Drug & supplement interaction

Eicosapentaenoic Acid (epa) + Enzalutamide

Enzalutamide brand name: Xtandi.

No Known Interaction
Medically reviewed by · Updated July 2026 · Pair last verified Sep 27, 2026
The bottom line No known interaction

We found no known interaction between Eicosapentaenoic Acid (epa) and Enzalutamide in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the two are separately associated with some of the same side effects, which would make a new symptom harder to attribute to one or the other.

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Interaction report

Eicosapentaenoic Acid (epa) and Enzalutamide

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Enzalutamide and Eicosapentaenoic Acid (epa) in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Eicosapentaenoic Acid (epa) safety at a glance

Eicosapentaenoic A... overall Generally safe EPA is generally well tolerated for most adults at typical supplement doses.
Pregnancy Use caution Omega-3s are often used in pregnancy, but check with your doctor about the right product and dose.
Breastfeeding Use caution Likely acceptable from food and supplements, but confirm dosing with your healthcare provider.

Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Enzalutamide and Eicosapentaenoic Acid (epa)? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Enzalutamide

Interactions in our licensed database are recorded against drug classes, not just single drug names. Enzalutamide is filed under 6 classifications — including cytochrome p450 2c9 (cyp2c9) inducers, cytochrome p450 2c19 (cyp2c19) inducers, cytochrome p450 3a4 (cyp3a4) inducers. Eicosapentaenoic Acid (epa) has documented interactions with 2 drug classes — the most serious being anticoagulant/antiplatelet drugs (moderate) and antihypertensive drugs (moderate) — and none of Enzalutamide’s classifications are among them.

Classification data comes from our licensed Natural Medicines dataset. A medication can belong to classes beyond those recorded there, so this describes how the check was run — it is not a safety guarantee.

Keep it in perspective

Eicosapentaenoic Acid (epa) Does Interact With Other Medications

Eicosapentaenoic Acid (epa) has 289 moderate known drug interactions in our database — Enzalutamide isn’t one of them. If you take anything else, check it against the full list below.

Moderate 289 No known interaction 2,541 (incl. Enzalutamide)
Taking anything else?

Check Another of Your Medications Against Eicosapentaenoic Acid (epa)

Covers the 2,830 medications we’ve checked against Eicosapentaenoic Acid (epa). Pick one to open its full report.

What to actually watch for

No Interaction Found — But Data Suggests Eicosapentaenoic Acid (epa) and Enzalutamide May Share Several of the Same Side Effects

This is not an interaction. Neither one changes how your body handles the other, and nothing here says they react together. What our sources do show is that each has separately been linked to the effects below — so taking both can make those effects more likely to turn up, and harder to pin on one or the other if they do. 2 of them are worth acting on rather than waiting out — marked below.

  • An irregular heartbeat Worth acting on Additional detail

    Eicosapentaenoic Acid (epa)

    “Orally, taking the prescription ethyl-EPA product (Vascepa, Amarin) 4 grams daily has been linked to a 1% greater risk of atrial fibrillation or atrial flutter that required hospitalization when compared with placebo.”

    Eicosapentaenoic Acid (epa) · Natural Medicines adverse-effect record, reported in atrial fibrillation.

    1 source cited
    1. 101286. Prescribing information: Vascepa (icosapent ethyl). Amarin Pharma, Inc. Bridgewater, NJ, USA. Revised 12/2019. Available at: https://www.vascepa.com/assets/pdf/Vascepa_PI.pdf [Accessed 12/16/2019].

    Enzalutamide

    Listed in the ADVERSE REACTIONS section of the FDA label for Enzalutamide. Read the label on DailyMed ›

  • Bleeding or bruising Worth acting on Additional detail

    Eicosapentaenoic Acid (epa)

    “Orally, reported side effects of EPA, as well as fish oils containing EPA and docosahexaenoic acid (DHA), have included nosebleed. There is some concern that taking high doses of oils providing EPA along with DHA might decrease blood coagulation and increase the risk of bleeding.”

    Eicosapentaenoic Acid (epa) · Natural Medicines adverse-effect record, reported in bleeding.

