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Eicosapentaenoic acid (EPA) is an omega-3 fatty acid. It's found in the flesh of cold-water fish, including mackerel, herring, tuna, halibut, salmon, cod liver, whale blubber, or seal blubber.

EPA is used as a prescription medicine to reduce triglyceride levels. As a supplement, EPA is most commonly used for heart disease, preventing adverse events after a heart attack, and depression. It is also used for chemotherapy-related side effects, recovery after surgery, and many other conditions, but there is no good scientific evidence to support many of these uses.

Don't confuse EPA with similar fatty acids, such as alpha-linolenic acid and docosahexaenoic acid (DHA), as well as with oils like algal, krill, or fish oils, which contain both EPA and DHA. Most available research involving EPA is from the use of fish oil products containing variable combinations of EPA and DHA. See the separate listings for algal oil, alpha-linolenic acid, DHA, fish oil, and krill oil.

Natural Medicines rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, Ineffective, and Insufficient Evidence to Rate.
  • Hypertriglyceridemia.  Oral prescription ethyl-EPA 4 grams daily reduces triglyceride levels in patients with hypertriglyceridemia, especially in severe cases. It is unclear if oral EPA supplements are beneficial in hypertriglyceridemia.
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No data available.
  • Cardiovascular disease (CVD).  Oral prescription ethyl-EPA seems to reduce the risk of CVD events when used as an adjunct to statin therapy in patients with CVD risk. It is unclear if oral EPA supplements are beneficial in CVD.
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  • Depression.  Oral EPA seems to reduce symptoms of depression, especially in patients already being treated with conventional antidepressants.
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  • Myocardial infarction (MI).  Oral prescription ethyl-EPA reduces the risk of MI when used as an adjunct to statin therapy in patients with cardiovascular disease (CVD) risk. Oral EPA supplements also seem to be beneficial for this purpose.
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No data available.
No data available.
No data available.

EPA can prevent the blood from clotting easily. These fatty acids also reduce pain and swelling.

When taken by mouth: EPA is LIKELY SAFE for most adults when taken as a prescription product or as fish oil. It has been used safely in studies for up to 7 years. Most side effects are mild and may include nausea, diarrhea, discomfort in the upper abdomen, or belching. Taking EPA with meals can often decrease these side effects. EPA is POSSIBLY SAFE when taken as part of an oil from algae (algal oil) for up to 12 weeks. But people should limit intake of EPA and other omega-3 fatty acids to 3 grams per day, with no more than 2 grams per day from a dietary supplement unless approved by a healthcare provider. Doses of EPA and other omega-3 fatty acids greater than 3 grams per day is POSSIBLY UNSAFE. Taking more than 3 grams per day of omega-3 fatty acids might slow blood clotting and may increase the chance of bleeding.

When given by IV: EPA is POSSIBLY SAFE for most people when given by IV under the supervision of a healthcare provider. It is usually well tolerated.

Special Precautions & Warnings:

Pregnancy and breast-feeding: There isn't enough reliable information to know if EPA is safe to use when pregnant or breast-feeding. Stay on the safe side and avoid using more than food amounts.

Irregular heartbeat (arrhythmia): In people with a history of arrhythmias, EPA may further increase risk of irregular heartbeat. If you have had arrhythmias, talk with your healthcare provider before you start taking EPA.

Aspirin-sensitivity: If you are sensitive to aspirin, EPA might affect your breathing.

Medications for high blood pressure (Antihypertensive drugs)

Interaction Rating=Moderate Be cautious with this combination.

EPA can decrease blood pressure. Taking EPA along with medications for high blood pressure might cause you blood pressure to go too low.

Some medications for high blood pressure include captopril (Capoten), enalapril (Vasotec), losartan (Cozaar), valsartan (Diovan), diltiazem (Cardizem), Amlodipine (Norvasc), hydrochlorothiazide (HydroDiuril), furosemide (Lasix), and many others.

Medications that slow blood clotting (Anticoagulant / Antiplatelet drugs)

Interaction Rating=Moderate Be cautious with this combination.

EPA (eicosapentaenoic acid) might slow blood clotting. Taking EPA (eicosapentaenoic acid) along with medications that also slow clotting might increase the chances of bruising and bleeding.

Some medications that slow blood clotting include aspirin, clopidogrel (Plavix), diclofenac (Voltaren, Cataflam, others), ibuprofen (Advil, Motrin, others), naproxen (Anaprox, Naprosyn, others), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, warfarin (Coumadin), and others.

Herbs and supplements that might lower blood pressure: EPA might lower blood pressure. Using it along with other herbs and supplements that can lower blood pressure might cause blood pressure to go too low. Other herbs and supplements that can lower blood pressure include andrographis, casein peptides, cat's claw, coenzyme Q10, L-arginine, lycium, stinging nettle, theanine, and others.
Herbs and supplements that might slow blood clotting: EPA might slow blood clotting. Using EPA along with other herbs and supplements that might slow blood clotting might increase the risk of bleeding or bruising in some people. These herbs include angelica, clove, danshen, garlic, ginger, ginkgo, Panax ginseng, red clover, turmeric, and others.

There are no known interactions with foods.

The following doses have been studied in scientific research:


  • For high levels of fats called triglycerides in the blood (hypertriglyceridemia): A specific prescription medicine containing pure EPA (Vascepa) has been taken in doses of 2 grams twice daily along with dieting, and sometimes with cholesterol-lowering drugs called "statins."
  • For heart disease (cardiovascular disease): A specific prescription medicine containing pure EPA (Vascepa) 4 grams daily has been used for about 4.9 years.
  • For depression: For treating depression, 0.5-1 gram of EPA (as ethyl-EPA) twice daily has been used along with antidepressant medication. In some cases, EPA is taken with docosahexaenoic acid. The combination formulas containing at least 60% EPA seem to work best. For preventing depression in people receiving interferon-alpha treatment, 3.5 grams of EPA per day has been used for 2 weeks.
  • For heart attack: 1.8 grams of EPA daily in combination with "statins" has been taken for one month or one year following a procedure called percutaneous coronary intervention (PCI). Taking 1.8 grams daily in combination with "statins" for one month before PCI has also been used.
Many fatty acid preparations such as EPA also contain small amounts of vitamin E as an antioxidant to prevent spoilage.

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