Herb & supplement monograph

Eicosapentaenoic Acid (epa) Drug Interactions, Uses, Effectiveness, Safety & More

Medically reviewed by ·Updated July 2026
What is this page for?

First and foremost: how Eicosapentaenoic Acid (epa) interacts with medications. The heart of this page is the interaction list — every drug Eicosapentaenoic Acid (epa) is known to interact with, and how serious each one is.

But these pages have grown well beyond that into a full monograph — what Eicosapentaenoic Acid (epa) is, what people use it for and how strong the evidence is, its safety and side effects, and answers to the questions we’re asked most — written and reviewed by the clinical staff at HelloPharmacist. It’s educational information from our licensed clinical databases, not medical advice, and we don’t sell or endorse products. Our editorial policy

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Eicosapentaenoic Acid (epa) Drug Interactions: The Bottom Line

From the HelloPharmacist Editorial Team · Updated July 2026

Based on the available evidence, Eicosapentaenoic Acid (epa) drug interactions carry a moderate but manageable level of risk for most people, centered on blood pressure medicines and blood thinners. None of the listed interactions are rated major, and every one falls into just two moderate categories rather than many separate concerns.

Interactions deserving the most attention

The best-documented concern is with antihypertensive drugs, since fish oils containing EPA can lower blood pressure on their own and may add to the effect of these medicines, so blood pressure could drop more than expected. There is also a theoretical bleeding concern with anticoagulant and antiplatelet drugs, because human research shows EPA can make platelets less sticky. Anyone on a blood thinner or closely managed blood pressure treatment should watch for signs like unusual bruising or lightheadedness.

What the rest of the list means

Although hundreds of medications appear on the interaction list, they all trace back to these two shared effects, not to hundreds of separate problems. Much of the bleeding concern remains theoretical and has not been shown to cause meaningful harm in most people, while the blood pressure effect is simply additive rather than dangerous on its own.

Check your medications against Eicosapentaenoic Acid (epa)

Based on HelloPharmacist’s Eicosapentaenoic Acid (epa) interaction data and reviewed under our editorial standards.

Interaction report

Drugs that interact with Eicosapentaenoic Acid (epa)

289 medications have a known interaction with Eicosapentaenoic Acid (epa), graded by severity. Select any drug for the full evidence-based detail.

2,830 drugs
AbciximabReoPro
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, EPA may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

Read the full Eicosapentaenoic Acid (epa) + Abciximab interaction
AbrocitinibCibinqo
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, EPA may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

Read the full Eicosapentaenoic Acid (epa) + Abrocitinib interaction Abrocitinib drug page: uses, dosage & side effects
AcebutololRhotral, Sectral
Moderate Antihypertensive Drugs

Theoretically, taking EPA with antihypertensive drugs might increase the risk of hypotension.

Read the full Eicosapentaenoic Acid (epa) + Acebutolol interaction Acebutolol drug page: uses, dosage & side effects
AcenocoumarolSintrom
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, EPA may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

Read the full Eicosapentaenoic Acid (epa) + Acenocoumarol interaction
Acetaminophen, AspirinGemnisyn
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, EPA may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

Read the full Eicosapentaenoic Acid (epa) + Acetaminophen, Aspirin interaction
Acetaminophen, Aspirin, CaffeineExcedrin, Excedrin Extra Strength, Excedrin Migraine
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, EPA may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

Read the full Eicosapentaenoic Acid (epa) + Acetaminophen, Aspirin, Caffeine interaction
Acetaminophen, IbuprofenCombogesic
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, EPA may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

Read the full Eicosapentaenoic Acid (epa) + Acetaminophen, Ibuprofen interaction
AcetazolamideAk-Zol, Diamox
Moderate Antihypertensive Drugs

Theoretically, taking EPA with antihypertensive drugs might increase the risk of hypotension.

