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# Prescription omega-3 fatty acids

Purified fish-oil fatty acids (EPA, with or without DHA) that lower triglycerides; one, icosapent ethyl, also lowers cardiovascular events.

Updated Nov 1, 2026

## What they are

Prescription-strength ethyl esters of omega-3 fatty acids. Icosapent ethyl contains only EPA; other products mix EPA and DHA. Over-the-counter fish oil supplements are not the same products.

## Mechanism of action

Omega-3 fatty acids reduce the liver's production of triglyceride-rich VLDL and speed triglyceride clearance from the blood. The exact molecular target is not fully defined.

Target: Hepatic triglyceride and VLDL production (no single receptor)

## Key points

- Used for severe hypertriglyceridaemia, with diet.
- Icosapent ethyl (EPA only) reduced cardiovascular events in statin-treated patients with raised triglycerides.
- Mixtures with DHA can raise LDL cholesterol; EPA alone seems not to.
- Warnings: atrial fibrillation or flutter, and bleeding, especially with antithrombotic drugs.
- Caution in people allergic to fish or shellfish.

## Drugs in this class

- [**Icosapent ethyl** A purified EPA (fish-oil) ethyl ester that lowers triglycerides and, with a statin, reduces heart attack and stroke in… Hepatic triglyceride and VLDL synthesis (no single protein target)](https://durgical.com/en/pharmacology/icosapent-ethyl/)

## Others in the class

- omega-3-acid ethyl esters (EPA + DHA)

## Test yourself

Think of the answer, then tap the question to see it.

## What is the main lipid effect of prescription omega-3 fatty acids?

They lower triglycerides by reducing VLDL production in the liver.

## Which two warnings appear for icosapent ethyl?

Atrial fibrillation or flutter, and increased bleeding.

## How does icosapent ethyl differ from most other omega-3 products?

It contains only EPA, without DHA.

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Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: [Icosapent Ethyl: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a613024.html) (MedlinePlus (U.S. National Library of Medicine), 2026); [DailyMed - ICOSAPENT ETHYL capsule](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=886aa8d8-b293-258f-b16d-be40418787a8) (DailyMed (U.S. National Library of Medicine), 2026).

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Representative model, for educational purposes only.

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