••••			•••••••

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Associated Therapies

• Skin Care

Contraindications & Blackbox Warnings

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Pharmacodynamics

As cod liver oil is a composite of several other nutritional compounds including the omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) as well as vitamin A and vitamin D ^2,7,6, the presence in varying amounts of all of these compounds at once makes it difficult to recommend or use cod liver oil as an appropriate supplement to confer any one particular health effect or for any one particular nutritional deficiency.

For example, one tablespoon of cod liver oil contains approximately 4,080 ug of retinol (vitamin A) and 34 ug (1,360 IU) of vitamin D ⁶. Since the general dietary reference intake of vitamin A is only 900 ug per day for adult men, 700 ug per day for women, and 3000 ug per day as the tolerable upper intake level, the regular intake of cod liver oil as a regular supplement can result in harmful levels of vitamin A accumulating in the liver and sufficient to cause hypervitaminosis A ³, which is associated with various symptoms such as blurred vision, changes in consciousness, skin and hair changes, liver damage, among many others.

Moreover, while cod liver oil only contains a certain percentage of the omega-3 fatty acids EPA and DHA per amount of the oil ⁶, separate fish oils supplement products that exclusively consist of only EPA and DHA are available in a great variety of different percentage content formulations, even including prescription strength formulations should certain patients need such a level of therapy. Furthermore, such exclusive omega-3 fatty acid supplement products do not contain any vitamin A or D either, which allows patients to use the supplements without any concern about affecting their vitamin A or D levels or exposing themselves to the unnecessary excess intake of vitamins.

Subsequently, although cod liver oil contains a combination of healthy dietary supplements like EPA, DHA, vitamin A, and vitamin D, the presence in varying amounts of all of these compounds all at once makes it difficult to effectively titrate for appropriate amounts of intake for all the compounds involved when using cod liver oil as a general supplement, often resulting in either an excess or insufficient amount of one or more the aforementioned compounds.

Nevertheless, because cod liver oil does consist of the component compounds of EPA, DHA, vitamin A, and vitamin D, further information about the pharmacodynamics of these cod liver oil components can be found by searching for fish oil, vitamin A, and vitamin D on DrugBank.

Mechanism of action

As cod liver oil consists of the component compounds of eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), vitamin A, and vitamin D ^2,7,6 further information about the mechanisms of action of these cod liver oil components can be found by searching for fish oil, vitamin A, and vitamin D on DrugBank.

Absorption

As cod liver oil consists of the component compounds of eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), vitamin A, and vitamin D ^2,7,6 further information about the absorptions of these cod liver oil components can be found by searching for fish oil, vitamin A, and vitamin D on DrugBank.

Volume of distribution

As cod liver oil consists of the component compounds of eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), vitamin A, and vitamin D ^2,7,6 further information about the volumes of distribution of these cod liver oil components can be found by searching for fish oil, vitamin A, and vitamin D on DrugBank.

Protein binding

As cod liver oil consists of the component compounds of eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), vitamin A, and vitamin D ^2,7,6 further information about the protein binding of these cod liver oil components can be found by searching for fish oil, vitamin A, and vitamin D on DrugBank.

Metabolism

As cod liver oil consists of the component compounds of eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), vitamin A, and vitamin D ^2,7,6 further information about the metabolism of these cod liver oil components can be found by searching for fish oil, vitamin A, and vitamin D on DrugBank.

Route of elimination

As cod liver oil consists of the component compounds of eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), vitamin A, and vitamin D ^2,7,6 further information about the routes of elimination of these cod liver oil components can be found by searching for fish oil, vitamin A, and vitamin D on DrugBank.

Half-life

As cod liver oil consists of the component compounds of eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), vitamin A, and vitamin D ^2,7,6 further information about the half-lives of these cod liver oil components can be found by searching for fish oil, vitamin A, and vitamin D on DrugBank.

Clearance

As cod liver oil consists of the component compounds of eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), vitamin A, and vitamin D ^2,7,6 further information about the clearance of these cod liver oil components can be found by searching for fish oil, vitamin A, and vitamin D on DrugBank.

Adverse Effects

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Toxicity

As cod liver oil consists of the component compounds of eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), vitamin A, and vitamin D ^2,7,6 further information about the toxicities of these cod liver oil components can be found by searching for fish oil, vitamin A, and vitamin D on DrugBank.

