Why many doctors are switching patients from Lovaza to Vascepa.
Vascepa significantly reduces triglycerides, VLDL and non-HDL cholesterol.
Until recently, the only drug available to Americans for triglycerides has been Lovaza, also marketed as Omacor in several countries.
Both Vascepa and Lovaza are made from fish oil but there are a couple of key differences – see table below for a summary of differences.
Without insurance, Vascepa costs around $7 per day – dosage is 4 pills per day.
Vascepa – will half-dose work?
If you decide to save a few pennies and reduce your dosage from 4 Vascepa pills a day, down to 2 a day, then you’ll notice less triglyceride reduction. Talk to your doctor about this! At half-dose, patients noticed only a 20% drop compared to 33% drop at full dose. Higher your starting triglyceride level, the bigger the drop.
Vascepa vs Lovaza – key differences
- EPA to DHA Ratio.
- As you may know, EPA and DHA are the two key Omega-3 fatty acids in fish oil.
- Lovaza contains both EPA and DHA, while Vascepa contains only EPA. There is no DHA in Vascepa.
- DHA increases LDL (or ‘bad’) cholesterol
- DHA increases LDL cholesterol. EPA does not.
- The DHA in Lovaza can increase LDL levels by as much as 45%.
- LDL cholesterol plays an integral role in immunity and healing, so some doctors do not want it reduced, preferring to monitor their HDL, non-HDL and triglycerides instead.
- However, many doctors and their patients who are ‘watching their cholesterol’ do not want a triglyceride lowering drug to increase their LDL.
- ‘Off-label’ use for depression
Lovaza can increase LDL by up to 45%
The fact that Vascepa has no ‘LDL issues’ is the #1 reason why doctors are switching their patients over from Lovaza to Vascepa.
Clinicians argue whether an increase in LDL is as predictive for future heart disease risk as a decrease in HDL. Studies show that low HDL is 4-times better at predicting future risk than high LDL. Some doctors believe that LDL is “pretty much useless” in predicting risk, instead preferring to focus on the overlooked Triglyceride to HDL ratio.
From this more progressive stance, Lovaza still does a bang up job of reducing triglycerides – by 44% – and your overall heart disease risk.
This eye-opening study shows that CRP is a much better predictor of ‘cardiac events’ than LDL and that women with low LDL levels get just as many heart attacks. There are no drugs available to reduce CRP, so this marker is ignored.
Regardless, watching Total Cholesterol and LDL numbers have become a pastime for the over-50 crowd.
(My personal opinion: I’m extremely concerned about my heart health, so I watch my triglycerides, HDL, TG/HDL ratio, A1C, blood glucose, CRP, Apo B, homocysteine, insulin, LDL particle size/number and thyroid levels. I could rattle off all these numbers if you woke me up in the middle of the night, but I honestly don’t know (or care about) my total cholesterol or LDL-C number.
Just my 2 cents.)
Here’s a video by Dr. Mark Hyman to put things in perspective:
Compare Vascepa to Lovaza:
|Cost (without insurance)||$8.60/day||About $7/day|
|Dosage||4 Pills Per Day||4 Pills Per Day|
|Omega-3 Per Pill||840 mg||960 mg|
|Active Ingredients||EPA and DHA Omega-3||EPA only|
|Made from||Fish Oil||Fish Oil|
|FDA Approved Drug||Yes||Yes|
|Fatty Acid Form||Ethyl Ester||Ethyl Ester|
|EPA Omega-3 Content||465 mg||960 mg|
|DHA Omega-3 Content||375 mg||0 mg|
|Purification Method||Molecular distillation||Chromatography|
|Mercury and Heavy Metals||Purified – passes all standards||Purified – passes all standards|
|Certificate of Analysis Availability||No||No|