Peringatan Keamanan

There have been some concerns that high doses of DHA and/or EPA (in the range of 900mg/day or EPA plus 600 mg/day of DHA or more for several weeks) could potentially reduce an individual's immune function due to the suppression of inflammatory responses L784. However, according to the European Food Safety Authority, long-term consumption of EPA and DHA supplements at combined doses of up to about 5 g/day appears to be safe L784.

Commonly reported side effects of omega-3 supplements are usually mild L784. These include unpleasant taste, bad breath, heartburn, nausea, gastrointestinal discomfort, diarrhea, headache, and odoriferous sweat L784.

Fish oil

DB13961

biotech approved nutraceutical

Deskripsi

Fish oil is a component of SMOFLIPID, which was FDA approved in July 2016. It is indicated in adults as a source of calories and essential fatty acids for parenteral nutrition when oral or enteral nutrition is not possible, insufficient, or contraindicated.

More commonly, fish oil refers to the omega-3-fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) FDA Label. In general, dietary or pharmaceutical intake of these acids is primarily the only way to increase their levels in the human body where they are overall an essential element to dietary health as they have demonstrated abilities in minimizing or preventing hypertriglyceridemia when taken as an adjunct to a healthy diet FDA Label.

Such fish oils are available in both non-prescription and prescription-only varieties at different concentrations. For many individuals, taking non-prescription fish oils as part of their multivitamin regimen is an effective way to supplement their diets with the healthy fatty acids. However, prescription-only fish oil products are sometimes prescribed for individuals who demonstrate severe (>= 500 mg/dL) hypertriglyceridemia FDA Label.

Furthermore, a variety of studies regarding additional potential actions of fish oil omega-3-fatty acids EPA and DHA are ongoing. Such experimental actions include inflammation modulation, cardioprotective effects, the attenuation of oxidative stress, and more. Regardless, the specific mechanisms of action for these effects have yet to be formally elucidated.

Struktur Molekul 2D

Struktur tidak tersedia

Peta Jejaring Molekuler
Legenda: Obat • Target • Gen • Enzim • (Panah → menunjukkan arah efek / relasi) • Transporter • Carrier

Profil Farmakokinetik

Waktu Paruh (Half-Life) The half-life of EPA is recorded to be about 37 hours while that of DHA is documented to be about 46 hours [FDA Label].
Volume Distribusi The volume of distribution of EPA is documented as being approximately 82 L [A18890].
Klirens (Clearance) The clearance of EPA is recorded to be about 548 ml/hr while that of DHA is documented to be about 518 ml/hr hours [FDA Label].

Absorpsi

The absorption process of fish oil EPA and DHA acids have been documented as being very efficient, with an absorption rate of about 95%, which is similar to that of other ingested fats L784.

Metabolisme

During and after absorption there are three main pathways for the metabolism of the fish oil omega-3-fatty acids: (a) the acids are transported to the liver where they are incorporated into various categories of lipoproteins and then channeled to the peripheral lipid stores, or (b) the cell membrane phospholipids are replaced by lipoprotein phospholipids and the fatty acids can then act as precursors for various eicosanoids, or (c) the majority of the fatty acids are oxidised to meet energy requirements F33, L2661. The concentration of the EPA and DHA fish oil omega-3-fatty acids in the plasma phospholipids corresponds to the EPA and DHA incorporated into the cell membranes F33, L2661. Ultimately, animal pharmacokinetic studies have shown that there is a complete hydrolysis of the ethyl ester accompanied by satisfactory absorption and incorporation of EPA and DHA into the plasma phospholipids and cholesterol esters L2661. Furthermore, it also known that EPA can act as a precursor to DHA A176741.

Rute Eliminasi

Based on what is known about the elimination of EPA and DHA, it is understood that such fatty acids do not undergo renal excretion FDA Label.

