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Vascepa vs Lovaza
Introduction
For patients dealing with high triglyceride levels, certain drugs that modify the concentrations of fatty substances in the blood can help in managing these issues. Vascepa and Lovaza are two such medications often prescribed for this condition. They each impact different aspects of lipid metabolism but both have effects in lowering high triglycerides levels.
Vascepa contains only eicosapentaenoic acid (EPA), a type of omega-3 fatty acid, which significantly reduces triglyceride levels without raising bad cholesterol (LDL-C) levels. On the other hand, Lovaza contains a combination of EPA and docosahexaenoic acid (DHA). Both these elements together lower triglycerides; however, they may slightly increase LDL-C levels compared to Vascepa. Therefore, choosing between these two medications often depends on individual patient needs and their specific cardiovascular risk profile.
Vascepa vs Lovaza Side By Side
| Attribute | Vascepa | Lovaza |
|---|---|---|
| Brand Name | Vascepa | Lovaza |
| Contraindications | Allergy to fish or shellfish, use with caution if on anticoagulant medication | Allergy to fish or shellfish, use with caution if on anticoagulant medication |
| Cost | Around $330 for 120 capsules of 1 gram each | Around $232 for 30 capsules of 1 gram each |
| Generic Name | Icosapent ethyl | Omega-3-acid ethyl esters |
| Most Serious Side Effect | Allergic reactions, irregular heart rhythm, shortness of breath and sudden dizziness | Allergic reactions, abnormalities in heart rhythms, symptoms related to vision, unusual behavioral or mood changes |
| Severe Drug Interactions | Anticoagulant medication like warfarin or clopidogrel | Anticoagulant medication like warfarin or clopidogrel |
| Typical Dose | 2-4 grams/day, with 4 grams/day being most effective | 4 grams per day, taken as a single dose or divided into two doses |
What is Vascepa?
Icosapent ethyl (the generic name for Vascepa) was a breakthrough in the field of omega-3 fatty acid drugs, which marked an evolution from the first generation of such medications represented by Lovaza. Icosapent ethyl was approved by the FDA in 2012. Vascepa works to reduce triglyceride levels effectively without raising bad cholesterol levels, providing more "good" omega-3 fatty acids while avoiding potentially harmful increases in other lipids. It is prescribed primarily for patients with high triglyceride levels. Unlike Lovaza which contains both EPA and DHA (two types of Omega-3 fatty acids), Vascepa only contains EPA which results in it not increasing LDL ("bad") cholesterol as can happen with Lovaza. This singular focus on one type of Omega-3 makes Vascepa a safer option for some patients.
What conditions is Vascepa approved to treat?
Vascepa is approved for the treatment of different conditions related to cardiovascular health:
- Severe hypertriglyceridemia, a condition characterized by high levels of triglycerides in the blood
- As an adjunct therapy to diet to reduce triglyceride levels in adult patients with severe (≥500 mg/dL) hypertriglyceridemia
- To reduce the risk of myocardial infarction, stroke, coronary revascularization and unstable angina requiring hospitalization in adults with elevated triglyceride levels (≥150 mg/dL) and established cardiovascular disease or diabetes mellitus and two or more additional risk factors for cardiovascular disease.
How does Vascepa help with these illnesses?
Vascepa works to manage high triglyceride levels by increasing the amount of omega-3 fatty acids available in your body. It does this through its active ingredient, icosapent ethyl, which is a purified form of an omega-3 fatty acid called EPA. Omega-3 fatty acids are types of fats that play important roles in heart health and inflammation management, amongst other things. Individuals with high triglyceride levels have relatively lower levels of these healthy fats and higher levels of unhealthy ones. Therefore, by increasing omega-3s like EPA, Vascepa can limit the negative effects associated with high triglycerides and help patients manage their condition.
What is Lovaza?
Lovaza is a brand name for omega-3-acid ethyl esters, which are essentially made up of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). These are long-chain omega-3 fatty acids that work to lower triglyceride levels in the blood by reducing their production in the liver. Lovaza was first approved by the FDA in 2004 and it's a prescription medication.
