Triglycerides are a type of fat found in the blood that are essential for energy. Hypertriglyceridemia is a condition marked by elevated levels of triglycerides in the blood. High triglycerides are a risk factor for cardiovascular disease. Elevated triglycerides are also a significant risk factor for pancreatitis, a condition where the pancreas is inflamed. While lifestyle modifications such as diet and exercise are important in managing high triglycerides, some individuals require medication treatment to reach healthy triglyceride levels. Vascepa (icosapent ethyl) is one prescription medication option for managing hypertriglyceridemia.
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What is Hypertriglyceridemia?
Hypertriglyceridemia occurs when triglyceride levels in the blood are greater than 150 mg/dL. Triglycerides of 150–499 mg/dL are considered high, and > 500 mg/dL is very high. Elevated triglycerides can result from several factors, including:
- A diet high in refined sugars and unhealthy fats
- Overweight and obesity
- Lack of physical activity
- Excessive alcohol consumption
- Medical conditions such as diabetes, hypothyroidism, and kidney disease
What is Vascepa?
Vascepa (icosapent ethyl) is a prescription medication derived from eicosapentaenoic acid (EPA), an omega-3 fatty acid found in fish oil. However, unlike many other fish oil-based products that contain a mix of EPA and docosahexaenoic acid (DHA), Vascepa is a highly purified form of EPA. Vascepa works by enhancing the clearance of triglycerides from the bloodstream, lowering overall triglyceride levels in the bloodstream.
Vascepa is approved by the Food and Drug Administration (FDA) for the treatment of triglyceride levels ≥ 150 mg/dL for people with established cardiovascular disease or diabetes mellitus with 2 or more additional risk factors for cardiovascular disease. It is also approved as an adjunct to diet to reduce triglyceride levels in adults with severe (≥ 500 mg/dL) hypertriglyceridemia.
Vascepa is generally used in conjunction with a heart-healthy diet and lifestyle modifications, including weight management, physical activity, and controlling blood sugar levels. It may also be prescribed alongside statins medications, which are commonly used to lower cholesterol and reduce cardiovascular risk.
Considerations for Vascepa:
- Dosage: The typical dosage of Vascepa is 2 grams twice daily with food.
- Consistency: For optimal effectiveness, it is important to take Vascepa consistently as prescribed. Do not skip doses or alter the dosing schedule without consulting your healthcare provider.
- Diet and Lifestyle: While taking Vascepa, it is important to continue following a healthy diet and exercise regularly to help manage triglyceride levels.
- Potential Side Effects While Vascepa is generally well-tolerated, it can cause side effects in some individuals. Common side may effects include:
- Constipation
- Joint pain or stiffness
- Heart rhythm problems
- Possible allergic reactions if you are allergic to fish or shellfish
- Bleeding Risk: Vascepa may increase the risk of bleeding, particularly in individuals taking blood-thinning medications (e.g., aspirin, warfarin)
- Monitoring: Regular follow-up appointments with your healthcare provider are important to monitor your triglyceride levels to determine effectiveness of the medication.
Conclusion:
Vascepa (icosapent ethyl) is one medication option for the management of hypertriglyceridemia for certain people to help reduce cardiovascular risk and risk of pancreatitis. In combination with healthy lifestyle modifications, Vascepa can be a treatment option for individuals with elevated triglycerides and other risk factors for heart disease. If you have high triglycerides, it is important to work closely with your healthcare provider to determine what medication therapy may be appropriate for you. As with any medication, it is important to use Vascepa as prescribed and work closely with your healthcare provider to ensure the best possible overall health outcomes.
Resources:
1) Virani, S, Morris, P, Agarwala, A. et al. 2021 ACC Expert Consensus Decision Pathway on the Management of ASCVD Risk Reduction in Patients With Persistent Hypertriglyceridemia: A Report of the American College of Cardiology Solution Set Oversight Committee. JACC. 2021 Aug, 78 (9) 960–993. https://doi.org/10.1016/j.jacc.2021.06.011
2) Karanchi H, Muppidi V, Wyne K. Hypertriglyceridemia. [Updated 2023 Aug 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459368/
3) VASCEPA® (icosapent ethyl) capsules [package insert]. Bridgewater, NJ: Amarin Pharma; 2019.
4) https://www.nhlbi.nih.gov/health/high-blood-triglycerides#:~:text=Triglyceride%20levels%20usually%20fall%20into,200%20and%20499%20mg%2FdL
