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**Vitamin d + omega-3-acid ethyl esters** is a combination of vitamin D, typically used as cholecalciferol, and prescription omega-3-acid ethyl esters containing primarily the ethyl esters of eicosapentaenoic acid and docosahexaenoic acid. As a combination, it does not represent a single approved INN product but rather concurrent supplementation or co-packaged use of two active ingredients with distinct mechanisms: vitamin D is converted to active vitamin D metabolites that signal through the vitamin D receptor to regulate calcium-phosphate homeostasis and broad immunometabolic pathways, while omega-3-acid ethyl esters alter hepatic triglyceride metabolism and very-low-density lipoprotein handling, lowering serum triglycerides. This combination has been studied most prominently in preventive settings such as the VITAL trial, in which vitamin D3 and Omacor fish oil were tested factorially for primary prevention of cancer and cardiovascular disease, rather than as a uniquely branded fixed-dose pharmaceutical. In practice, the combination sits at the intersection of dietary supplementation and drug therapy, with omega-3-acid ethyl esters being a prescription pharmaceutical for severe hypertriglyceridemia and vitamin D commonly used as a nutritional supplement or deficiency treatment.
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