    5 sources cited
    1. 10007. Kris-Ehterton PM, Harris WS, Appel LJ, et al. Fish consumption, fish oil, omega-3 fatty acids, and cardiovascular disease. Circulation 2002;106:2747-57. PubMed
    2. 15497. Yokoyama M, Origasa H, Matsuzaki M, et al. Effects of eicosapentaenoic acid on major coronary events in hypercholesterolaemic patients (JELIS): a randomised open-label, blinded endpoint analysis. Lancet 2007;369:1090-8. PubMed
    3. 1313. FDA. Center for Food Safety and Applied Nutrition. Letter regarding dietary supplement health claim for omega-3 fatty acids and coronary heart disease. Available at: http://www.fda.gov/ohrms/dockets/dockets/95s0316/95s-0316-Rpt0272-38-Appendix-D-Reference
    4. 95739. FDA announces qualified health claims for omega-3 fatty acids. Available at: https://www.fda.gov/Food/LabelingNutrition/ucm072756.htm. Accessed April 15 2019.
    5. 101286. Prescribing information: Vascepa (icosapent ethyl). Amarin Pharma, Inc. Bridgewater, NJ, USA. Revised 12/2019. Available at: https://www.vascepa.com/assets/pdf/Vascepa_PI.pdf [Accessed 12/16/2019].

    Enzalutamide

    Listed in the ADVERSE REACTIONS section of the FDA label for Enzalutamide. Read the label on DailyMed ›

  • Joint pain / Muscle pain Additional detail

    Eicosapentaenoic Acid (epa)

    “Orally, EPA may cause musculoskeletal pain in some patients, although results from clinical research are conflicting. In one clinical study, a higher percentage of patients treated with ethyl-EPA 2 or 4 grams daily experienced joint pain compared to placebo (3.4% and 1.7% vs 0.4%, respectively).”

    Eicosapentaenoic Acid (epa) · Natural Medicines adverse-effect record, reported in pain.

    2 sources cited
    1. 91409. Ballantyne CM, Bays HE, Kastelein JJ, Stein E, Isaacsohn JL, Braeckman RA, Soni PN. Efficacy and safety of eicosapentaenoic acid ethyl ester (AMR101) therapy in statin-treated patients with persistent high triglycerides (from the ANCHOR study). Am J Cardi PubMed
    2. 15497. Yokoyama M, Origasa H, Matsuzaki M, et al. Effects of eicosapentaenoic acid on major coronary events in hypercholesterolaemic patients (JELIS): a randomised open-label, blinded endpoint analysis. Lancet 2007;369:1090-8. PubMed

    Enzalutamide

    Listed in the ADVERSE REACTIONS section of the FDA label for Enzalutamide. Read the label on DailyMed ›

  • Itching / A skin rash Additional detail

    Eicosapentaenoic Acid (epa)

    “Orally, reported side effects of EPA have included skin rash and itching.”

    Eicosapentaenoic Acid (epa) · Natural Medicines adverse-effect record, reported in pruritus.

    1 source cited
    1. 15497. Yokoyama M, Origasa H, Matsuzaki M, et al. Effects of eicosapentaenoic acid on major coronary events in hypercholesterolaemic patients (JELIS): a randomised open-label, blinded endpoint analysis. Lancet 2007;369:1090-8. PubMed

    Enzalutamide

    Listed in the ADVERSE REACTIONS section of the FDA label for Enzalutamide. Read the label on DailyMed ›

  • Diarrhea / Nausea Additional detail

    Eicosapentaenoic Acid (epa)

    “Orally, reported side effects of EPA have included nausea, diarrhea, and epigastric discomfort. For fish oils containing EPA and docosahexaenoic acid, side effects can include fishy taste, belching, nausea, and loose stools.”

    Eicosapentaenoic Acid (epa) · Natural Medicines adverse-effect record, reported in diarrhea.

    5 sources cited
    1. 15497. Yokoyama M, Origasa H, Matsuzaki M, et al. Effects of eicosapentaenoic acid on major coronary events in hypercholesterolaemic patients (JELIS): a randomised open-label, blinded endpoint analysis. Lancet 2007;369:1090-8. PubMed
    2. 103314. Rao A, Briskey D, Nalley JO, Ganuza E. Omega-3 eicosapentaenoic acid (EPA) rich extract from the microalga Nannochloropsis decreases cholesterol in healthy individuals: A double-blind, randomized, placebo-controlled, three-month supplementation study. Nut PubMed
    3. 110365. Mori T, Murasaki K, Yokoyama Y. Long-term safety and efficacy of MND-2119 (self-emulsifying formulation of highly purified eicosapentaenoic acid ethyl ester) in patients with hypertriglyceridemia: Results from a multicenter, 52-week, open-label study. J C PubMed
    4. 110366. Frangou S, Lewis M, McCrone P. Efficacy of ethyl-eicosapentaenoic acid in bipolar depression: Randomized double-blind placebo-controlled study. Br J Psychiatry. 2006;188:46-50.
    5. 10007. Kris-Ehterton PM, Harris WS, Appel LJ, et al. Fish consumption, fish oil, omega-3 fatty acids, and cardiovascular disease. Circulation 2002;106:2747-57. PubMed