Interaksi Obat

448 Data
Efavirenz The metabolism of Fish oil can be decreased when combined with Efavirenz.
Dantrolene The risk or severity of hyperkalemia can be increased when Dantrolene is combined with Fish oil.
Boceprevir The metabolism of Fish oil can be decreased when combined with Boceprevir.
Ibutilide Ibutilide may increase the arrhythmogenic activities of Fish oil.
Hyoscyamine Hyoscyamine may increase the arrhythmogenic activities of Fish oil.
Atropine Atropine may increase the arrhythmogenic activities of Fish oil.
Adenosine Adenosine may increase the arrhythmogenic activities of Fish oil.
Moricizine Moricizine may increase the arrhythmogenic activities of Fish oil.
Levosimendan Levosimendan may increase the arrhythmogenic activities of Fish oil.
Procainamide Procainamide may increase the arrhythmogenic activities of Fish oil.
Tocainide Tocainide may increase the arrhythmogenic activities of Fish oil.
Flecainide Flecainide may increase the arrhythmogenic activities of Fish oil.
Encainide Encainide may increase the arrhythmogenic activities of Fish oil.
Ajmaline Ajmaline may increase the arrhythmogenic activities of Fish oil.
Aprindine Aprindine may increase the arrhythmogenic activities of Fish oil.
Azimilide Azimilide may increase the arrhythmogenic activities of Fish oil.
Tedisamil Tedisamil may increase the arrhythmogenic activities of Fish oil.
Vernakalant Vernakalant may increase the arrhythmogenic activities of Fish oil.
Cariporide Cariporide may increase the arrhythmogenic activities of Fish oil.
Xylometazoline Xylometazoline may increase the arrhythmogenic activities of Fish oil.
Sparteine Sparteine may increase the arrhythmogenic activities of Fish oil.
Fasudil Fasudil may increase the arrhythmogenic activities of Fish oil.
Melperone Melperone may increase the arrhythmogenic activities of Fish oil.
Tropisetron Tropisetron may increase the arrhythmogenic activities of Fish oil.
Simendan Simendan may increase the arrhythmogenic activities of Fish oil.
Spiradoline Spiradoline may increase the arrhythmogenic activities of Fish oil.
Pilsicainide Pilsicainide may increase the arrhythmogenic activities of Fish oil.
Cicletanine Cicletanine may increase the arrhythmogenic activities of Fish oil.
Cibenzoline Cibenzoline may increase the arrhythmogenic activities of Fish oil.
Nizofenone Nizofenone may increase the arrhythmogenic activities of Fish oil.
Prajmaline Prajmaline may increase the arrhythmogenic activities of Fish oil.
Tiracizine Tiracizine may increase the arrhythmogenic activities of Fish oil.
Ethacizine Ethacizine may increase the arrhythmogenic activities of Fish oil.
Lorajmine Lorajmine may increase the arrhythmogenic activities of Fish oil.
Bunaftine Bunaftine may increase the arrhythmogenic activities of Fish oil.
Lorcainide Lorcainide may increase the arrhythmogenic activities of Fish oil.
Hydroquinine Hydroquinine may increase the arrhythmogenic activities of Fish oil.
Fosfructose Fosfructose may increase the arrhythmogenic activities of Fish oil.
Carteolol Fish oil may increase the arrhythmogenic activities of Carteolol.
Metipranolol Fish oil may increase the arrhythmogenic activities of Metipranolol.
Bioallethrin Fish oil may increase the arrhythmogenic activities of Bioallethrin.
Hydroquinidine Fish oil may increase the arrhythmogenic activities of Hydroquinidine.
SOR-C13 Fish oil may increase the arrhythmogenic activities of SOR-C13.
Digoxin Digoxin may increase the arrhythmogenic activities of Fish oil.
Acetyldigitoxin Acetyldigitoxin may increase the arrhythmogenic activities of Fish oil.
Deslanoside Deslanoside may increase the arrhythmogenic activities of Fish oil.
Cymarin Cymarin may increase the arrhythmogenic activities of Fish oil.
Metildigoxin Metildigoxin may increase the arrhythmogenic activities of Fish oil.
Acetyldigoxin Acetyldigoxin may increase the arrhythmogenic activities of Fish oil.
Niguldipine Niguldipine may increase the arrhythmogenic activities of Fish oil.
Bretylium Bretylium may increase the arrhythmogenic activities of Fish oil.
Isradipine Isradipine may increase the arrhythmogenic activities of Fish oil.
Diltiazem Diltiazem may increase the arrhythmogenic activities of Fish oil.
Trimethadione Trimethadione may increase the arrhythmogenic activities of Fish oil.
Amlodipine Amlodipine may increase the arrhythmogenic activities of Fish oil.
Nimodipine Nimodipine may increase the arrhythmogenic activities of Fish oil.
Lercanidipine Lercanidipine may increase the arrhythmogenic activities of Fish oil.
Lamotrigine Lamotrigine may increase the arrhythmogenic activities of Fish oil.
Cinnarizine Cinnarizine may increase the arrhythmogenic activities of Fish oil.
Nicardipine Nicardipine may increase the arrhythmogenic activities of Fish oil.
Verapamil Verapamil may increase the arrhythmogenic activities of Fish oil.
Losartan Losartan may increase the arrhythmogenic activities of Fish oil.
Levomenthol Levomenthol may increase the arrhythmogenic activities of Fish oil.
Zonisamide Zonisamide may increase the arrhythmogenic activities of Fish oil.
Nitrendipine Nitrendipine may increase the arrhythmogenic activities of Fish oil.
Perhexiline Perhexiline may increase the arrhythmogenic activities of Fish oil.
Bepridil Bepridil may increase the arrhythmogenic activities of Fish oil.
Nimesulide Nimesulide may increase the arrhythmogenic activities of Fish oil.
Prenylamine Prenylamine may increase the arrhythmogenic activities of Fish oil.
Cyclandelate Cyclandelate may increase the arrhythmogenic activities of Fish oil.
Flunarizine Flunarizine may increase the arrhythmogenic activities of Fish oil.
Fluspirilene Fluspirilene may increase the arrhythmogenic activities of Fish oil.
Clevidipine Clevidipine may increase the arrhythmogenic activities of Fish oil.
Methsuximide Methsuximide may increase the arrhythmogenic activities of Fish oil.
Seletracetam Seletracetam may increase the arrhythmogenic activities of Fish oil.
Nylidrin Nylidrin may increase the arrhythmogenic activities of Fish oil.
Ziconotide Ziconotide may increase the arrhythmogenic activities of Fish oil.
Dotarizine Dotarizine may increase the arrhythmogenic activities of Fish oil.
Nilvadipine Nilvadipine may increase the arrhythmogenic activities of Fish oil.
Tranilast Tranilast may increase the arrhythmogenic activities of Fish oil.
Agmatine Agmatine may increase the arrhythmogenic activities of Fish oil.
Fendiline Fendiline may increase the arrhythmogenic activities of Fish oil.
Eperisone Eperisone may increase the arrhythmogenic activities of Fish oil.
Trimebutine Trimebutine may increase the arrhythmogenic activities of Fish oil.
Pinaverium Pinaverium may increase the arrhythmogenic activities of Fish oil.
Nicorandil Nicorandil may increase the arrhythmogenic activities of Fish oil.
Barnidipine Barnidipine may increase the arrhythmogenic activities of Fish oil.
Aranidipine Aranidipine may increase the arrhythmogenic activities of Fish oil.
Azelnidipine Azelnidipine may increase the arrhythmogenic activities of Fish oil.
Benidipine Benidipine may increase the arrhythmogenic activities of Fish oil.
Cilnidipine Cilnidipine may increase the arrhythmogenic activities of Fish oil.
Darodipine Darodipine may increase the arrhythmogenic activities of Fish oil.
Efonidipine Efonidipine may increase the arrhythmogenic activities of Fish oil.
Lacidipine Lacidipine may increase the arrhythmogenic activities of Fish oil.
Manidipine Manidipine may increase the arrhythmogenic activities of Fish oil.
Niludipine Niludipine may increase the arrhythmogenic activities of Fish oil.
Carboxyamidotriazole Carboxyamidotriazole may increase the arrhythmogenic activities of Fish oil.
Naftopidil Naftopidil may increase the arrhythmogenic activities of Fish oil.
Tetrahydropalmatine Tetrahydropalmatine may increase the arrhythmogenic activities of Fish oil.
Vinpocetine Vinpocetine may increase the arrhythmogenic activities of Fish oil.

