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Lipid-Lowering Agents

Icosapent Ethyl

Brand names: Vascepa

Icosapent ethyl is a purified ethyl ester of the omega-3 fatty acid eicosapentaenoic acid (EPA), used to reduce cardiovascular risk in high-risk patients with raised triglycerides who are on statin therapy.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

Its precise cardioprotective mechanism is not fully established, but it lowers triglyceride levels and is thought to exert additional anti-inflammatory, antithrombotic and membrane-stabilising effects beyond triglyceride reduction.

Prescribing in practice

  • It is associated with an increased risk of atrial fibrillation or flutter and of bleeding, particularly when combined with antiplatelet or anticoagulant therapy, so patients should be monitored accordingly.
  • Unlike mixed fish-oil preparations it is a high-purity EPA-only product and is used as an adjunct to, not a replacement for, statin treatment.
  • Use caution in patients with known hypersensitivity to fish or shellfish.

Monitoring

Monitor triglyceride and lipid levels, and review for new palpitations or atrial fibrillation and for signs of bleeding.

Counselling the patient

  • Report palpitations or an irregular heartbeat.
  • Tell clinicians about any unusual bruising or bleeding, especially if you take blood thinners.
  • Continue your statin and take this as directed alongside it.

Evidence & guidelines

The REDUCE-IT trial demonstrated that icosapent ethyl reduced major cardiovascular events in statin-treated patients with elevated triglycerides.

Reference: REDUCE-IT trial NEJM 2018; 380(1):11-22; NICE TA805; MHRA approval 2021; ESC/EAS Lipid Guidelines 2019; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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