Action and Spectrum

Actions and Spectrum: 

omega-3 carboxylic acids are a type of polyunsaturated fatty acid that is key to human health. They are commonly found in fish oils, such as salmon and tuna, and are also available as dietary supplements. 

The main actions of omega-3 carboxylic acids are: 

• Anti-inflammatory effects: omega-3 carboxylic acids have been shown to have anti-inflammatory effects by diminishing the production of inflammatory molecules in the body. This can helps to decrease the risk of chronic inflammatory conditions like arthritis and heart disease. 
• Cardiovascular effects: omega-3 carboxylic acids have been shown to have cardiovascular benefits by reducing triglyceride levels and bp and decreasing the risk of heart attack and stroke. 
• Cognitive effects: omega-3 carboxylic acids are essential for brain health and development. They have been shown to ameliorate cognitive function, memory, and mood. 
• Immune system effects: omega-3 carboxylic acids can modulate the immune system by typically increasing the activity of immune cells and reducing inflammation. 

The spectrum of omega-3 carboxylic acids includes several different types of fatty acids, including eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). These fatty acids have different biological effects, with EPA being more anti-inflammatory and DHA being more critical for brain health. Together, they are essential in maintaining overall health and preventing chronic diseases. 

Drug Interaction

Adverse Reaction

Frequency defined 

>10% 

Diarrhea (7-15%) 

1-10% 

Eructation (3%) 

Abdominal pain or discomfort (3-5%) 

Nausea (4-6%) 

Frequency not defined 

Flatulence 

Vomiting 

Dysgeusia 

Black Box Warning

Black Box Warning: 

omega-3 carboxylic acids may have potential side effects like any medication or supplement. 

Some of the possible side effects of omega-3 carboxylic acids include: 

• Upset stomach: omega-3 carboxylic acids may cause gastrointestinal symptoms, such as nausea, diarrhea, and indigestion. 
• Fishy aftertaste and breath: Omega-3 carboxylic acids are derived from fish oil, and some people may experience a fishy aftertaste or breath odor. 
• Bleeding: omega-3 carboxylic acids may increase the risk of bleeding, mostly when taken with blood-thinning medications, such as aspirin or warfarin. 
• Allergic reactions: Certain people might be allergic to omega-3 carboxylic acids, although this is rare. 

It is key to talk to your physician before taking omega-3 carboxylic acids, especially if you have a bleeding disorder, taking blood-thinning medications, or have other medical conditions. They can advise you on the dosage, potential risks, or interactions with other medications. 

Contraindication / Caution

Contraindication/Caution: 

Contraindication 

omega-3 carboxylic acids are generally considered safe and well-tolerated by most people. However, there are some situations where their use may need to be revised. Some possible contraindications of omega-3 carboxylic acids include: 

• Bleeding disorders: omega-3 carboxylic acids may increase the risk of bleeding, mostly when taken with other blood-thinning medications. People with bleeding disorders and conditions like hemophilia should avoid taking omega-3 carboxylic acids without consulting a healthcare provider. 
• Surgery: omega-3 carboxylic acids should be stopped at least 2 weeks before surgery to diminish the risk of excessive bleeding during, after the procedure. 
• Fish or shellfish allergy: omega-3 carboxylic acids are derived from fish oil, so people with a fish or shellfish allergy should avoid taking them. 
• Pregnancy and breastfeeding: omega-3 carboxylic acids are generally safe for pregnant and breastfeeding women, but they should consult their healthcare provider before taking them, as high doses may be harmful. 
• Drug interactions: omega-3 carboxylic acids may interact with certain medications, including blood-thinning, cholesterol-lowering, and some psychiatric medications. People taking these medications should consult their healthcare provider before taking omega-3 carboxylic acids. 

Caution 

While omega-3 carboxylic acids are generally safe and well-tolerated, there are some cautions to keep in mind when taking them: 

• Dosage: It is crucial to take omega-3 carboxylic acids as directed by your healthcare provider or according to the instructions written on the product label. Too much can enhance the risk of side effects, such as gastrointestinal symptoms and bleeding. 
• Quality: omega-3 carboxylic acids supplements may vary in quality, so it is crucial to choose a reputable brand that has been tested for purity and potency. 
• Source: omega-3 carboxylic acids are derived from fish oil, so choosing a common contaminant source, such as mercury and PCBs, is crucial. Look for products certified by independent organizations, like the International Fish Oil Standards program. 
• Interactions: omega-3 carboxylic acids may interact with certain medications, such as blood-thinning medications and cholesterol-lowering medications, so it is key to talk to your physician before taking them if you are taking any medications. 
• Medical conditions: If you have any certain medical conditions, such as diabetes or liver disease, you must talk to your physician before taking omega-3 carboxylic acids, as they may affect these conditions. 
• Allergies: Certain people may be allergic to fish or shellfish, which are sources of omega-3 carboxylic acids. If you have a known allergy, avoiding these supplements or choosing a non-fish source of omega-3 fatty acids, such as flaxseed oil, is essential. 

Overall, omega-3 carboxylic acids are generally safe for most people when taken as directed.

Pregnancy / Lactation

Pregnancy consideration:  

AU TGA pregnancy category: B1
US FDA pregnancy category: Not assigned 

Lactation:   

Excreted into human milk: Yes. 

