Supplements Dietary Supplements Prescription Omega-3s vs. Supplements By Jennifer Moll, PharmD Jennifer Moll, PharmD Facebook Jennifer Moll, MS, PharmD, is a pharmacist actively involved in educating patients about the importance of heart disease prevention. Learn about our editorial process Updated on July 10, 2020 Medically reviewed Verywell Health articles are reviewed by board-certified physicians and healthcare professionals. These medical reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Arno Kroner, DAOM, LAc Medically reviewed by Arno Kroner, DAOM, LAc Facebook LinkedIn Twitter Arno Kroner, DAOM, LAc, is a board-certified acupuncturist, herbalist, and integrative medicine doctor practicing in Santa Monica, California. Learn about our Medical Expert Board Print Verywell / Anastasia Tretiak Table of Contents View All Table of Contents Why Supplement? Types and Omega-3 Content Availability and Efficacy Potential Side Effects and Risks Safety and Purity Cost Omega-3s have been shown to improve heart, vascular, and brain health in a number of ways. Given this, many seek to get more of them by eating more foods that are rich in these fatty acids and by using omega-3 supplements, be them over-the-counter (OTC) or prescription versions. There are differences in fish oil and other omega-3 supplements that should be considered, which, in part, is why Rx versions are not appropriate for everyone. And though omega-3s are beneficial, there are some individuals for which supplementation is not advised. Why Supplement? Omega-3 fatty acids are in a group of polyunsaturated fats, or “good” fats, that include eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and alpha-linolenic acid (ALA). They boast a number of health benefits, so ensuring that you get an adequate amount is a worthy goal. Among the health benefits of omega-3s: Studies of individuals with high triglyceride levels have shown that taking anywhere between 2 and 4 grams (2,000 to 4,000 milligrams) of omega-3s per day may reduce triglyceride levels by up to 50%. High triglycerides are linked with heart health concerns, such as stroke and heart attack. Omega-3s may raise HDL ("good") cholesterol and increase the particle size of LDL ("bad") cholesterol, reducing the potential of atherosclerosis. Consuming omega-3s may have other heart-healthy benefits, such as lowering blood pressure and reducing inflammation, among others. There is also evidence to suggest that omega-3s support brain health by, for example, improving mood and sleep, and slowing cognitive decline. Omega-3s are found in foods such as certain fatty fish; seeds like flax, chia, and hemp; as well as walnuts, soybeans, kidney beans, and seaweed. However, omega-3s are available in much higher amounts in a variety of OTC supplements and prescription drugs. Types and Omega-3 Content Visit a vitamin shop and you'll see a wide variety of omega-3 supplements on the shelf. These may be made from: Fish oil (most common)Other marine animal oils (e.g., krill)Plant sources (e.g., algae) The source of omega-3s plays into a product's overall omega-3 content and its bioavailability (the ease with with your body is able to use it), among other things. And because OTC supplements aren't subjected to the rigorous testing required of prescription drugs, there could be varying levels of EPA and DHA in each product that don't always match what's stated on the label. Regardless, prescription drugs across the board contain more omega-3s than OTC supplements. Prescription medications may contain up to 90% omega-3 fatty acids, whereas over-the-counter fish oil supplements contain roughly between 30% and 50% omega-3 fatty acids, depending on the product. Prescription omega-3 drugs include: Lovaza (omega-3-acid ethyl esters): Contains both EPA and DHA Vascepa (icosapent ethyl): Contains only EPA, potentially making it better suited for those who have high LDL cholesterol. Epanova (omega-3-carboxylic acids) and Omtryg (omega-3-Acid ethyl esters A): Though approved by the FDA in 2014, these are not yet commercially available. Lovaza Side effects: Burping and indigestion; changes in taste Has a generic form Cost (without insurance): $312 for 120 capsules, 1 g each ($105 for generic) Contains EPA and DHA Vascepa Side effects: Joint pain No generic form Cost (without insurance): $326 for 120 capsules, 1 g each Only contains EPA Availability and Efficacy Verywell / Anastasia Tretiak While fish oil supplements are available for anyone to purchase for a variety of uses, omega-3 prescriptions are usually indicated for use in the 25% of American adults who have elevated triglycerides (200 mg/dL to 499 