Usage
Omega-3 fatty acid + Tocotrienol is primarily used as a nutritional supplement to support overall health and well-being. It is often prescribed to address vitamin E deficiency and manage conditions such as heart disease, inflammation, hypercholesterolemia, hypertension, eye disorders, premenstrual syndrome, Alzheimer’s disease, and to improve skin health, hair growth, and cognitive function. It may also be used as an adjunct treatment for asthma and rheumatoid arthritis. It can also be used for congestive cardiac failure, coronary artery disease. Its pharmacological classification can be considered as a combination of a vitamin supplement and an antioxidant.
The mechanism of action involves the combined effects of omega-3 fatty acids and tocotrienols. Omega-3 fatty acids, particularly DHA and EPA, reduce inflammation, improve cell membrane fluidity, and may have positive effects on cardiovascular health. Tocotrienols, a form of vitamin E, act as potent antioxidants, protecting cells from damage caused by free radicals. They can augment cellular energy by facilitating the transport of fatty acids into mitochondria, which are the primary sites of energy production within cells.
Alternate Names
This combination doesn’t have a universally recognized International Nonproprietary Name (INN). It’s generally referred to as “Omega-3 fatty acid + Tocotrienol.” A popular brand name is Evitol.
How It Works
Pharmacodynamics: Omega-3 fatty acids exert anti-inflammatory effects by modulating the production of eicosanoids and cytokines. They also influence cell membrane fluidity, affecting various cellular processes. Tocotrienols scavenge free radicals, preventing oxidative stress and protecting cell membranes from lipid peroxidation.
Pharmacokinetics: Omega-3 fatty acids are absorbed in the small intestine, incorporated into chylomicrons, and transported to the liver. They are then metabolized and incorporated into cell membranes throughout the body. Tocotrienols are absorbed similarly and distributed to various tissues, including adipose tissue. Elimination pathways for both omega-3 fatty acids and tocotrienols involve hepatic metabolism and excretion in bile and urine.
Mode of Action: Omega-3 fatty acids influence cell membrane structure and function. They may bind to and activate peroxisome proliferator-activated receptors (PPARs), affecting gene expression related to lipid metabolism and inflammation. Tocotrienols primarily exert their antioxidant effects by scavenging free radicals and inhibiting lipid peroxidation.
Dosage
Standard Dosage
Adults:
The typical dosage is 1–2 capsules twice daily, or as directed by a physician. The dosage should provide 250–500 mg of combined EPA and DHA per day.
Children:
Dosage should be determined by a pediatrician and depends on age, weight and specific health considerations.
Special Cases:
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Elderly Patients: No specific dosage adjustments are generally recommended for elderly patients, but monitoring for potential side effects is important.
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Patients with Renal Impairment: Dosage adjustments may be necessary in patients with severe renal impairment.
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Patients with Hepatic Dysfunction: Caution should be exercised in patients with hepatic dysfunction, and dosage adjustments may be required.
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Patients with Comorbid Conditions: Consider interactions with anticoagulant, antiplatelet, anti-diabetic, antihypertensive medications or any chemotherapy treatment when determining dosage for patients with comorbid conditions.
Clinical Use Cases
The use of omega-3 fatty acid + tocotrienol in specific clinical settings like intubation, surgical procedures, mechanical ventilation, ICU use, and emergency situations isn’t established. Dosage adjustments in such cases should be determined on a case-by-case basis by the attending physician.
Dosage Adjustments
Dose modifications may be necessary based on patient factors such as renal or hepatic dysfunction, pre-existing medical conditions, or concomitant medications.
Side Effects
Common Side Effects
Nausea, diarrhea, stomach cramps, tiredness, dizziness, blurred vision, headache, eructation, dyspepsia, unpleasant taste, bad breath, burping, stomach ache, and easy bleeding/bruising.
Rare but Serious Side Effects
Allergic reactions (rash, itching, swelling), vitamin E toxicity, gastrointestinal hemorrhage, and increased bleeding risk (especially in patients taking anticoagulants or with bleeding disorders).
Long-Term Effects
Limited data are available on long-term effects.
Adverse Drug Reactions (ADR)
Severe allergic reactions, significant bleeding events.
Contraindications
Hypersensitivity to any component of the formulation, severe bleeding disorders (hemophilia, von Willebrand disease), upcoming surgery, uncontrolled diabetes, liver disease, kidney disease, and chronic diarrhea.
Drug Interactions
Anticoagulants and antiplatelet drugs (warfarin, aspirin), immunosuppressants (cyclosporine), vitamin B3 (niacin), chemotherapy drugs, cholesterol-lowering medications, diabetes medications, antibiotics, and antiviral medications. Alcohol may interact with this combination and potentially increase liver damage.
Pregnancy and Breastfeeding
Insufficient reliable information is available regarding the safety of this combination during pregnancy and breastfeeding. It’s generally recommended to avoid use during these periods unless specifically advised by a physician.
Drug Profile Summary
- Mechanism of Action: Combined anti-inflammatory, antioxidant, and cellular energy-enhancing effects.
- Side Effects: Nausea, gastrointestinal discomfort, bleeding/bruising, allergic reactions.
- Contraindications: Bleeding disorders, upcoming surgery, hypersensitivity.
- Drug Interactions: Anticoagulants, antiplatelets, immunosuppressants.
- Pregnancy & Breastfeeding: Insufficient safety data, avoid use.
- Dosage: 1–2 capsules twice daily for adults; pediatric dosage as directed by a physician.
- Monitoring Parameters: Lipid profile, coagulation tests (if applicable), vitamin E levels.
Popular Combinations
No specific, established popular combinations exist for this drug combination.
Precautions
Screen patients for allergies, bleeding disorders, and liver or kidney dysfunction. Caution in patients with diabetes, cardiovascular disease, or taking anticoagulant/antiplatelet medications. Advise patients to avoid alcohol during treatment.
FAQs (Frequently Asked Questions)
Q1: What is the recommended dosage for Omega-3 fatty acid + Tocotrienol?
A: For adults, the typical dosage is 1–2 capsules twice daily. Pediatric dosages should be determined by a pediatrician.
Q2: What are the primary uses of this combination?
A: It’s used as a nutritional supplement to support overall health, manage vitamin E deficiency, and as adjunctive therapy for certain conditions like heart disease and inflammation.
Q3: What are the common side effects?
A: Common side effects include nausea, gastrointestinal discomfort, headache, easy bruising/bleeding.
Q4: Are there any serious side effects?
A: Rare but serious side effects include allergic reactions, vitamin E toxicity, and increased bleeding risk.
Q5: Who should not take this combination?
A: People with bleeding disorders, upcoming surgery, or hypersensitivity to the components should avoid this supplement.
Q6: Does it interact with other medications?
A: Yes, it can interact with anticoagulants, antiplatelets, immunosuppressants, and several other medications.
Q7: Can it be taken during pregnancy or breastfeeding?
A: It’s generally advised to avoid use during pregnancy and breastfeeding due to limited safety data.
Q8: What are the long-term effects of taking this combination?
A: Data on long-term effects are limited.
Q9: How should I store this medication?
A: Store in a cool, dry place away from direct sunlight. Do not refrigerate or freeze.
Q10: What should I do if I miss a dose?
A: Take the missed dose as soon as you remember, unless it is close to the time of your next dose. Do not double the dose to catch up.