    Enzalutamide

    Listed in the ADVERSE REACTIONS section of the FDA label for Enzalutamide. Read the label on DailyMed ›

Reported for Eicosapentaenoic Acid (epa) but not commonly for Enzalutamide: stomach upset and bloating or gas.

Effects for Enzalutamide come from the ADVERSE REACTIONS section of its FDA label; effects for Eicosapentaenoic Acid (epa) come from the Natural Medicines adverse-effect record, quoted above. Where a percentage is shown, it is the share of 58,437 voluntary FDA FAERS reports for Enzalutamide that mention that effect — a reporting proportion, not an incidence rate and not evidence the drug caused it. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

Overlapping uses

What Enzalutamide Is Prescribed For, and What Eicosapentaenoic Acid (epa) Has Been Studied For

These two come up together because they touch the same health topic — not because they do the same job. Enzalutamide is a prescription medicine with approved uses on its FDA label. Eicosapentaenoic Acid (epa) is a supplement: what follows is what researchers have looked at it for, and how strong that evidence is.

Enzalutamide is prescribed for: Xtandi (enzalutamide) is used to treat prostate cancer in three specific situations: castration-resistant prostate cancer (CRPC), metastatic castration-sensitive prostate cancer (mCSPC), and non-metastatic castration-sensitive prostate cancer with biochemical recurrence at high risk for metastasis (high-risk BCR). Castration-resistant means the cancer has continued to grow despite low testosterone levels. Castration-sensitive means the cancer still responds to testosterone-lowering therapy. In most of these cases, Xtandi is used alongside a GnRH analog (a hormone-lowering injection) or after surgical removal of the testicles — except in the high-risk BCR setting, where it may be used with or without a GnRH analog.

Eicosapentaenoic Acid (epa) has been studied for:

  • Prostate cancer studied, not established Eicosapentaenoic Acid (epa) has been studied for this. Natural Medicines rates the evidence: Insufficient Reliable Evidence To Rate Read what the research shows

    Eicosapentaenoic Acid (epa) for prostate cancer

    It is unclear if oral EPA is beneficial for prostate cancer treatment or prevention.

Effectiveness ratings and the research summaries above are the verbatim record from the Natural Medicines database, which grades evidence from “Effective” down to “Insufficient Reliable Evidence To Rate”. A rating below the top of that scale means researchers have looked at it — not that it works, and never that it can stand in for a prescribed medicine. Do not stop or replace Enzalutamide on your own; if you are taking Eicosapentaenoic Acid (epa) for the same health topic, tell your prescriber, especially if the medicine is being adjusted to a target.

Everything else you take

See Every Supplement That Interacts With Enzalutamide

This page covers Eicosapentaenoic Acid (epa) only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Enzalutamide page lists 49 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Alkanna (moderate), Alpine Ragwort (moderate), Black Tea (moderate) and Boneset (moderate).

By severity: 1 major · 36 moderate · 12 minor.

Open the Enzalutamide interaction page

How much people look this up

Where Eicosapentaenoic Acid (epa) and Enzalutamide Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Eicosapentaenoic Acid (epa)
Steady interest

#1,011 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Enzalutamide
Steady interest

#1,503 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Eicosapentaenoic Acid (epa) reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 27, 2026. The Eicosapentaenoic Acid (epa) and Enzalutamide records this page draws on were last updated July 10, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
Supplement

About Eicosapentaenoic Acid (epa)

What is Eicosapentaenoic Acid (epa)?

  • Heart and triglyceride health
  • Inflammation
  • Mood and depression support
  • Joint comfort
  • General omega-3 supplementation

EPA is an omega-3 fatty acid found mostly in fatty fish and fish oil, and it is best known for lowering high triglycerides. It may also help with inflammation and mood in some people, but evidence varies by condition. Talk with your pharmacist or doctor before starting, especially if you take blood thinners or have a fish allergy.