Read the full Eicosapentaenoic Acid (epa) + Acetazolamide interaction Acetazolamide drug page: uses, dosage & side effects
Acetylsalicylic AcidEntrophen
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, EPA may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

Read the full Eicosapentaenoic Acid (epa) + Acetylsalicylic Acid interaction Acetylsalicylic Acid drug page: uses, dosage & side effects
AliskirenTekturna
Moderate Antihypertensive Drugs

Theoretically, taking EPA with antihypertensive drugs might increase the risk of hypotension.

Read the full Eicosapentaenoic Acid (epa) + Aliskiren interaction Aliskiren drug page: uses, dosage & side effects
Alteplase, TpaActilyse, Activase
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, EPA may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

Read the full Eicosapentaenoic Acid (epa) + Alteplase, Tpa interaction
Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium HydroxideAscriptin Codeine #2
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, EPA may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

Read the full Eicosapentaenoic Acid (epa) + Aluminum Hydroxide, Aspirin, Codeine Phosphate, Magnesium Hydroxide interaction
Aluminum Hydroxide, Aspirin, Magnesium HydroxideAscriptin
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, EPA may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

Read the full Eicosapentaenoic Acid (epa) + Aluminum Hydroxide, Aspirin, Magnesium Hydroxide interaction Aluminum Hydroxide, Aspirin, Magnesium Hydroxide drug page: uses, dosage & side effects
AmbrisentanLetairis, Volibris
Moderate Antihypertensive Drugs

Theoretically, taking EPA with antihypertensive drugs might increase the risk of hypotension.

Read the full Eicosapentaenoic Acid (epa) + Ambrisentan interaction Ambrisentan drug page: uses, dosage & side effects
AmilorideAmilamont, Midamor
Moderate Antihypertensive Drugs

Theoretically, taking EPA with antihypertensive drugs might increase the risk of hypotension.

Read the full Eicosapentaenoic Acid (epa) + Amiloride interaction Amiloride drug page: uses, dosage & side effects
Amiloride, HydrochlorothiazideAmil-Co, Amilzide, Moduret 25, Moduretic
Moderate Antihypertensive Drugs

Theoretically, taking EPA with antihypertensive drugs might increase the risk of hypotension.

Read the full Eicosapentaenoic Acid (epa) + Amiloride, Hydrochlorothiazide interaction Amiloride, Hydrochlorothiazide drug page: uses, dosage & side effects
AmlodipineNorliqva
Moderate Antihypertensive Drugs

Theoretically, taking EPA with antihypertensive drugs might increase the risk of hypotension.

Read the full Eicosapentaenoic Acid (epa) + Amlodipine interaction Amlodipine drug page: uses, dosage & side effects
Amlodipine BenzoateKaterzia
Moderate Antihypertensive Drugs

Theoretically, taking EPA with antihypertensive drugs might increase the risk of hypotension.

Read the full Eicosapentaenoic Acid (epa) + Amlodipine Benzoate interaction Amlodipine Benzoate drug page: uses, dosage & side effects
Amlodipine BesilateIstin
Moderate Antihypertensive Drugs

Theoretically, taking EPA with antihypertensive drugs might increase the risk of hypotension.

Read the full Eicosapentaenoic Acid (epa) + Amlodipine Besilate interaction
Amlodipine BesylateNorvasc
Moderate Antihypertensive Drugs

Theoretically, taking EPA with antihypertensive drugs might increase the risk of hypotension.

Read the full Eicosapentaenoic Acid (epa) + Amlodipine Besylate interaction Amlodipine Besylate drug page: uses, dosage & side effects
Amlodipine Besylate, BenazeprilLotrel
Moderate Antihypertensive Drugs

Theoretically, taking EPA with antihypertensive drugs might increase the risk of hypotension.

Read the full Eicosapentaenoic Acid (epa) + Amlodipine Besylate, Benazepril interaction
Amlodipine, CelecoxibConsensi
Moderate Antihypertensive Drugs

Theoretically, taking EPA with antihypertensive drugs might increase the risk of hypotension.