mg/dL) or extremely high triglyceride levels (500 mg/dL or more). Your medical practitioner may also write a prescription for other medical conditions that could benefit from omega-3s. When taken in equivalent amounts, prescription omega-3s and over-the-counter omega-3 supplements should lower triglycerides in the same manner. Potential Side Effects and Risks Possible side effects of omega-3 supplements and drugs include: Low blood pressureIncreased bleeding, including bleeding gums and nose bleedsIndigestion, heartburn, or burpingDiarrhea or flatulence Stomach upset is often due to the high fat content of fish oil and can be mitigated by taking fish oil supplements with a meal and early in the day, rather than on an empty stomach or at dinner or bedtime. Because OTC omega-3 supplements may contain fish and Rx omega-3s are derived from fish, they should not be used by individuals with fish allergies. People who take blood pressure medications or anticoagulants, who have hypotension, or who have an increased risk of bleeding or hemorrhagic stroke should seek medical advice before starting omega-3 supplements, given their blood thinning and blood-pressure-lowering capabilities. Safety and Purity Supplements and prescriptions containing omega-3 fatty acids are not all created equal. They each undergo different monitoring as required by the Food and Drug Administration (FDA). Fish oil supplements found in your local drugstore, like similar OTC products, are classified as “foods” by the FDA. This means that it is the manufacturer’s responsibility to make sure that these products are safe, free of contaminants, correctly labeled, and made in a clean environment. That's why it's very important to do your research and only buy OTC supplements from reputable brands. The only way the FDA will remove a supplement from the market is if there have been numerous health complaints about the product after it has reached store shelves, which depends on public reporting. Prescription drugs, on the other hand, are monitored differently. To be approved for use as a prescription medication, drugs containing omega-3 fatty acids must undergo extensive testing before they can be prescribed by healthcare providers and sold in pharmacies. The manufacturers must provide evidence to the FDA that the drug works how it is supposed to, that it is safe, and that it contains all of the ingredients stated on the label. They must also disclose any adverse effects experienced by individuals taking the medication. Because they're not regulated heavily by the FDA, there is no guarantee that OTC fish oil supplements are fresh or free from chemicals like dioxins and heavy metals like mercury, which are prevalent in the tissues of ocean fish. Nevertheless, some research suggests that the amount of potential contaminants in OTC fish oil supplements is far less than in a serving of fish that you would eat. Prescription omega-3s on the other hand, which are extracted from fish oil, are highly purified to remove isomers, heavy metals, and all other impurities to the level of detection. Note: Fish oil is highly susceptible to oxidation (becoming rancid), which can compromise OTC supplements. Cost Because fish oil supplements do not have to undergo the extensive testing requirements for prescriptions, they are usually much cheaper than prescription options. A Word From Verywell If you are considering adding omega-3 supplements to your diet, you should consult with your healthcare provider. The FDA currently recommends that you should not take more than 2g of fish oil supplements a day unless it is under the guidance of your healthcare provider. Even though fish oil supplements are readily available, they can still cause certain side effects and aggravate certain medical conditions. Was this page helpful? Thanks for your feedback! Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit 1 Source Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. National Institutes of Health. Omega-3 Fatty Acids. Additional Reading Scientific Opinion on the Tolerable Upper Intake Level of eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA) and docosapentaenoic acid (DPA). EFSA Journal. 2012;10(7). doi:10.2903/j.efsa.2012.2815 Amminger GP, Nelson B, Markulev C, Yuen HP, Schäfer MR, Berger M, Mossaheb N, Schlögelhofer M, Smesny S, Hickie IB, Berger GE, Chen EYH, de Haan L, Nieman DH, Nordentoft M, Riecher-Rössler A, Verma S, Thompson A, Yung AR, McGorry PD. The NEURAPRO biomarker analysis: Long-chain omega-3 fatty acids improve 6-month and 12-month outcomes in youths at ultra-high risk for psychosis. 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