Vascepa vs. Lovaza: FDA-Approved Prescription Medications for Lowering Triglycerides

While many people are aware of cholesterol, triglycerides often receive less attention. These fats circulate in your blood, and elevated levels can increase your risk for serious conditions like heart attacks, strokes, and even pancreatic problems.

Because high triglycerides usually have no symptoms, they're often discovered during routine blood tests. If your levels are high, especially above 500 mg/dL, your doctor may recommend a prescription medication to help lower them. Two common options are Lovaza and Vascepa.

What Are Lovaza and Vascepa?

Lovaza and Vascepa are prescription-strength omega-3 medications, not the same as over-the-counter fish oil supplements. They are purified, FDA-approved, and manufactured under strict quality standards.

• Lovaza contains two omega-3 fatty acids: EPA and DHA, in a form called ethyl esters. It is approved for adults with very high triglycerides. It has not been studied in children.
• Vascepa contains only EPA (as icosapent ethyl) and no DHA. Its safety and effectiveness in children are also unknown.

How Are They Used?

Both Lovaza and Vascepa are used to help manage high triglyceride levels in adults. However, they have distinct indications.

Lovaza

• Approved for adults with very high triglycerides (≥500 mg/dL).
• Used alongside lifestyle changes like diet, exercise, and managing other health conditions (e.g. dibetes, thyroid disorders).
• Lovaza has not been proven to reduce the risk of heart attacks, strokes, or pancreatitis.

Vascepa

• Approved for adults with very high triglycerides (≥500 mg/dL).
• Additionally approved to be used with a statin to lower the risk of heart-related problems in adults with triglycerides of 150 mg/dL or more, particularly those with heart disease or diabetes plus other risk factors (e.g., high blood pressure, smoking).
• Vascepa has not been shown to reduce the risk of pancreatitis.

How to Take Lovaza and Vascepa

Both Lovaza and Vascepa are prescription omega-3 medications taken by mouth in capsule form. The standard dose for each is 4 grams per day, but how you take them can vary slightly depending on the medication.

Lovaza

• Dosage: 4 grams per day, as either one 4-capsule dose or two 2-capsule doses (morning and evening).
• Capsule content: Each 1-gram capsule contains 465 mg EPA and 375 mg DHA.
• With or without food: You can take Lovaza with or without meals, though some people find it easier on the stomach when taken with food. Try to take it the same way each day.
• Instructions::
  • Do not exceed 4 capsules per day.
  • Swallow capsules whole.
  • Maintain a low-fat, low-cholesterol diet.
  • Regular blood tests may be needed to monitor progress and liver function, especially if you have liver conditions.
  • If you miss a dose, take it as soon as you remember unless it's almost time for your next dose. Never double up.
  • If you accidentally take too much, contact your healthcare provider or poison control immediately.

Note: It would take about 14 standard fish oil capsules to match the EPA/DHA in your daily Lovaza dose.

Vascepa

• Dosage: 4 grams per day, as either four 0.5-gram capsules twice a day or two 1-gram capsules twice a day.
• With food: Always take with food to improve absorption.
• Instructions::
  • Take at the same times every day for best results.
  • Follow diet and exercise recommendations; medication works best as part of an overall health plan.
  • Your healthcare provider will monitor your triglyceride levels while on therapy.
  • Swallow capsules whole, do not break, crush, or chew them.

For both medications: Do not make changes to your dosing or stop taking your medication without your provider’s guidance. Always follow your healthcare team’s instructions for the safest and most effective treatment.

Side Effects

Like most medications, Lovaza and Vascepa can cause side effects. Not everyone experiences them, but it’s helpful to know what to watch for.

Lovaza

Common side effects reported in clinical studies include:

• Burping
• Upset stomach or indigestion
• Changes in taste (e.g., metallic or unusual flavors)

Less common side effects may include:

• Constipation
• Stomach discomfort or vomiting
• Skin rash or itching
• Mild changes in liver enzymes (ALT or AST), which your doctor may monitor with blood tests

After Lovaza's approval, some additional reactions were reported by patients, though these were voluntary reports and may not apply to everyone:

• Allergic reactions, such as swelling or hives
• Unusual bleeding or bruising

If you experience any new or concerning symptoms, especially unexplained bleeding, skin welts, or difficulty breathing, contact your healthcare provider immediately.

Note: Lovaza may slightly increase LDL cholesterol and affect liver function tests, which is why regular bloodwork is often recommended.

Vascepa

One of the more serious but less common side effects of Vascepa is atrial fibrillation (AFib), a type of irregular heartbeat. This has been seen more often in people with existing heart disease or diabetes.

Signs of AFib may include: Fast or irregular heartbeat, lightheadedness, fainting, chest tightness, or shortness of breath.

Other potential side effects:

• Allergic reactions (especially if allergic to fish or shellfish)
• Bleeding, especially if you are also taking blood thinners

More common side effects include:

• Muscle or joint pain
• Swelling in the hands, legs, or feet
• Constipation
• Gout

our doctor may also monitor liver function and triglyceride levels while you're on Vascepa.

Talk to Your Doctor

If you’ve been told your triglycerides are high, or you’re not sure what that means for you, start by having a conversation with your doctor. They can help you understand your test results and talk through whether a prescription omega-3 medication, like Lovaza or Vascepa, might be right for you.

Everyone’s health story is different, and your doctor is there to help you make sense of it, one step at a time.