Drug Guide
Icosapent Ethyl
Classification
Therapeutic: Lipid-Lowering Agent, Omega-3 Fatty Acid Derivative
Pharmacological: Eicosapentaenoic Acid Ethyl Ester
FDA Approved Indications
- Reduction of cardiovascular risk in adults withEditor's note: Original user query- At risk of cardiovascular disease, with elevated triglycerides (≥150 mg/dL) despite management of other risk factors.
Mechanism of Action
Icosapent ethyl reduces hepatic triglyceride synthesis and enhances triglyceride clearance, primarily through anti-inflammatory, anti-thrombotic, and membrane-stabilizing effects of eicosapentaenoic acid, decreasing plasma triglyceride levels.
Dosage and Administration
Adult: 2 grams twice daily, with food.
Pediatric: Not approved for pediatric use.
Geriatric: No specific dose adjustments; monitor renal/hepatic function as appropriate.
Renal Impairment: No specific adjustment needed; monitor levels.
Hepatic Impairment: Use with caution; no specific guidelines, monitor liver function.
Pharmacokinetics
Absorption: Well absorbed when taken with food.
Distribution: Widely distributed; high plasma protein binding.
Metabolism: Minimal hepatic metabolism; primarily excreted unchanged.
Excretion: Excreted mainly in feces; minor renal excretion.
Half Life: Approximately 89 hours.
Contraindications
- Hypersensitivity to fish or shellfish.
- Use with caution in patients on anticoagulants or antiplatelet agents due to increased bleeding risk.
Precautions
- Monitor bleeding time.
- Use with caution in patients with bleeding disorders or those taking medications affecting coagulation.
- Pregnancy Category: Not established; consult healthcare provider.
Adverse Reactions - Common
- Arthralgia (Less than 5%)
- Pain in extremities (Less than 5%)
- Back pain (Less than 5%)
- Muscle pain (myalgia) (Less than 5%)
Adverse Reactions - Serious
- Bleeding or abnormal bleeding (Rare)
- Atrial fibrillation and/flutter (Rare)
Drug-Drug Interactions
- Anticoagulants (e.g., warfarin, apixaban) — increased bleeding risk.
- Antiplatelet agents — increased bleeding risk.
Drug-Food Interactions
- No significant food interactions identified.
Drug-Herb Interactions
- Caution with concomitant herbal supplements affecting coagulation (e.g., ginseng, garlic, ginkgo).
Nursing Implications
Assessment: Monitor lipid profile, liver function tests, and signs of bleeding.
Diagnoses:
- Risk for bleeding.
- Imbalanced nutrition: less than body requirements (if gastrointestinal side effects occur).
Implementation: Advise taking with food, monitor for signs of bleeding, and assess response to therapy.
Evaluation: Aim for reduction in triglyceride levels and stabilization of cardiovascular risk.
Patient/Family Teaching
- Take medication exactly as prescribed, with food.
- Report any signs of bleeding (e.g., unusual bruising, bleeding gums).
- Maintain a healthy diet and lifestyle to support cardiovascular health.
- Inform healthcare providers about all medications and supplements.
Special Considerations
Black Box Warnings:
- Increase in bleeding risk.
Genetic Factors: No specific genetic considerations identified.
Lab Test Interference: May affect coagulation tests; interpret results accordingly.
Overdose Management
Signs/Symptoms: Excessive bleeding, gastrointestinal bleeding.
Treatment: Supportive care; discontinue medication; consider consultation with poison control for further guidance.
Storage and Handling
Storage: Store at room temperature, 20–25°C (68–77°F).
Stability: Stable under recommended storage conditions for the duration of the shelf life.