High triglyceride levels are a serious threat to cardiovascular health, impacting an estimated 25% of adults in the United States. Hypertriglyceridemia, or high triglycerides, is associated with an increased risk of heart disease, heart attack, and stroke. That’s why doctors often prescribe medications to lower triglycerides.
Two common prescription omega-3 fatty acid medications used to manage high triglyceride levels are Lovaza and Vascepa. While both medications help lower triglycerides, they aren’t identical. Vascepa contains only EPA (eicosapentaenoic acid), while Lovaza contains both EPA and DHA (docosahexaenoic acid). This key difference can sometimes impact LDL cholesterol levels — sometimes called “bad” cholesterol.
So, which medication is right for you? This article provides a comprehensive comparison of Lovaza vs Vascepa, covering their efficacy, safety profiles, potential side effects, cost, and other relevant factors. Our goal is to give you the information you need to discuss treatment options with your doctor and make informed decisions about your cardiovascular health.
Hypertriglyceridemia and Cardiovascular Risk
High triglycerides are a common health issue, and they can increase your risk of cardiovascular disease.
Prevalence and Significance of Elevated Triglyceride Levels
It’s estimated that about 25% of adults in the U.S. have elevated triglyceride levels. Some earlier data suggested the number might even be higher.
Elevated triglycerides are not something to ignore because they’re linked to cardiovascular disease. Elevations in TG levels have long been associated with CV disease.
Economic Burden of Hypertriglyceridemia
High triglycerides do more than harm your health; they can also impact your wallet. Annual healthcare costs for those with severe hypertriglyceridemia (TG levels of 500 mg/dL or more) are about 33% higher than the costs for people with lower TG levels.
Research shows that lower triglyceride levels correlate with better health outcomes and lower costs. TG levels of less than 500 mg/dL were associated with a significantly lower risk of adverse clinical events and lower cost than TG levels of at least 500 mg/dL.
Vascepa: Composition, Mechanism of Action, and Clinical Use
Vascepa is a prescription medication that contains only one active ingredient: EPA (eicosapentaenoic acid), an omega-3 fatty acid.
Composition and Mechanism of Action
EPA works through several pathways in your body to lower triglyceride levels. It reduces the production of very low-density lipoprotein (VLDL) and ramps up the activity of lipoprotein lipase, an enzyme that breaks down triglycerides in the blood.
Approved Uses and Clinical Evidence
Vascepa has been approved by the FDA to help reduce the risk of cardiovascular events in adults with elevated triglyceride levels who also have established cardiovascular disease or diabetes along with other risk factors.
Clinical trials have shown that Vascepa is effective in reducing cardiovascular risks. Several meta-analyses suggest that Vascepa provides better cardiovascular protection than other omega-3 treatments that contain both EPA and DHA.
Lovaza: How it works and what it’s used for
Lovaza is a prescription medication used to lower very high triglyceride levels. Here’s a look at its composition, how it works, and what the clinical trials say.
What’s in it and how does it work?
Lovaza is made from omega-3-acid ethyl esters, which contain both EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid). Both EPA and DHA are types of omega-3 fatty acids.
While scientists don’t fully understand how these acids work to lower triglycerides, they appear to affect the liver, reducing the production of triglycerides and helping to clear them from the bloodstream.
What is it approved to treat and how well does it work?
Lovaza is FDA-approved for treating adults with very high triglyceride levels (500 mg/dL or greater).
Clinical trials have shown that Lovaza can be effective at lowering triglycerides, particularly when changes to diet alone aren’t enough. It’s often used in conjunction with a healthy diet and lifestyle changes.
It’s important to note that Lovaza, like all medications, can have potential side effects. Talk to your doctor about whether Lovaza is right for you and whether it interacts with any other medications you’re taking.
Comparing Efficacy: Vascepa vs. Lovaza
So, how do Vascepa and Lovaza stack up against each other when it comes to actually improving your health?
Triglyceride-Lowering Effects
Both medications can help lower your triglyceride levels, but Vascepa appears to have a slight edge in some studies. A recent head-to-head clinical trial found that Vascepa was more effective at reducing triglycerides compared to Lovaza.
Impact on LDL Cholesterol
This is another key difference between the two drugs. Vascepa has been shown not to raise LDL cholesterol (the “bad” cholesterol). Lovaza, on the other hand, may slightly increase LDL cholesterol levels in some people.
Cardiovascular Outcomes
The potential for cardiovascular benefits is where Vascepa really shines, thanks to its pure EPA composition. The article suggests that Vascepa may offer superior cardiovascular protection compared to Lovaza.
The REDUCE-IT trial provided strong evidence of this, demonstrating significant cardiovascular benefits with Vascepa in patients at high risk. More research is ongoing to further explore the cardiovascular effects of both drugs.
