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Omega-3-acid ethyl ester is a prescription medication composed primarily of the ethyl esters of two long-chain omega-3 polyunsaturated fatty acids found in fish oil—eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). It is used as an adjunct to diet to reduce very high triglyceride levels (≥500 mg/dL) in adults. The drug works by reducing hepatic production of triglycerides, increasing fatty acid metabolism through enhanced beta-oxidation, inhibiting the release of free fatty acids by competing for enzymes involved in triglyceride synthesis, increasing clearance via lipoprotein lipase activity, and decreasing production of very low-density lipoprotein cholesterol (VLDL-C). The exact mechanism is not fully understood. Omega-3-acid ethyl ester may also modestly increase HDL ("good" cholesterol), but can raise LDL ("bad" cholesterol) in some patients. It is taken orally as a liquid-filled capsule[1][4][5][6].
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