Target Protein

Diacylglycerol O-acyltransferase 2 DGAT2
Prostaglandin G/H synthase 2 PTGS2
Free fatty acid receptor 4 FFAR4
Voltage gated L-type calcium channel CACNA1C
Sodium channel protein SCN1A
Free radicals
Nuclear factor NF-kappa-B NFKB2
Sterol regulatory element-binding protein 1 SREBF1
Peroxisome proliferator-activated receptor alpha PPARA
Peroxisome proliferator-activated receptor gamma PPARG
Peroxisome proliferator-activated receptor delta PPARD

Referensi & Sumber

Artikel (PubMed)
  • PMID: 26097787
    Braeckman RA, Stirtan WG, Soni PN: Pharmacokinetics of Eicosapentaenoic Acid in Plasma and Red Blood Cells After Multiple Oral Dosing With Icosapent Ethyl in Healthy Subjects. Clin Pharmacol Drug Dev. 2014 Mar;3(2):101-108. Epub 2013 Oct 22.
  • PMID: 20699674
    Weitz D, Weintraub H, Fisher E, Schwartzbard AZ: Fish oil for the treatment of cardiovascular disease. Cardiol Rev. 2010 Sep-Oct;18(5):258-63. doi: 10.1097/CRD.0b013e3181ea0de0.
  • PMID: 22393325
    Visioli F, Giordano E, Nicod NM, Davalos A: Molecular targets of omega 3 and conjugated linoleic Fatty acids - "micromanaging" cellular response. Front Physiol. 2012 Feb 29;3:42. doi: 10.3389/fphys.2012.00042. eCollection 2012.
  • PMID: 26662863
    Simon MV, Agnolazza DL, German OL, Garelli A, Politi LE, Agbaga MP, Anderson RE, Rotstein NP: Synthesis of docosahexaenoic acid from eicosapentaenoic acid in retina neurons protects photoreceptors from oxidative stress. J Neurochem. 2016 Mar;136(5):931-46. doi: 10.1111/jnc.13487. Epub 2016 Jan 20.
  • PMID: 26380055
    Ferguson LR: Fish oils in parenteral nutrition: Why could these be important for gastrointestinal oncology? World J Gastrointest Oncol. 2015 Sep 15;7(9):128-31. doi: 10.4251/wjgo.v7.i9.128.

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