Omega-3 fatty acid derived mainly from fatty fish and fish oil; also from algae · Softgel capsules, liquid fish oil, prescription-strength capsules, algae-based supplements

An interaction check asks whether these two react with each other — it does not ask whether Eicosapentaenoic Acid (epa) is a good idea for someone in your situation. Here is what our Eicosapentaenoic Acid (epa) record says about it on its own.

Eicosapentaenoic Acid (epa): dosing

There is no single standard dose of EPA for everyone, and the right amount depends on why you are taking it. Look at the actual amount of EPA listed on the label, since total fish oil is not the same as EPA content.

From our Eicosapentaenoic Acid (epa) monograph — the full record covers uses, side effects and every documented interaction.

Read the full Eicosapentaenoic Acid (epa) monograph & all interactions
Medication

About Enzalutamide

What Is Enzalutamide Used For?

Brand name: Xtandi

Xtandi (enzalutamide) is used to treat prostate cancer in three specific situations: castration-resistant prostate cancer (CRPC), metastatic castration-sensitive prostate cancer (mCSPC), and non-metastatic castration-sensitive prostate cancer with biochemical recurrence at high risk for metastasis (high-risk BCR).

Castration-resistant means the cancer has continued to grow despite low testosterone levels. Castration-sensitive means the cancer still responds to testosterone-lowering therapy. In most of these cases, Xtandi is used alongside a GnRH analog (a hormone-lowering injection) or after surgical removal of the testicles — except in the high-risk BCR setting, where it may be used with or without a GnRH analog.

Most-Reported Side Effects for Enzalutamide

From FAERS, the FDA’s public side-effect reporting system (58,437 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Fatigue 10,267 reports
Malignant neoplasm progression 5,468 reports
Prostatic specific antigen increased 4,344 reports
Asthenia 4,171 reports
Hot flush 3,882 reports
See full Enzalutamide drug information
Keep checking

Other Drugs & Eicosapentaenoic Acid (epa)

Browse every other medication we’ve checked against Eicosapentaenoic Acid (epa) — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
289Moderate
0Minor
2,540No known interaction
289 Moderate 2,540 No interaction
Moderate

289 interactions

Showing 60 of 289 moderate interactions — see all 289 on the Eicosapentaenoic Acid (epa) page.

No interaction 2,540 drugs checked — show the list

We also checked Eicosapentaenoic Acid (epa) against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,540 medications checked with no known interaction — see the full Eicosapentaenoic Acid (epa) list.

See the full Eicosapentaenoic Acid (epa) interactions page
See every supplement checked against Enzalutamide, ranked by severity
Evidence & sources