Read the full Eicosapentaenoic Acid (epa) + Amlodipine, Celecoxib interaction
Ammonium ChlorideAmmonium Chloride
Moderate Antihypertensive Drugs

Theoretically, taking EPA with antihypertensive drugs might increase the risk of hypotension.

Read the full Eicosapentaenoic Acid (epa) + Ammonium Chloride interaction
Anacaulase-bcdbNexoBrid
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, EPA may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

Read the full Eicosapentaenoic Acid (epa) + Anacaulase-bcdb interaction
AnagrelideAgrylin
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, EPA may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

Read the full Eicosapentaenoic Acid (epa) + Anagrelide interaction Anagrelide drug page: uses, dosage & side effects
AnisindioneMiradon
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, EPA may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

Read the full Eicosapentaenoic Acid (epa) + Anisindione interaction
Antithrombin IiiThrombate III
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, EPA may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

Read the full Eicosapentaenoic Acid (epa) + Antithrombin Iii interaction
ApixabanEliquis
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, EPA may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

Read the full Eicosapentaenoic Acid (epa) + Apixaban interaction Apixaban drug page: uses, dosage & side effects
AprocitentanTryvio
Moderate Antihypertensive Drugs

Theoretically, taking EPA with antihypertensive drugs might increase the risk of hypotension.

Read the full Eicosapentaenoic Acid (epa) + Aprocitentan interaction Aprocitentan drug page: uses, dosage & side effects
ArgatrobanArgatroban
Moderate Anticoagulant/antiplatelet Drugs

Theoretically, EPA may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.

Read the full Eicosapentaenoic Acid (epa) + Argatroban interaction
Read The List Like a Pharmacist

What Severity, Likelihood & Evidence Mean

Severity — How Serious It Can Be

  • Major. Clinically significant; generally best avoided, or used only under direct professional supervision.
  • Moderate. May need monitoring, a dose adjustment, or separating the times you take each one.
  • Minor. Generally not clinically significant, but still worth noting and mentioning to your pharmacist.
  • No known interaction. Checked against our sources with nothing documented — not the same as proven safety.

Likelihood — How Well It’s Documented

  • Likely. Well-controlled human studies have demonstrated the likely existence of this interaction
  • Probable. 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.
  • Possible. 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
  • Unlikely. Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans.

Where This Data Comes From

  • Interaction records are evidence-graded and sourced from the Natural Medicines database (TRC Healthcare), the same reference used by pharmacists and hospitals.
  • Each drug listed above links to the full report for that exact Eicosapentaenoic Acid (epa) combination — clinical detail, likelihood, evidence level, and citations.
  • Content is reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.
The big picture

The kinds of drugs Eicosapentaenoic Acid (epa) affects

Every type of medication (drug category) Eicosapentaenoic Acid (epa) is known to interact with. Open any category for the detail — or search your exact drug in the checker above.

All 2 drug categories Eicosapentaenoic Acid (epa) interacts with
Anticoagulant/antiplatelet DrugsAntihypertensive Drugs
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.

Likelihood Possible Evidence B
Antihypertensive Drugs

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.

Likelihood Probable Evidence B
Monograph

Eicosapentaenoic Acid (epa): Uses, Safety & Side Effects

Medically reviewed by · Reviewed July 2026 ·
The bottom line

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.

Part used
Omega-3 fatty acid derived mainly from fatty fish and fish oil; also from algae
Common forms
Softgel capsules, liquid fish oil, prescription-strength capsules, algae-based supplements
People commonly use it for
  • Heart and triglyceride health
  • Inflammation
  • Mood and depression support
  • Joint comfort
  • General omega-3 supplementation

Popular and traditional uses — not proof it works. See “Uses & effectiveness” below for the evidence.

Safety at a glance
OverallLikely safe

EPA is generally well tolerated for most adults at typical supplement doses.

