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Diabetes Medications and New Drugs

Omacor

What is OmacorR?

OmacorOmacor is a capsule which contains a concentrated preparation of fish oils. These oils are rich in a special type of fat – the n-3 PUFA (PUFA = polyunsaturated fatty acids) or omega-3 fatty acids. 90% of a 1 gm capsule of Omacor consists of these n-3 fatty acids.

What’s special about fish oils?

The benefit of fish oils was first recognised by scientists who studied the Eskimos of Greenland who have a remarkably low rate of coronary heart disease even though they consume a very high fat diet. The fat in their diet was derived from seals and other marine animals which were rich in omega-3 fatty acids. Certain type of cold water fish are also rich in fish oils.

FishIt is thought these fish oils work in several different ways to reduce cardiovascular risk. Among the potential benefits are reduction in atheroma and tendency to form clots or thromboses. They may also help lower blood pressure slightly.

What is the benefit of taking Omacor?

Reduces levels of triglycerides in the blood by 25-30%.

Omacor is licensed for the treatment of raised triglycerides and is also considered a useful treatment following a heart attack.

Will it reduce my blood cholesterol?

Fish oils do not reduce blood cholesterol concentrations as they tend to work mainly on a different component of blood fats which are called triglycerides.

Are there any side effects?

The main reported side effects of these capsules are related to the digestive system. Reflux or eructation of an oily taste or odour of fish has been mentioned as well as nausea.

At doses of 2-4 g daily Omacor is well tolerated and no serious adverse effects have been reported.

With high doses an increase in bleeding time can occur. Patients who take warfarin concurrently may be at increased risk of bleeding.

Can these capsules be taken with cholesterol lowering therapy?

Yes, Omacor can be safely combined with statins or fibrates in the treatment for treatment of raised cholesterol and raised triglycerides.

Will eating a lot of fish achieve the same benefit?

There is no doubt that eating fish as a part of a balanced diet has many health benefits. However, you would have to eat a very large amount of fish to consume the quantities of fish oil which you would take in the form of a fish oil capsule.

I prefer to eat fish – which fish are rich in these oils?

Herring, mackerel, pilchards, tuna and sardines are all rich in fish oils. The British Nutrition Foundation recommends that all adults in the UK should have at least two portions a week of oily fish. Fish is an excellent source of protein and doesn’t have high amounts of saturated or ‘unhealthy’ fats as other meat products do.

Is there a benefit over other fish oil capsules currently available?

Omacor has a higher concentration of fish oils within a 1 gm capsule. The number of capsules you are required to take may be less than with older preparations. There is no other significant difference.

What are the other available treatments for raised triglycerides?

The following table lists available treatments for raised triglycerides and the potential benefits.

Preparation

Potential reduction in triglycerides

n-3 PUFA

25 - 30 %

Nicotinic acid

20 – 40 %

fibrates

20 – 55 %

statins

Up to 30 %

How much does it cost?

100 capsules of Omacor would cost the NHS about fifty pounds. A dose of 3 capsules a day would therefore cost approximately fifty pounds a month.

 

Dr Nishan Wijenaike
Consultant Physician
West Suffolk Diabetes Service
Bury St Edmunds
March 2006

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