Fish Oil

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Are there any interactions with medications?



Birth control pills (Contraceptive drugs)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

There is some evidence that birth control pills might interfere with the triglyceride-lowering effects of fish oil.

Some of these drugs include ethinyl estradiol and levonorgestrel (Triphasil), ethinyl estradiol and norethindrone (Ortho-Novum 1/35, Ortho-Novum 7/7/7), and others.



Medications for high blood pressure (Antihypertensive drugs)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Using fish oil with drugs that lower blood pressure can increase the effects of these drugs and may lower blood pressure too much.

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.



Orlistat (Xenical, Alli)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Orlistat (Xenical, Alli) might keep the beneficial fatty acids in fish oil from being absorbed by the body. Taking fish oil and orlistat (Xenical, Alli) at least 2 hours apart may keep this from happening.



Medications that slow blood clotting (Anticoagulant / Antiplatelet drugs)
Interaction Rating: Minor Be cautious with this combination.
Talk with your health provider.

Using fish oil with medications that slow clotting may cause bleeding.

Some of these drugs include aspirin, clopidogrel (Plavix), dalteparin (Fragmin), dipyridamole (Persantine), enoxaparin (Lovenox), heparin, ticlopidine (Ticlid), warfarin (Coumadin), and others.

Dosing considerations for Fish Oil.

The following doses have been studied in scientific research:

BY MOUTH:
  • For high triglycerides: 1-4 grams/day of fish oil.
  • For high blood pressure: Either 4 grams of fish oil or fish oil providing 2.04 grams of EPA and 1.4 grams of DHA per day.
  • For atrial fibrillation (one of the chambers of the heart doesn't empty properly and this increases the risk of blood clot formation leading to stroke): Eating tuna or baked or broiled fish providing omega-3 fatty acids (fish oil) one or more times per week seems to reduce the risk of atrial fibrillation in patients aged 65 or older compared to consuming fish once per month or less. But there is no benefit from eating fried fish or a fish sandwich.
  • For kidney problems related to using cyclosporine to prevent organ transplant rejection: 12 grams/day containing 2.2 grams EPA and 1.4 grams DHA.
  • For reducing the overall risk of death and risk of sudden death in patients with coronary heart disease: Fish oil providing 0.3-6 grams of EPA with 0.6 to 3.7 grams of DHA.
  • For asthma in children: Fish oil providing 17-26.8 mg/kg EPA and 7.3-11.5 mg/kg DHA for reducing symptoms. Maternal ingestion of fish oil 4 grams daily, providing 32% EPA and 23% DHA with tocopherol, during late-phase pregnancy has been used for preventing the development of asthma in children.
  • For preventing childhood allergies: Maternal ingestion of fish oil 4 grams daily, providing 32% EPA and 23% DHA with tocopherol, during late-phase pregnancy.
  • For preventing childhood atopic dermatitis: Maternal ingestion of fish oil 4 grams daily, providing 32% EPA and 23% DHA with tocopherol, during late-phase pregnancy.
  • For treating asthma: 17-26.8 mg/kg EPA and 7.3-11.5 mg/kg DHA.
  • For preventing and reversing the progression of hardening of the arteries: 6 grams/day of fish oil for the first three months, followed by 3 grams/day thereafter.
  • For rheumatoid arthritis: Fish oil providing 3.8 grams/day of EPA and 2 grams/day DHA.
  • For attention deficit-hyperactivity disorder (ADHD): A specific supplement containing fish oil 400 mg and evening primrose oil 100 mg (Eye Q, Novasel) six capsules daily.
  • For preventing miscarriage in women with antiphospholipid antibody syndrome and a history of past miscarriage: 5.1 grams fish oil with a 1.5 EPA:DHA ratio.
  • For painful menstrual periods: A daily dose of EPA 1080 mg and DHA 720 mg.
  • For Raynaud's syndrome: A daily dose of 3.96 grams EPA and 2.64 grams DHA.
  • For weight loss: A daily serving of 2-7 ounces of fish containing approximately 3.65 grams omega-3 fatty acids (0.66 gram from EPA and 0.60 gram from DHA).
  • For slowing weight loss in patients with cancer: 7.5 grams/day of fish oil providing EPA 4.7 grams and DHA 2.8 grams.
  • For improving movement disorders in children with poor coordination (dyspraxia): Fish oil providing DHA 480 mg combined with 35 mg arachidonic acid and 96 mg gamma-alpha linoleic acid from evening primrose oil, 24 mg thyme oil, and 80 mg vitamin E (Efalex).
  • For developmental coordination disorder in children: Fish oil providing EPA 558 mg and DHA 174 in 3 divided doses.
  • For depression along with conventional antidepressants: Fish oil 9.6 grams/day.
  • To prevent full psychosis from developing in people with mild symptoms: Fish oil 1.2 grams/day.
  • For keeping veins open after coronary bypass surgery: 4 grams/day of fish oil containing EPA 2.04 grams and DHA 1.3 grams.
  • For preventing the collapse of arteries opened by "balloon" therapy (PTCA): 6 grams/day of fish oil starting one month before PTCA and continuing one month after PTCA, followed by 3 grams of fish oil daily thereafter for six months.
  • For reducing and preventing the long-term continuous rise in blood pressure and to preserve kidney function after heart transplantation: 4 grams/day of fish oil (46.5% EPA and 37.8% DHA).
  • For preventing clotting after placement of a tube for dialysis: 6 grams/day of fish oil.
  • For preserving kidney function in patients with severe IgA nephropathy: 4-8 grams/day of fish oil has been used.
  • For combined high triglycerides and high cholesterol: Fish oil providing EPA 1800-2160 mg and DHA 1200-1440 mg combined with garlic powder 900-1200 mg/day has been used to lower total cholesterol, LDL, triglycerides, and the ratios of total cholesterol to HDL, and LDL to HDL.
  • For salicylate intolerance: Fish oil 10 grams daily.

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