Reduction in risk of MI, stroke, coronary revascularization, and unstable angina requiring hospitalization in patients with elevated triglyceride levels (≥150 mg/dL) and either established cardiovascular disease or type 2 diabetes with ≥2 additional risk factors for cardiovascular disease (as adjunctive therapy with maximally tolerated statin therapy).
Reduction of triglyceride levels in patients with severe hypertriglyeridemia (≥500 mg/dL) (as adjunctive therapy to diet).
Action
Decreases hepatic production of triglycerides and increases triglyceride clearance.
Therapeutic Effect(s):
Reduction in triglyceride levels.
Reduction in risk of MI, stroke, coronary revascularization, and unstable angina requiring hospitalization.
Pharmacokinetics
Absorption: Converted during absorption to the active metabolite eicosapentaenoic acid (EPA), which is then absorbed in the small intestine and enters systemic circulation through the lymphatic system.
Distribution: Most EPA circulates incorporated into phospholipids, triglycerides and cholesteryl esters. Enters breast milk.
Metabolism and Excretion: Mostly metabolized by the liver, some metabolism results in liberation of acetyl Coenzyme A which the Krebs cycle uses to produce energy. No renal elimination.
Half-life: 89 hr.
TIME/ACTION PROFILE (EPA levels)
ROUTE
ONSET
PEAK
DURATION
PO
unknown
5 hr
unknown
Contraindication/Precautions
Contraindicated in:
Hypersensitivity.
Use Cautiously in:
Hypersensitivity to fish/shellfish
Diabetes mellitus, hypothyroidism and excess alcohol intake may ↑ triglycerides and should be managed prior to treatment
History of atrial fibrillation or atrial flutter
OB: Use during pregnancy only if potential maternal benefit justifies potential fetal risk
Lactation: Use while breastfeeding only if potential maternal benefit justifies potential risk to infant
Pedi: Safety and effectiveness in children not established.
Adverse Reactions/Side Effects
CV: atrial fibrillation/flutter
Hemat: bleeding
MS: arthralgia
* CAPITALS indicate life-threatening. Underline indicate most frequent.
Interactions
Drug-Drug
Beta-blockers, thiazides and estrogens may ↑ triglycerides and should be discontinued/changed prior to treatment.
PO Administer 2 capsules twice daily with food. DNC: Swallow capsules whole; do not open, crush, dissolve, or chew.
Patient/Family Teaching
Instruct patient to take as directed. Take missed doses as soon as remembered unless almost time for next dose; do not double doses. Do not discontinue without consulting health care professional.
Advise patient to eat a well balanced, low fat and low cholesterol diet, exercise regularly, and avoid alcohol intake.
Advise patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and to consult with health care professional before taking other medications, especially anticoagulants.
Advise females of reproductive potential to notify health care professional if pregnancy is planned or suspected, or if breastfeeding.
Evaluation/Desired Outcomes
Decrease in triglyceride levels.
Reduction in risk of MI, stroke, coronary revascularization, and unstable angina requiring hospitalization.
icosapent ethyl is a sample topic from the Davis's Drug Guide.
Davis’s Drug Guide for Nurses App + Web from F.A. Davis and Unbound Medicine covers 5000+ trade name and generic drugs. Includes App for iPhone, iPad, and Android smartphone + tablet. Handbook covers dosage, side effects, interactions, uses. Davis Drug Guide PDF. Complete Product Information.