Difference between prescription fish oil and supplements


Omega-3s have been shown to improve heart, vascular and brain health in a number of ways. With this in mind, many seek to gain more by consuming more foods rich in these fatty acids and using omega-3 supplements, either over-the-counter or prescription versions.

There are differences in fish oil and other omega-3 supplements to consider, which is, in part, why the prescription versions aren't right for everyone. And while omega-3s are beneficial, there are some people who are not advised to take supplements.

Why do you need a supplement?

Omega-3 fatty acids belong to the group of polyunsaturated fats, or "good" fats, which include eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and alpha-linolenic acid (ALA). They have a number of health benefits, so making sure you're getting enough is a worthy goal.

Among the health benefits of omega-3s are:

  • Studies of people with high triglyceride levels have shown that taking 2 to 4 grams (2,000 to 4,000 milligrams) of omega-3s per day can reduce triglyceride levels by 50%. High triglyceride levels have been linked to heart health problems , such as strokes and heart attacks.
  • Omega-3s can raise HDL ("good") cholesterol and increase the size of LDL ("bad") cholesterol particles , reducing the likelihood of atherosclerosis.
  • Consuming omega-3s may also have other benefits for heart health, such as lowering blood pressure and inflammation, among others.
  • There is also evidence to suggest that omega-3s support brain health, such as improving mood and sleep and slowing cognitive decline.

Omega-3s are found in foods like certain fatty fish; flax, chia and hemp seeds; as well as nuts, soybeans, beans, and seaweed. However, omega-3s are available in much greater amounts in a variety of over-the-counter supplements and prescription drugs.

Types and content of omega-3

Visit a vitamin store and you will see a wide selection of omega-3 supplements on the shelf. They can be made of:

  • Fish oil (most common)
  • Oils from other marine animals (such as krill)
  • Plant sources (for example, algae)

The source of omega-3 affects, among other things, the total omega-3 content of a product and its bioavailability (how easily your body can use it). And because over-the-counter supplements do not undergo the rigorous testing required for prescription drugs, each product may have different levels of EPA and DHA, which may not always match what is stated on the label.

However, prescription drugs contain more omega-3s than over-the-counter supplements.

Prescription medications can contain up to 90% omega-3 fatty acids, while over-the-counter fish oil supplements contain 30% to 50% omega-3 fatty acids, depending on the product.

Prescription omega-3s include:

  • Lovaza (omega-3 acid ethyl esters): contains both EPA and DHA.
  • Vascepa (Icosapent Ethyl) – Contains only EPA, potentially making it more suitable for people with high LDL cholesterol.
  • Epanova (omega-3 carboxylic acids) and Omtryg (ethyl esters of omega-3-A acids): Although approved by the FDA in 2014, they are not yet commercially available.

  • Side effects: belching and upset stomach; taste changes

  • It has a general shape

  • Cost (without insurance): $ 312 for 120 1g capsules ($ 105 for generic).

  • Contains EPA and DHA

Availability and efficiency

Get Drug Information / Anastasia Tretyak

While fish oil supplements are commercially available for a variety of purposes, omega-3 prescriptions are generally indicated for the 25% of American adults with elevated triglyceride levels (200 mg / dL to 499 mg / dL) or extremely high. triglyceride levels (500 mg / dL or more). Your doctor may also prescribe other conditions for which omega-3s can help.

When taken in equivalent amounts, prescription omega-3 supplements and over-the-counter omega-3 supplements should similarly lower triglyceride levels.

Possible Side Effects and Risks.

Possible side effects of omega-3 supplements and medications include:

  • Low blood pressure
  • Increased bleeding, including bleeding gums and nosebleeds;
  • Indigestion, heartburn, or belching
  • Diarrhea or flatulence

Upset stomach is often caused by the high fat content of fish oil and can be relieved by taking fish oil supplements with meals and early in the day rather than on an empty stomach, during dinner, or before bed.

Because over-the-counter omega-3 supplements may contain fish, and prescription omega-3s are derived from fish, they should not be used by people with a fish allergy.

People who take blood pressure or anticoagulant medications, are hypotensive, or have an increased risk of bleeding or hemorrhagic stroke, should consult a doctor before taking omega-3 supplements, given their ability to thin the blood and decrease blood pressure. blood pressure.

Safety and cleanliness

Not all omega-3 fatty acid supplements and recipes are the same. Each of them is subjected to different controls in accordance with the requirements of the Food and Drug Administration (FDA) .

Fish oil supplements, which can be found at your local drugstore, and similar over-the-counter products, are classified as "food products" by the FDA. This means that the manufacturer is responsible for ensuring that these products are safe, free from contaminants, properly labeled, and manufactured in a clean environment.

This is why it is very important to research and buy only well-known brands of over-the-counter supplements. The only way the FDA will remove the additive from the market is if there are multiple health complaints about the product after it hits store shelves, which is subject to public reporting.

On the other hand, prescription drugs are controlled differently. To be approved for use as a prescription drug, omega-3 fatty acid products must undergo rigorous testing before healthcare providers can prescribe and sell them in pharmacies. Manufacturers must provide evidence to the FDA that the drug is working as it should, that it is safe, and that it contains all of the ingredients listed on the label. They should also report any side effects experienced by people taking the drug.

Since they are not strictly regulated by the FDA, there is no guarantee that over-the-counter fish oil supplements are fresh or free of chemicals such as dioxins and heavy metals such as mercury, which are predominant in the tissues of the fish. ocean. However, some studies show that the amount of potential contaminants in over-the-counter fish oil supplements is much less than in one serving of fish you would eat.

On the other hand, prescription omega-3s that are extracted from fish oil are highly refined to remove isomers, heavy metals, and all other impurities to a detection level.

Note: Fish oil is very susceptible to oxidation (rancid), which can negatively affect over-the-counter supplements.


Because fish oil supplements don't have to go through extensive prescription testing, they are generally much cheaper than prescription options.

Get the word of drug information

If you are considering adding omega-3 supplements to your diet, you should consult your doctor. Currently, the FDA recommends taking no more than 2 grams of fish oil supplements per day, unless directed by your doctor. While fish oil supplements are readily available, they can still cause certain side effects and exacerbate certain medical conditions.

Related Articles
Foods to Avoid If You Have Dry Mouth From Radiation

Dry mouth (xerostomia) is a common side effect of radiation therapy for people undergoing treatment for head and neck cancer. Read more

Thyroid adenoma: Causes, Treatment, and Diagnosis

The thyroid is a small, butterfly-shaped gland in the front of your throat that produces hormones affecting a number of Read more

NSAIDs and You Thyroid Function

Nonsteroidal anti-inflammatory drugs (NSAIDs) are the most frequently taken over-the-counter medications. Due to their systemic or whole body effects, it's Read more

How Doctors Are Failing Thyroid Disease Patients

The thyroid disease community has continually mentioned the lack of support they experience and the difficulty they have navigating the Read more