Eicosapentaenoic Acid (epa) References

The 14 references that drive our Eicosapentaenoic Acid (epa) monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. Prisco D, Paniccia R, Bandinelli B, et al. Effect of medium-term supplementation with a moderate dose of n-3 polyunsaturated fatty acids on blood pressure in mild hypertensive patients. Thromb Res 1998;1:105-12.
  2. Toft I, Bonaa KH, Ingebretsen OC, et al. Effects of n-3 polyunsaturated fatty acids on glucose homeostasis and blood pressure in essential hypertension. A randomized, controlled trial. Ann Intern Med 1995;123:911-8.
  3. Sacks FM, Hebert P, Appel LJ, et al. Short report: the effect of fish oil on blood pressure and high-density lipoprotein-cholesterol levels in phase I of the trials of hypertension prevention. J Hypertens 1994;12:209-13.
  4. Vandongen R, Mori TA, Burke V, et al. Effects on blood pressure of omega 3 fats in subjects at increased risk of cardiovascular disease. Hypertension 1993;22:371-9. PubMed
  5. FDA. Center for Food Safety and Applied Nutrition. Letter regarding dietary supplement health claim for omega-3 fatty acids and coronary heart disease. Available at: http://www.fda.gov/ohrms/dockets/dockets/95s0316/95s-0316-Rpt0272-38-Appendix-D-Reference
  6. Terano T, Hirai A, Hamazaki T, et al. Effect of oral administration of highly purified eicosapentaenoic acid on platelet function, blood viscosity and red cell deformability in healthy human subjects. Atherosclerosis 1983;46:321-31.. PubMed
  7. Kris-Ehterton PM, Harris WS, Appel LJ, et al. Fish consumption, fish oil, omega-3 fatty acids, and cardiovascular disease. Circulation 2002;106:2747-57. PubMed
  8. Yokoyama M, Origasa H, Matsuzaki M, et al. Effects of eicosapentaenoic acid on major coronary events in hypercholesterolaemic patients (JELIS): a randomised open-label, blinded endpoint analysis. Lancet 2007;369:1090-8. PubMed
  9. Ballantyne CM, Bays HE, Kastelein JJ, Stein E, Isaacsohn JL, Braeckman RA, Soni PN. Efficacy and safety of eicosapentaenoic acid ethyl ester (AMR101) therapy in statin-treated patients with persistent high triglycerides (from the ANCHOR study). Am J Cardi PubMed
  10. FDA announces qualified health claims for omega-3 fatty acids. Available at: https://www.fda.gov/Food/LabelingNutrition/ucm072756.htm. Accessed April 15 2019.
  11. Prescribing information: Vascepa (icosapent ethyl). Amarin Pharma, Inc. Bridgewater, NJ, USA. Revised 12/2019. Available at: https://www.vascepa.com/assets/pdf/Vascepa_PI.pdf [Accessed 12/16/2019].
  12. Rao A, Briskey D, Nalley JO, Ganuza E. Omega-3 eicosapentaenoic acid (EPA) rich extract from the microalga Nannochloropsis decreases cholesterol in healthy individuals: A double-blind, randomized, placebo-controlled, three-month supplementation study. Nut PubMed
  13. Mori T, Murasaki K, Yokoyama Y. Long-term safety and efficacy of MND-2119 (self-emulsifying formulation of highly purified eicosapentaenoic acid ethyl ester) in patients with hypertriglyceridemia: Results from a multicenter, 52-week, open-label study. J C PubMed
  14. Frangou S, Lewis M, McCrone P. Efficacy of ethyl-eicosapentaenoic acid in bipolar depression: Randomized double-blind placebo-controlled study. Br J Psychiatry. 2006;188:46-50.

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking Eicosapentaenoic Acid (epa) and Enzalutamide Together: Common Questions

Is it safe to take Eicosapentaenoic Acid (epa) with Enzalutamide?
We do not list a known interaction between Eicosapentaenoic Acid (epa) and Enzalutamide. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
Do Eicosapentaenoic Acid (epa) and Enzalutamide have any of the same side effects?
Yes — our sources link each of them separately to 8 of the same effects. That is not an interaction: neither changes how your body handles the other. It does mean that if one of those effects turns up, it can be harder to tell which one is behind it. They are listed on this page with the source behind each.
Are Eicosapentaenoic Acid (epa) and Enzalutamide used for the same thing?
They overlap in purpose, which usually means the real question is whether you need both rather than whether they are safe together. This page lists the shared uses and how strong the evidence is for Eicosapentaenoic Acid (epa) in each. That is a conversation for your prescriber, especially if Enzalutamide is being adjusted to a target.
How was the Eicosapentaenoic Acid (epa) and Enzalutamide combination checked?
Interactions in our licensed database are recorded against drug classes. Enzalutamide is filed under 6 classifications, and Eicosapentaenoic Acid (epa) has documented interactions with 2 drug classes — none of Enzalutamide's classifications are among them. A medication can belong to classes beyond those recorded in our dataset, so this describes how the check was run rather than guaranteeing safety.
Does Eicosapentaenoic Acid (epa) interact with any other medications?
Yes. Eicosapentaenoic Acid (epa) has 289 documented drug interactions in our database — Enzalutamide is simply not one of them. If you take anything else, it is worth checking each one; they are all listed on this page.
Does Enzalutamide interact with any supplements?
Yes. Enzalutamide has documented interactions with 49 supplements in our database — Eicosapentaenoic Acid (epa) is not one of them. The Enzalutamide interaction page linked on this page lists every one, ranked by severity.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Where next

Keep Exploring

Eicosapentaenoic Acid (epa) monograph Uses, safety profile, and every drug interaction in one place Enzalutamide drug information The full plain-English guide to this medication Enzalutamide supplement interactions Every supplement checked against Enzalutamide, ranked by severity Supplement interaction checker Check any supplement or product against your medications Browse medications A–Z Every drug we’ve checked against herbs & supplements References The 14 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Enzalutamide and Eicosapentaenoic Acid (epa)?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.