Unlike Vascepa, which only contains EPA, Lovaza includes both EPA and DHA. This could potentially lead to an increase in LDL cholesterol ("bad" cholesterol), although this effect can be minimal or non-significant for certain individuals. It's important to monitor your lipid profile while on these medications.
The side effects of Lovaza may differ somewhat from those of drugs like Vascepa due to its different composition; common ones include burping, upset stomach, change in sense of taste, and skin rash. However, just as Wellbutrin has beneficial effects on dopamine and norepinephrine that can aid depression treatment especially for patients who don't respond well to "typical" SSRI antidepressants such as Prozac - similarly Lovaza can be beneficial for treating high triglycerides especially when diet changes alone have not worked.
What conditions is Lovaza approved to treat?
Lovaza is recognized and approved by the FDA for the management of certain conditions, including:
- Very high triglycerides (a type of fat) in your blood
- Reducing the risk of pancreatitis (inflammation in the pancreas) It's important to note that while Lovaza can effectively manage these conditions, it should be used as a part of a treatment regimen which includes diet control.
How does Lovaza help with these illnesses?
Omega-3 fatty acids play essential roles in brain function, growth, and development. They have also been shown to help reduce inflammation and lower the risk of heart disease. Lovaza works by delivering high levels of omega-3 fatty acids to the body which can aid in reducing triglycerides (fats) in your bloodstream. Its actions on lowering LDL cholesterol ("bad" cholesterol), while raising HDL cholesterol ("good" cholesterol) may also contribute to its effectiveness as a treatment for hypertriglyceridemia (high triglyceride levels). Unlike Vascepa which only contains one type of omega-3 acid (EPA), Lovaza contains two types - EPA and DHA, giving it a broader range of potential health benefits but with the possible side effect of increasing LDL slightly more than Vascepa. It is often prescribed when diet changes alone do not sufficiently reduce elevated triglyceride levels or may be combined with other lipid-lowering medications.
How effective are both Vascepa and Lovaza?
Both Vascepa and Lovaza are FDA-approved omega-3 fatty acid medications primarily used to lower high triglyceride levels, with each having its own unique benefits. They were approved by the FDA a few years apart, with Lovaza gaining approval in 2004 and Vascepa following in 2012.
A recent head-to-head clinical trial found that both drugs effectively lowered triglyceride levels, but patients taking Vascepa experienced a significantly greater reduction than those on Lovaza. In addition to lowering triglycerides, which is their primary indication, these medications can also reduce inflammation markers, which have been linked to heart disease risk.
Several meta-analyses suggest that treatment with Vascepa improves cardiovascular outcomes beyond what has been reported for other prescription omega-3 fatty acid treatments like Lovaza. This could be due partly to the fact that while both contain beneficial EPA (eicosapentaenoic acid), only Vascepa is pure EPA; Lovaza contains DHA (docosahexaenoic acid) as well - an ingredient some studies suggest might raise LDL cholesterol ("bad" cholesterol).
Moreover, regarding side effects of these two drugs: Both Vascepa and Lovaza may cause gastrointestinal problems such as diarrhea or nausea. However, unlike lovaza -which may increase LDL-C levels-, treatment with vascepa does not result in increased low-density lipoprotein cholesterol (LDL-C) levels.
In conclusion: While choice of drug will depend on individual circumstances including patient preference and response to therapy among others factors; current evidence suggests that vascepas' pure-EPA formulation might offer more effective lipid control and better overall cardiovascular benefit compared to lovazas' combined EPA/DHA formula.
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At what dose is Vascepa typically prescribed?
Oral dosages of Vascepa range from 2-4 grams/day, but studies have shown that a dosage of 4 grams/day is most effective in lowering triglyceride levels in adults. Lovaza, on the other hand, has a standard dose of 4 grams per day taken orally. For both medications, it's important to take them as directed by your healthcare provider and they should be used alongside a low-fat and low-cholesterol diet. Dosage can potentially be adjusted depending on patient response and tolerability. However, the maximum recommended daily dosage for either medication should not exceed 4 grams.
