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Omega-3 acid ethyl esters are used in addition to changes in diet to reduce triglyceride levels in adults with severe (≥ 500 mg/dL) hypertriglyceridemia. [10] In the European Union and other major markets outside the US, omega-3 acid ethyl esters are indicated for hypertriglyceridemia by itself, or in combination with a statin for people with mixed dyslipidemia.
An omega−3 fatty acid is a fatty acid with multiple double bonds, where the first double bond is between the third and fourth carbon atoms from the end of the carbon atom chain. "Short-chain" omega−3 fatty acids have a chain of 18 carbon atoms or less, while "long-chain" omega−3 fatty acids have a chain of 20 or more.
There are other omega-3 fish oil based drugs on the market that have similar uses and mechanisms of action. [8] Omega-3 acid ethyl esters (brand names Omarcor or Lovaza, [9] Omtryg, [10] and as of March 2016, four generic versions). [11] Ethyl eicosapentaenoic acid (Vascepa, and 1 generic as ethyl icosapent) [12]
As of 2019, the US Food and Drug Administration (FDA) has approved four fish oil-based prescription drugs, namely Lovaza, Omtryg (both omega-3 acid ethyl esters), Vascepa (ethyl eicosapentaenoic acid), and Epanova (omega-3 carboxylic acids). [8] None of these drugs are actually fish oil; they are all derivatives of acids found in fish oil.
Cervonic acid (or docosahexaenoic acid) has 22 carbons, is found in fish oil, is a 4,7,10,13,16,19-hexa unsaturated fatty acid. In the human body its generation depends on consumption of omega 3 essential fatty acids (e.g., ALA or EPA), but the conversion process is inefficient. [ 22 ]
Ethyl eicosapentaenoic acid (E-EPA) was the second fish-oil drug to be approved, after omega-3-acid ethyl esters (GlaxoSmithKline's Lovaza, which was approved in 2004. [ 31 ] [ 7 ] [ 32 ] ) Initial sales were not as robust as Amarin had hoped.
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