Drug & supplement interaction

Eicosapentaenoic Acid (epa) + Selexipag

Selexipag brand name: Uptravi.

Moderate Interaction
Medically reviewed by · Updated September 2026
The bottom line Moderate

Selexipag falls into 2 drug categories that Eicosapentaenoic Acid (epa) can interact with; the most serious is rated moderate. Theoretically, taking EPA with antihypertensive drugs might increase the risk of hypotension.

Read the full interaction report
SeverityModerate
LikelihoodProbable
Interactions2
EvidenceB
What do Severity, Likelihood & Evidence mean?
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Interaction report

Eicosapentaenoic Acid (epa) and Selexipag

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

Eicosapentaenoic Acid (epa) interacts with whole categories of medication. Selexipag falls into 2 of those categories, so it can interact with Eicosapentaenoic Acid (epa) in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

ANTIHYPERTENSIVE DRUGS

1 of 2

Why this applies to Selexipag

Selexipag falls under ANTIHYPERTENSIVE DRUGS — the group Eicosapentaenoic Acid (epa) interacts with.

Theoretically, taking EPA with antihypertensive drugs might increase the risk of hypotension.
Fish oils containing EPA can lower blood pressure and might have additive effects in patients treated with antihypertensives; use with caution.
Severity Moderate Likelihood Probable Evidence B

Interaction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the gist for Uptravi (selexipag): this drug already works by relaxing and widening the blood vessels in your lungs, which can nudge your blood pressure downward. EPA from fish oil tends to gently lower blood pressure too. Put them together and those small effects can stack up, which is what we call an additive interaction. This isn't about EPA changing how your body breaks selexipag down, it's simply two things pulling in the same direction.

In real life that might show up as feeling lightheaded, dizzy, or a little washed out, especially when you stand up quickly. The evidence here is fairly modest and mostly theoretical, so don't panic. Just give your pharmacist or doctor a heads-up before adding an EPA supplement, and let them know if you notice new dizziness.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  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
Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

2 of 2

Selexipag also falls under ANTICOAGULANT/ANTIPLATELET DRUGS.

Theoretically, EPA may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
In human research, taking EPA has been shown to inhibit platelet aggregation.
Severity Moderate Likelihood Possible Evidence B

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the thing to know about pairing EPA (fish oil) with Uptravi (selexipag). The concern here isn't really about how your liver processes the drug. Instead, it's about an added effect on your platelets. EPA can make your platelets a little less sticky, which mildly nudges you toward easier bleeding or bruising. Selexipag itself relaxes blood vessels and can also have a mild effect on blood flow, so stacking the two could, in theory, make you bruise more easily or bleed a bit longer from a cut.

To be fair, this is mostly theoretical and the evidence is modest. Everyday amounts of fish in your diet are unlikely to matter much, but concentrated fish oil capsules are worth mentioning to your pharmacist or cardiologist, especially if you notice unusual bruising or nosebleeds. Don't stop either one on your own.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. 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

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Eicosapentaenoic Acid (epa) Also Interacts With Other Medications

Eicosapentaenoic Acid (epa) has 288 moderate known drug interactions in our database — the Selexipag one above is among them. If you take anything else, check it against the full list below.

Moderate 288 No known interaction 2,542 (incl. Selexipag)
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.

Everything else you take

See Every Supplement That Interacts With Selexipag

This page covers Eicosapentaenoic Acid (epa) only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Selexipag page lists 291 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Hellebore (major), American Mistletoe (major), Danshen (major) and Piracetam (major).

By severity: 6 major · 258 moderate · 27 minor.

From our pharmacist’s overview on the Selexipag page

“People take selexipag (Uptravi) for pulmonary arterial hypertension, dangerously high pressure in the arteries of the lungs, and that diagnosis raises the stakes on this list of 291 interacting supplements. I would treat it with real vigilance.”

Reviewed by 2 · Jul 18, 2026

Open the Selexipag interaction page

How much people look this up

Where Eicosapentaenoic Acid (epa) and Selexipag 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

#1,248 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Selexipag
Steady interest

#1,433 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.

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.

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

About Selexipag

What Is Selexipag Used For?

Brand name: Uptravi

Selexipag tablets are used to treat pulmonary arterial hypertension (PAH, WHO Group I) — a type of high blood pressure in the arteries of the lungs. The goal is to slow the disease from getting worse and to reduce the chances of being hospitalized because of PAH.

Uptravi (selexipag) tablets are approved for both adults and children aged 2 years and older. Uptravi for injection (intravenous) is also available for adult patients who are already on Uptravi tablets but temporarily cannot take medicine by mouth.

See full Selexipag 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
288Moderate
0Minor
2,541No known interaction
288 Moderate 2,541 No interaction
Moderate

288 interactions

Showing 60 of 288 moderate interactions — see all 288 on the Eicosapentaenoic Acid (epa) page.

No interaction 2,541 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 2,541 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 Selexipag, ranked by severity
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

Keep exploring
Eicosapentaenoic Acid (epa) monograph › Uses, safety, and every drug interaction in one place Selexipag supplement interactions › Every supplement checked against Selexipag, ranked by severity Selexipag drug information › The full plain-English guide to this medication Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

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

Can you take Eicosapentaenoic Acid (epa) with Selexipag?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
Why are there 2 interactions listed for Eicosapentaenoic Acid (epa) and Selexipag?
Selexipag belongs to more than one drug category, and Eicosapentaenoic Acid (epa) interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Eicosapentaenoic Acid (epa) and Selexipag interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

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

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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.