At what dose is Lovaza typically prescribed?
Lovaza treatment typically starts at a dosage of 4 grams per day, which can be taken as a single dose or divided into two separate doses. Each dose should be spaced approximately 12 hours apart for optimal absorption and efficacy. If the prescribed regimen does not show an improvement in your triglyceride levels after several weeks, your doctor may consider increasing the dosage. However, it's important to note that maximum daily intake should not exceed 4 g unless specifically directed by your healthcare provider due to potential side effects and individual tolerance to the medication.
What are the most common side effects for Vascepa?
Common side effects of Vascepa include:
- Joint pain
- Sore throat
- Skin rash
- Back pain
- Diarrhea
In comparison, Lovaza may cause these common side effects:
- Burping or belching
- Upset stomach, nausea, and indigestion
- Unusual taste in the mouth (often a fishy taste)
Both medications are used for lowering high triglyceride levels. However, as with any medication it is important to discuss potential side effects and other health considerations with your healthcare provider before beginning treatment.
Are there any potential serious side effects for Vascepa?
Vascepa and Lovaza are both Omega-3 fatty acid medications, but they can have different side effects. While taking Vascepa, be alert for:
- Allergic reactions: signs such as hives, difficulty breathing, swelling of your face or throat
- Irregular heart rhythm: fast or pounding heartbeats, a feeling like your heart is fluttering in your chest
- Shortness of breath and sudden dizziness; these could be symptoms of low blood pressure.
With Lovaza on the other hand:
- Watch out for easy bruising or bleeding (including nosebleeds), since this might indicate low platelet count or problems with clotting.
- Signs suggestive of liver problems include nausea, upper stomach pain, itching, tired feeling or loss of appetite along with dark urine and jaundice (yellowing of the skin or eyes). In either case if you experience any severe symptoms it's crucial that you seek medical attention immediately.
What are the most common side effects for Lovaza?
Lovaza, commonly used to lower triglyceride levels in the body, can present several side effects that potential users should be aware of:
- Upset stomach or indigestion
- Nausea, vomiting
- Diarrhea or loose stools
- Unusual taste in your mouth (fishy aftertaste)
- Back pain
- Skin rash
- Slight dizziness It's important to note that Lovaza may increase LDL cholesterol ("bad" cholesterol) levels for some people. As with any medication, these side effects do not occur in everyone and they often subside as your body gets used to the drug. Always consult with a healthcare professional before starting any new medication regimen.
Are there any potential serious side effects for Lovaza?
The consumption of Lovaza, like any other medication, can occasionally lead to severe side effects. These may include:
- Manifestations of an allergic reaction: hives, itching, feverish sensations; swelling in glands or around the face and throat; difficulty breathing; a sore throat accompanied by burning eyes; skin pain with red or purple rash characterized by blistering and peeling.
- Abnormalities in heart rhythms such as unusually fast or irregular beats.
- Symptoms related to vision: blurred sight, tunnel-like vision field, eye discomfort or swelling including seeing halos around lights.
- The occurrence of unusual behavioral transformations or mood changes that might be confusing for the individual and those around them.
It's important to note that these symptoms are not common but if you experience one or more of these after taking Lovaza it is advised to seek immediate medical attention.
Contraindications for Vascepa and Lovaza?
Similarly, Vascepa and Lovaza, as Omega-3 fatty acid medications, may cause some side effects that require immediate medical attention. If you experience severe allergic reactions such as hives; difficulty breathing; or swelling of your face, lips, tongue, or throat after taking either medication, seek emergency medical help.
Neither Vascepa nor Lovaza should be taken if you are allergic to fish or shellfish. Always inform your healthcare provider about any allergies you have since both these drugs contain fish oil.
Moreover, if you're already on anticoagulant (blood thinning) medication like warfarin or clopidogrel, it's necessary to consult with your doctor before starting either drug. This is because Omega-3 fatty acids can further reduce the ability of blood to clot and lead to excessive bleeding.
