Safety considerations with omega-3 fatty acid therapy
Safety considerations with omega-3 fatty acid therapy
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DOI：
10.1016/j.amjcard.2006.11.020
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发表时间：
2007-03-19
影响因子：
2.8
通讯作者：
Bays, Harold E.
中科院分区：
文献类型：
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作者：
Bays, Harold E.
有研究表明，鱼油潜在的抗血栓作用在理论上可能会增加出血的风险，这可能是个别患者的安全问题。然而，临床试验证据并不支持摄入omega-3脂肪酸会增加出血，即使与其他可能增加出血的药物(如阿司匹林和华法林)联合使用也是如此。另一个潜在的安全问题是omega-3脂肪酸制剂容易发生氧化，这会导致患者不耐受和潜在的毒性。最后，大量食用鱼类可能导致不良体验，因为潜在存在环境毒素，如汞、多氯联苯、二恶英和其他污染物。通过用于开发精选的浓缩鱼油补充剂和处方制剂的提纯工艺，大大降低了因食用鱼类而暴露于环境毒素和维生素过多症的风险。因此，在选择推荐哪种鱼油疗法时，临床医生应该了解可获得的信息，以最好地评估其相对安全性，其中包括美国食品和药物管理局(FDA)和环境保护局(EPA)关于鱼类消费的咨询声明，某些标签的含义(如通过美国药典进行“验证”)，以及FDA对非处方鱼油补充剂和处方鱼油制剂之间的监管要求的差异，以及所有这些对患者的最佳治疗是多么重要。(C)2007 Elsevier Inc.保留所有权利。
It has been suggested that the potential antithrombotic effect of fish oils may theoretically increase the risk for bleeding, which may be a safety concern for individual patients. However, clinical trial evidence has not supported increased bleeding with omega-3 fatty acid intake, even when combined with other agents that might also increase bleeding (such as aspirin and warfarin). Another potential safety concern is the susceptibility of omega-3 fatty acid preparations to undergo oxidation, which contributes to patient intolerance and potential toxicity. Finally, large amounts of fish consumption may result in adverse experiences due to the potential presence of environmental toxins such as mercury, polychlorinated biphenyls, dioxins, and other contaminants. The risks of exposure to environmental toxins and hypervitaminosis with fish consumption are substantially reduced through purification processes used to develop selected concentrated fish oil supplements and prescription preparations. Thus, in choosing which fish oil therapies to recommend, clinicians should be aware of available information to best assess their relative safety, which includes the US Food and Drug Administration (FDA) and Environmental Protection Agency (EPA) advisory statement regarding fish consumption, the meaning of certain labeling (such as "verification" through the US Pharmacopeia) and the differences in FDA regulatory requirements between nonprescription fish oil supplements and prescription fish oil preparations, and how all of this is important to the optimal treatment of patients. (c) 2007 Elsevier Inc. All rights reserved.