Icosapent ethyl (Vascepa)

Indicated as an addition to diet for the reduction of triglyceride levels in adults with severe hypertriglyceridemia (>500 mg/dL).

Vascepa trade name.

It is a type of omega-3 fatty acid, a fat found in fish oil.

Icosapent ethyl  is a highly purified and stable eicosapentaenoic acid ethyl ester and the security to placebo in preventing major adverse cardiovascular events in reducing triglyceride levels by almost 40 mg/dL.

Icosapent ethyl (Vascepa)  is the lone available EPA-only prescription product.

When used together with lifestyle changes of diet, weight loss, and exercise to reduce the amount of triglycerides.

It may work by decreasing the amount of triglycerides and other fats made in the liver.

Cardiovascular benefits are greater than would be predicted on the basis of the changes of triglyceride levels.

The medium reduction of 14 mg/dL in non-hi-density lipoprotein (HDL) cholesterol level from baseline with Icosapent  ethyl will be expected to translate into a lower risk of cardiovascular events of only 6-8%, not the 25% observed in the REDUCE-IT.

Comes as a liquid-filled gel capsule to be taken by mouth, with food two times a day.

REDUCE-IT trial randomized patient who had elevated triglyceride levels and had been receiving statin therapy to receive 2 g of icosapent ethyl twice daily or placebo: there was a 24% lower risk of cardiovascular death, non-fatal myocardial infarction, non-fatal stroke, coronary revascularization, or unstable angina.

REDUCE-IT trial demonstrated that patients with higher triglyceride level, and in spite of  being on maxially tolerated statins, responded well to addition of 2 g twice daily of icosapent ethyl and showed better cardiovascular outcomes.

Results of many previous trials of 3 n-fatty acids with a meta-analysis involving 78,000 patients did not show that groups received n-3 fatty acids had a lower risk of major adverse cardiac of cardiovascular events than those receiving placebo.

Side effects: include joint pain.

Most common adverse reaction with incidence >2% is arthralgia.

Lowers triglycerides and atherogenic lipids without raising LDL cholesterol.

Lowers triglyceride levels in patients with high triglyceride levels not controlled by diet and statin therapy.

Icosapent ethyl has literally no effect on low density lipoprotein cholesterol or high density lipoprotein cholesterol, because it does not contain DHA, which can raise LDL-C and HDL-C.

In ANCHOR trial 4 g per day significantly reduces triglycerides, non-HDL cholesterol, Apo B, VLDL-cholesterol and HDL-cholesterol levels from baseline relative to placebo.Effectiveness improved by the addition of statins.

Daily dose is 4 g per day taken as either 4 .5 g capsules twice a day with food or as 2 1 g capsules twice daily with food.

Capsules should be swallowed whole.

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