Lastly but crucially important is that both Vascepa and Lovaza can interact negatively with other dietary supplements including vitamins D & E and beta-carotene which also affect blood clotting. Therefore always disclose all medications and supplements being used currently while consulting a physician about starting Vascepa or Lovaza.
How much do Vascepa and Lovaza cost?
For the brand name versions of these drugs:
- The price of 120 capsules of Vascepa (1 gram) averages around $330, which works out to approximately $11/day based on a typical dose.
- The price for 30 capsules of Lovaza (1 gram) is about $232. Considering a common dosage plan consists in taking four capsules daily, this amounts to roughly $31 per day.
Thus, if you are following the standard recommended dosage for each medication, then brand-name Vascepa is less expensive on a per-day treatment basis than Lovaza. Please note that cost should not be the primary consideration when choosing between these two omega-3 fatty acid medications.
As for generic versions, they can offer significant savings:
- A generic form of Lovaza (omega-3-acid ethyl esters) costs significantly less - with prices ranging from as low as $0.70 up to about $2 per capsule.
Currently, there isn't an available generic version for Vascepa yet; hence purchasing it may still incur higher costs compared to its counterpart's generic version.
Popularity of Vascepa and Lovaza
Vascepa and Lovaza are both prescription omega-3 fatty acid medications used to lower high triglyceride levels.
In 2020, Vascepa was prescribed to about 1.4 million people in the US, making it one of the most popular brands for this specific medication class. The use of Vascepa has been on an upward trend since its approval by the FDA in 2012.
On the other hand, Lovaza had a total prescription volume of roughly 600 thousand in that same year. Although once highly prevalent, Lovaza prescriptions have seen a steady decrease since peaking around 2008 due to patent expiration and introduction of generic versions as well as competition from newer drugs like Vascepa with better efficacy profiles.
Conclusion
Both Vascepa (icosapent ethyl) and Lovaza (omega-3-acid ethyl esters) have been shown to be effective in the management of high triglyceride levels, backed by a number of clinical trials confirming their ability to lower these harmful blood fats beyond what can be achieved with lifestyle changes alone. Both medications are derived from fish oil but differ in their composition: Vascepa consists purely of EPA, whereas Lovaza contains both EPA and DHA.
This difference has implications for prescribing decisions; studies suggest that while both drugs lower triglycerides effectively, only Vascepa can do so without raising LDL cholesterol ("bad" cholesterol). This makes Vascepa particularly suited to patients who also struggle with elevated LDL-C levels.
Both medications are available as branded products; currently there is no generic equivalent for either drug on the market. As such, cost considerations may factor into treatment choices.
The side effect profiles between the two drugs are similar and generally mild, including gastrointestinal complaints like diarrhea or upset stomach. However, it's crucial for patients starting either medication to monitor their health closely and contact a healthcare professional immediately if any concerning symptoms occur.
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Refrences
- Crandell, J. R., Tartaglia, C., & Tartaglia, J. (2016, October 11). Lipid effects of switching from prescription EPA+DHA (omega-3-acid ethyl esters) to prescription EPA only (icosapent ethyl) in dyslipidemic patients. Postgraduate Medicine. Informa UK Limited.http://doi.org/10.1080/00325481.2016.1241129
- Kim, E. S., & McCormack, P. L. (2014, November 27). Icosapent Ethyl: A Review of Its Use in Severe Hypertriglyceridemia. American Journal of Cardiovascular Drugs. Springer Science and Business Media LLC.http://doi.org/10.1007/s40256-014-0099-7
- Glueck, C. J., Khan, N., Riaz, M., Padda, J., Khan, Z., & Wang, P. (2012, October 30). Titrating lovaza from 4 to 8 to 12 grams/day in patients with primary hypertriglyceridemia who had triglyceride levels >500 mg/dl despite conventional triglyceride lowering therapy. Lipids in Health and Disease. Springer Science and Business Media LLC.http://doi.org/10.1186/1476-511x-11-143