Pathways

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Interactions

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Food Interactions

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Products

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Over the Counter Products

Name	Dosage	Strength	Route	Labeller	Marketing Start	Marketing End	Region	Image
COD LIVER OIL CAPSULES	Capsule	270 mg		ห้างหุ้นส่วนจำกัด โรเยลดรักส์	1984-02-14	Not applicable
Cod Liver Oil Liq 100%	Liquid	100 %	Oral	Regal Pharms, Division Of Bradcan Corporation	1977-12-31	1998-07-29
Omeza Skin Protectant Gel	Gel	14.24 g/100mL	Topical	Omeza LLC	2022-11-21	Not applicable
Omeza Skin Protectant Gel	Gel	0.2712 mg/100mL	Topical	Omeza LLC	2022-11-21	Not applicable
น้ำมันตับปลา	Capsule	275 mg		บริษัท เมก้า ไลฟ์ไซแอ็นซ์ จำกัด (มหาชน)	1988-03-02	Not applicable

Mixture Products

Name	Ingredients	Dosage	Route	Labeller	Marketing Start	Marketing End	Region	Image
Caldesene Medicated Ointment	Cod liver oil (15 %) + Zinc oxide (15 %)	Ointment	Topical	Novartis	1994-04-21	2000-07-19
CURACID Dermal for cuts and burns	Cod liver oil (100 mg/1mL) + Petrolatum (300 mg/1mL)	Ointment	Topical	Rev Pharma Corp.	2019-05-01	Not applicable
Curefini	Cod liver oil (100 mg/1mL) + Petrolatum (300 mg/1mL)	Ointment	Topical	Miramar Cosmetic, Inc.	2022-06-01	Not applicable
Curefini	Cod liver oil (100 mg/1mL) + Petrolatum (300 mg/1mL)	Ointment	Topical	Rev Pharma Corp.	2013-01-17	Not applicable
Curefini	Cod liver oil (100 mg/1mL) + Petrolatum (300 mg/1mL)	Ointment	Topical	Pure Source, Llc	2013-01-17	Not applicable

Categories

Drug Categories

• Diet, Food, and Nutrition
• Dietary Fats
• Dietary Fats, Unsaturated
• Fats
• Fats, Unsaturated
• Fish Oils
• Food
• Lipids
• Micronutrients
• Oils
• Physiological Phenomena

Classification

Not classified

Affected organisms

• Humans and other mammals

Chemical Identifiers

UNII

BBL281NWFG

CAS number

8001-69-2

References

General References

1. Lentjes MA, Welch AA, Mulligan AA, Luben RN, Wareham NJ, Khaw KT: Cod liver oil supplement consumption and health: cross-sectional results from the EPIC-Norfolk cohort study. Nutrients. 2014 Oct 16;6(10):4320-37. doi: 10.3390/nu6104320. [Article]
2. Rajakumar K: Vitamin D, cod-liver oil, sunlight, and rickets: a historical perspective. Pediatrics. 2003 Aug;112(2):e132-5. [Article]
3. Lips P: Hypervitaminosis A and fractures. N Engl J Med. 2003 Jan 23;348(4):347-9. doi: 10.1056/NEJMe020167. [Article]
4. Haddad JG: Vitamin D--solar rays, the Milky Way, or both? N Engl J Med. 1992 Apr 30;326(18):1213-5. doi: 10.1056/NEJM199204303261808. [Article]
5. von Schacky C: n-3 fatty acids and the prevention of coronary atherosclerosis. Am J Clin Nutr. 2000 Jan;71(1 Suppl):224S-7S. doi: 10.1093/ajcn/71.1.224s. [Article]
6. USDA: Full Report (All Nutrients): 04589, Fish oil, cod liver [Link]
7. NIH NCCIH Clinical Digest for Health Professionals: Omega-3 Fatty Acids - What the Science Says [Link]

External Links

PubChem Substance

347911186

RxNav

2669

Wikipedia

Cod_liver_oil

MSDS

Download (47 KB)

Clinical Trials

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Phase	Status	Purpose	Conditions	Count

Pharmacoeconomics

Manufacturers

Not Available

Packagers

Not Available

Dosage Forms

Form	Route	Strength
Emulsion	Oral
Oil	Oral	100 %
Capsule		270 mg
Liquid	Oral	100 %
Cream	Topical
Capsule, liquid filled	Oral
Capsule, liquid filled	Oral
Gel	Topical	0.2712 mg/100mL
Gel	Topical	14.24 g/100mL
Ointment	Topical
Syrup	Oral
Capsule, gelatin coated	Oral
Capsule, liquid filled	Oral	800 mg
Capsule		275 mg

Prices

Not Available

Patents

Not Available

Properties

State

Not Available

Experimental Properties

Not Available

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

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Drug created at December 03, 2015 16:52 / Updated at September 28, 2021 21:54