Pregnancy category: 

• Category A: well-controlled and Satisfactory studies do not show risk to the fetus in the first/later trimester.        
• <b>Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women        
• Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.       
• Category D: adequate data with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.        
• Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.        
• Category N: There is no data available for the drug under this category 

Pharmacology

Pharmacology: 

omega-3 carboxylic acids are a type of polyunsaturated fatty acid that is derived from fish oil. They contain three main types of omega-3 fatty acids: eicosapentaenoic acid, docosahexaenoic acid (DHA), and docosapentaenoic acid (DPA). 

The pharmacology of omega-3 carboxylic acids is primarily due to the effects of EPA and DHA. These fatty acids have several mechanisms of action, including: 

• Anti-inflammatory effects: EPA and DHA can diminish inflammation by inhibiting the production of the inflammatory molecules, like prostaglandins and leukotrienes. 
• Lipid-lowering effects: EPA and DHA can reduce triglyceride levels in the blood, possibly lowering cardiovascular disease risk. 
• Blood-thinning effects: EPA and DHA can reduce the stickiness of platelets, reducing the risk of blood clots. 
• Neuroprotective effects: DHA is an essential component of brain cell membranes and may help protect against neurodegenerative diseases. 
• Mood-stabilizing effects: EPA and DHA may help to regulate mood and reduce symptoms of depression and anxiety. 

omega-3 carboxylic acids are available as prescription products for treating severe hypertriglyceridemia and as dietary supplements for general health and well-being. The pharmacokinetics of omega-3 carboxylic acids can vary depending on the product and formulation, but they are generally absorbed in the small intestine and metabolized by the liver. 

Pharmacodynamics: 

Mechanism of action: omega-3 fatty acids act by reducing the hepatic synthesis of triglyceride-rich, very low-density lipoproteins while also potentially enhancing the removal rate of TG-rich lipoprotein by enhancing lipoprotein lipase activity in humans. 

Several cellular mechanisms may be involved in this process, such as the inhibition of acyl-CoA:1,2-diacylglycerol acyltransferase, which is an enzyme involved in TG synthesis. omega-3 fatty acids may also promote increased mitochondrial and peroxisomal beta-oxidation in the liver, which results in an increased rate of fatty acid metabolism. Moreover, the medication may decrease lipogenesis in the liver, thereby reducing the hepatic synthesis of TG-rich VLDL. 

Pharmacokinetics: 

Absorption 

omega-3 carboxylic acids are absorbed in the small intestine with the help of bile and pancreatic enzymes. They are mainly absorbed as free fatty acids or as monoacylglycerols. The absorption of omega-3 carboxylic acids can be influenced by food’s presence, with absorption improved when taken with a high-fat meal. 

Distribution 

Once absorbed, omega-3 carboxylic acids are transported in the bloodstream to many tissues in the body. They are primarily incorporated into cell membranes, where they play essential roles in maintaining membrane fluidity and function. 

Metabolism 

omega-3 carboxylic acids are metabolized in the liver and other tissues. They can be oxidized to produce energy or used to synthesize other compounds in the body, such as eicosanoids (including prostaglandins, leukotrienes, and thromboxanes). The conversion of omega-3 carboxylic acids to eicosanoids can have anti-inflammatory and other physiological effects. 

Elimination and Excretion 

The excretion of omega-3 carboxylic acids occurs primarily through the feces, with a small amount being excreted in the urine. The excretion rate can depend on several factors, including the dose and formulation of the omega-3 carboxylic acid supplement. 

Adminstartion

Administration: 

Oral administration 

omega-3 carboxylic acids are typically available as oral capsules or soft gels, which should be taken with a full glass of water. The dosage and frequency of omega-3 carboxylic acids can vary depending on the specific product type and the reason for use. 

Following the dosage instructions the healthcare provider provides or on the product label is essential. omega-3 carboxylic acids may be taken with or without food, but taking them with a meal can help to diminish the risk of gastrointestinal side effects, like nausea or upset stomach. 

If a dose is missed, taking it as soon as possible is generally recommended. However, if the next scheduled dose is missed, it should be skipped and the following dose should be taken at the appropriate time. It is important to avoid taking a double dose of the medication to compensate for the missed dose.

It is crucial to store omega-3 carboxylic acids at room temperature(RT), away from heat, moisture, and light.

Patient Information Leaflet

Patient information leaflet 

Generic Name: omega 3 carboxylic acids 

Why do we use omega-3 carboxylic acids? 

omega-3 carboxylic acids are a type of polyunsaturated fatty acids that have several potential health benefits. Some of the uses of omega-3 carboxylic acids include: 

• Cardiovascular health: omega-3 carboxylic acids can help reduce triglyceride levels in the blood, lowering the risk of heart disease. They might also help to reduce inflammation and improve blood vessel function. 
• Brain health: omega-3 carboxylic acids, particularly docosahexaenoic acid (DHA), are key for brain development and function. They might also help to reduce the risk of age-related cognitive decline and dementia. 
• Eye health: omega-3 carboxylic acids, particularly DHA, are essential for eye health and may help to reduce the risk of age-related macular degeneration. 
• Inflammatory conditions: omega-3 carboxylic acids have anti-inflammatory properties and may help to reduce inflammation in conditions like rheumatoid arthritis and inflammatory bowel disease. 
• Mood disorders: omega-3 carboxylic acids may help to improve mood and diminish symptoms of depression, anxiety. 
• Pregnancy and breastfeeding: omega-3 carboxylic acids, particularly DHA, are key for fetal brain and eye development during pregnancy and breastfeeding. 

It is key to note that some evidence supports omega-3 carboxylic acids for these conditions, more research studies is needed to understand their effects and optimal dosages fully. omega-3 carboxylic acids should not be used as a substitute for conventional treatment and should always be generally used under the guidance of a physician.