Safety and Tolerability: Side Effects, Contraindications, and Warnings
When considering any medication, it’s important to weigh the benefits against the potential risks. Here’s a look at the safety profile of Lovaza and Vascepa.
Common Side Effects
In general, both Lovaza and Vascepa are well-tolerated. The most common side effects are mild and primarily involve the gastrointestinal system. You might experience:
- Upset stomach
- Diarrhea
- Nausea
Because these symptoms can be bothersome, they sometimes cause people to stop taking the medication.
Serious Side Effects and Contraindications
Serious side effects from either Lovaza or Vascepa are rare. However, it’s important to be aware of potential risks. Both drugs can increase the risk of bleeding, especially if you’re also taking anticoagulant medications (blood thinners) like warfarin.
A major contraindication for both Lovaza and Vascepa is an allergy to fish or shellfish. Since both medications are derived from fish oil, individuals with these allergies should not take them.
Warnings and Precautions
If you’re taking anticoagulant medications, you’ll need to be monitored closely by your doctor while taking Lovaza or Vascepa due to the increased risk of bleeding.
Regardless of your medical history, it’s essential to monitor your health closely while taking either medication. Report any concerning symptoms to your physician immediately.
Dosage and Administration
The typical dose of Vascepa is between 2 and 4 grams daily, but studies have shown that 4 grams is the most effective dose.
The typical dose of Lovaza is 4 grams daily, which you can take all at once or divide into multiple doses.
Whatever medication your doctor prescribes, be sure to follow their instructions. You’ll also likely need to follow a diet low in fat and cholesterol. Talk to your doctor about what kind of diet is right for you.
Cost and Availability: Brand Name vs. Generic Options
When it comes to prescription medications, cost and availability are always factors to consider. Here’s how Vascepa and Lovaza stack up.
Cost Comparison
Vascepa tends to be more expensive than Lovaza, particularly since generic versions of Lovaza are available. Vascepa, on the other hand, is only available as a brand-name drug.
GoodRx reports that 120 capsules of Vascepa (1 gram each) cost around $330, which works out to about $11 a day. Thirty capsules of brand-name Lovaza (1 gram each) cost around $232, about $31 a day.
Generic Lovaza, though, can offer significant savings. The price ranges from about 70 cents to $2 per capsule, depending on your pharmacy and insurance coverage.
Availability
Vascepa is only available as a brand-name medication. Lovaza, however, has generic alternatives, which may make it easier to obtain depending on your insurance plan and pharmacy.
Frequently Asked Questions
Is Lovaza better than fish oil?
It’s not really a question of “better,” but rather, “more appropriate for a specific need.” Lovaza is a prescription medication with a standardized dose of omega-3 fatty acids, while fish oil supplements vary widely in their composition and purity. Lovaza is generally used when higher, controlled doses of omega-3s are needed to treat high triglycerides.
Is Vascepa the best fish oil?
Vascepa isn’t technically “fish oil” in the traditional sense. It’s a highly purified form of EPA (eicosapentaenoic acid), an omega-3 fatty acid derived from fish oil. Whether it’s “best” depends on the individual. Vascepa has shown effectiveness in reducing cardiovascular events in certain high-risk patients, but it’s a prescription medication with potential side effects.
What is the downside of Vascepa?
Like all medications, Vascepa has potential downsides. Common side effects include musculoskeletal pain, peripheral edema, constipation, gout, and atrial fibrillation. It’s also a prescription drug, so it requires a doctor’s visit and ongoing monitoring. Cost can also be a factor, as Vascepa may be more expensive than over-the-counter fish oil supplements.
What is a good substitute for Vascepa?
There isn’t a direct, one-to-one substitute for Vascepa, as it’s a specific, purified EPA formulation. However, depending on your specific needs and health conditions, your doctor might suggest high-quality fish oil supplements with a high EPA content, lifestyle changes like diet and exercise, or other medications to manage cholesterol and triglycerides.
Key Takeaways
Vascepa and Lovaza are both prescription medications used to lower very high triglyceride levels, but they have some important differences. Vascepa contains only EPA, while Lovaza contains both EPA and DHA. Vascepa doesn’t usually raise LDL cholesterol, while Lovaza sometimes does. Finally, the cost of these two medications can vary depending on your insurance and pharmacy.
When it comes to choosing between Vascepa and Lovaza, the best choice depends on your specific needs and risk factors. For example, if you have high triglycerides and are also concerned about your LDL cholesterol levels, Vascepa might be a better option.
Talk to your doctor about which medication is right for you. They can help you weigh the pros and cons of each medication and determine the best course of treatment for your high triglyceride levels. More research is always useful, and ongoing studies will continue to shed light on the long-term cardiovascular benefits of both medications.