Vascepa (icosapent ethyl) is a prescription omega-3 fatty acid that is similar to fish oil but not exactly the same.
What is the difference between Vascepa and fish oil?
The main difference is that Vascepa only contains eicosapentaenoic acid (EPA), whereas supplemental fish oils contain both EPA and docosahexaenoic acid (DHA). By only containing EPA, Vascepa reduces high triglycerides without raising levels of “bad” cholesterol or LDL-C.
Vascepa is also a lot stronger than most over the counter (OTC) fish oils (up to four times the strength) and much more expensive than OTC fish oils, costing around $300 per month without insurance. Because it is prescription-strength, it is only available on a prescription written by a doctor to people with abnormally high triglyceride levels. This is because it is more likely to cause heart rhythm disturbances, thin the blood or increase the risk of bleeding than supplemental varieties. There is also more data to support the effectiveness and safety of prescription strength fish oils compared with OTC varieties.
How effective is Vascepa?
In the REDUCE-IT trial, Vascepa significantly reduced the risk of cardiovascular events, such as cardiovascular death, heart attack, stroke, coronary revascularization, or hospitalization for unstable angina by about 25%. In those with atherosclerotic cardiovascular disease (ASCVD), the risk of events decreased by 35%.
Vascepa works by reducing very-low-density triglyceride levels. Triglycerides are a type of fat in the blood (called a lipid). People with high triglyceride levels are more at risk of developing heart disease.
The most common causes of high triglycerides are obesity, high carbohydrate or high-sugar diets, excessive alcohol intake, physical inactivity, and poorly controlled diabetes.
Triglyceride levels are normally less than 150 milligrams per deciliter.
- Borderline-high levels are 150 to 199 mg/dL
- High levels are 200 to 499 mg/dL
- Very high levels are 500 mg/dL or higher.
What is Vascepa?
Vascepa contains high purity eicosapentaenoic acid (EPA), which is an ethyl ester of omega-3 fatty acid, and is obtained from the oil of fish. It only contains EPA, not DHA.
Vascepa is the only prescription omega-3 approved for CV reduction alongside diet modification. It may be used in addition to statins to reduce CV events in patients with elevated triglyceride levels (≥150 mg/dL) and established ASCVD or diabetes, and at least two other cardiovascular disease risk factors (eg, high blood pressure, smoking, inactivity, obesity, family or personal history).