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Interactions
with Eicosapentaenoic Acid (EPA) | |
Aspirin
In a double-blind, randomized, crossover study, six healthy volunteers were
given aspirin (40 mg/day) combined with omega-3 fatty acids (5.3 g) (Iacoviello
et al. 1992). The combination lowered the fibrinolytic response to venous
occlusion and could be helpful in the treatment of some forms of coronary artery
disease.
Cyclosporine
In a double-blind, randomized, placebo-controlled study, 28 cardiac
transplant patients received an immunosuppressive regimen consisting of
cyclosporine (6 mg/kg body weight), azathioprine (2 mg/kg/day), and prednisolone
(0.2 mg/kg/day) with either omega-3 fatty acids (4 g/day: 46.5% EPA and 37.8%
DHA) or placebo (Andreassen et al. 1997). Both treatment groups also received
alpha-tocopherol (3.7 mg). Treatment commenced 4 days postoperatively and
continued for 6 months, with blood levels of cyclosporine remaining stable for
both groups. After 6 months, systolic blood pressure decreased in the omega-3
group and increased in the control group. Diastolic blood pressure increased in
both groups; this increase was statistically significant in the control group.
An earlier study in 20 cardiac transplant patients receiving omega-3 fatty acids
(3 g/day: EPA and DHA) in conjunction with cyclosporine and antihypertensive
medications for 12 weeks supports these findings (Ventura et al. 1993). The
mechanism of action may be due to decreasing systemic vascular resistance. The
combination of omega-3 fatty acids with cyclosporine may show promise as
effective hypertension prophylaxis in cardiac transplant patients.
Another placebo-controlled, prospective, double-blind, randomized study
involving 26 patients was conducted to evaluate the effects of omega-3 fatty
acids on cyclosporine-induced nephrotoxicity (Badalamenti et al. 1995). Liver
transplant patients were given omega-3 fatty acids (12 g/day: 18% EPA and 12%
DHA) or placebo while on cyclosporine therapy. After 2 months, renal plasma flow
increased by 22%, the glomerular filtration rate (GFR) increased by 33%, renal
blood flow increased by 17%, and renal vascular resistance decreased by 20% for
patients receiving omega-3 fatty acids. No changes were noted in the control
group.
Kidney transplant recipients also benefited from supplementation with omega-3
fatty acids (6 g: 30% EPA and 20% DHA) during cyclosporine therapy in a
double-blind, placebo-controlled, prospective, randomized clinical trial
involving 21 subjects (Homan van der Heide et al. 1990). After 3 months, blood
pressure decreased in the omega-3 group, and GFR and renal plasma flow increased
by 20.3% and 16.4%, respectively. However, another double-blind, randomized,
controlled study with 25 renal transplant patients did not demonstrate any
clinically significant benefits derived from one year of treatment with omega-3
fatty acids (6 g: 30% EPA, 20% DHA) (Kooijmans-Coutinho et al.
1996). Etretinate
A randomized, open study was conducted to evaluate the effects of highly
purified EPA (1800 mg/day) in combination with low-dose etretinate (0.3 to 0.5
mg/kg/day) for 12 weeks in patients with chronic, stable psoriasis vulgaris
(Danno and Sugie 1998). Patients continued to be treated with a topical
corticosteroid that previously had been ineffective. At the end of the study,
clinical improvement was noted in 100% of the patients receiving etretinate with
EPA as compared to 90% in the patients receiving etretinate monotherapy. The
number of patients reporting adverse reactions was similar in both groups.
Nonsteroidal
Anti-inflammatory Drugs (NSAIDs)
Omega-3 fatty acids (5 and 10 mL/kg body weight) significantly protected the
gastric mucosa against ulcers induced by NSAIDs, reserpine, and necrotizing
agents in rats (Al-Harbi et al. 1995). |
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References |
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Al-Harbi MM, Islam MW, Al-Shabanah OA, Al-Gharably NM. Effect of acute
administration of fish oil (omega-3 marine triglyceride) on gastric ulceration
and secretion induced by various ulcerogenic and necrotizing agents in rats.
Food Chem Toxicol. 1995;33(7):555-558.
Andreassen AK, Hartmann A, Offstad J, Geiran O, Kvernebo K, Simonsen S.
Hypertension prophylaxis with omega-3 fatty acids in heart transplant
recipients. J Am Coll Cardiol. 1997;29(6):1324-1331.
Badalamenti S, Salerno F, Lorenzano E, et al. Renal effects of dietary
supplementation with fish oil in cyclosporine-treated liver transplant
recipients. Hepatol. 1995;22(6):1695-1701.
Danno K, Sugie N. Combination therapy with low-dose etretinate and
eicosapentaenoic acid for psoriasis vulgaris. J Dermatol.
1998;25(11):703-705.
Homan van der Heide JJ, Bilo HJ, Tegzess AM, Donker AJ. The effects of
dietary supplementation with fish oil on renal function in cyclosporine-treated
renal transplant recipients. Transplantation. 1990;49(3):523-527.
Iacoviello K, Amore C, De Curtis A, et al. Modulation of fibrinolytic
response to venous occlusion in humans by a combination of low-dose aspirin and
n-3 polyunsaturated fatty acids. Arterioscler Thromb.
1992;12(10):1191-1197.
Kooijmans-Coutinho MF, Rischen-Vos J, Hermans J, Arndt JW, van der Woude FJ.
Dietary fish oil in renal transplant recipients treated with cyclosporin-A: no
beneficial effects shown. J Am Soc Nephrol. 1996;7(3):513-518.
Ventura HO, Milani RV, Lavie CJ, et al. Cyclosporine-induced hypertension.
Efficacy of omega-3 fatty acids in patients after cardiac transplantation.
Circ. 1993;88(5 pt 2):II281-II285. |
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Communications This publication contains
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