PregnancyInsufficient reliable information

Insufficient reliable information available; avoid using.

Read the full pregnancy detail
BreastfeedingInsufficient reliable information

Insufficient reliable information available; avoid using.

Read the full breastfeeding detail

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center). Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Jump to a section

Overview

Eicosapentaenoic acid (EPA) is a type of omega-3 fatty acid. The body cannot make enough of it on its own, so we get it mainly from foods like salmon, sardines, mackerel, and anchovies. It is also made by certain types of marine algae, which is the original source that fish get it from.

EPA is one of the two main long-chain omega-3 fats in fish oil. The other is DHA (docosahexaenoic acid). Many supplements contain both EPA and DHA, but some products are made to contain mostly EPA.

People take EPA supplements for heart health, high triglycerides, inflammation, and mood. It comes in fish oil capsules, liquid oils, prescription products, and algae-based options for people who prefer to avoid fish.

How it works

EPA is a building block your body uses to make signaling molecules that help control inflammation. Unlike some other fats that can promote inflammation, EPA helps make compounds that tend to calm it down.

EPA can also lower the amount of triglycerides your liver makes and releases into the blood. It may have mild effects on blood clotting and blood vessel function as well.

Many of these effects come from laboratory and clinical research, but scientists are still learning exactly how EPA produces its benefits in different conditions.

Effectiveness

Does Eicosapentaenoic Acid (epa) work?

Here’s what the research actually shows for each use — graded by Natural Medicines and reviewed by .

Evidence overview · 46 uses evaluated
1 Effective 2 Possibly effective 43 Insufficient evidence
How to read these evidence grades

Natural Medicines’ 7-point scale. We show each rating’s label word-for-word.

1EffectiveStrong, consistent evidence it works.
2Likely EffectiveGood evidence, though not yet conclusive.
3Possibly EffectiveSome evidence suggests a benefit.
4Possibly IneffectiveSome evidence it may not help.
5Likely IneffectiveFairly strong evidence it doesn’t help.
6IneffectiveStrong evidence it doesn’t work.
7Insufficient Reliable Evidence to RateToo little research to say either way.
Effective Hypertriglyceridemia
Rating & evidence shown verbatim from Natural Medicines

Oral prescription ethyl-EPA 4 grams daily reduces triglyceride levels in patients with hypertriglyceridemia, especially in severe cases. It is unclear if oral EPA supplements are beneficial in hypertriglyceridemia.

Possibly Effective Depression
Rating & evidence shown verbatim from Natural Medicines

Oral EPA seems to reduce symptoms of depression, especially in patients already being treated with conventional antidepressants.

Possibly Effective Myocardial infarction (MI)
Rating & evidence shown verbatim from Natural Medicines

Oral prescription ethyl-EPA reduces the risk of MI when used as an adjunct to statin therapy in patients with cardiovascular disease (CVD) risk. Oral EPA supplements also seem to be beneficial for this purpose.

Also studied for 43 conditions — evidence insufficient to rate
Insufficient Reliable Evidence To Rate Age-related macular degeneration (AMD)
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral EPA is beneficial for AMD prevention.

Insufficient Reliable Evidence To Rate Allergic rhinitis (hay fever)
Rating & evidence shown verbatim from Natural Medicines

Although there has been interest in using oral EPA for allergic rhinitis, there is insufficient reliable information about the clinical effects of EPA for this condition.

Insufficient Reliable Evidence To Rate Alzheimer disease
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral EPA is beneficial for Alzheimer disease prevention.

Insufficient Reliable Evidence To Rate Asthma
Rating & evidence shown verbatim from Natural Medicines

Although there has been interest in using oral EPA for asthma, there is insufficient reliable information about the clinical effects of EPA for this condition.

Insufficient Reliable Evidence To Rate Atopic dermatitis (eczema)
Rating & evidence shown verbatim from Natural Medicines

Although there has been interest in using oral EPA for atopic dermatitis, there is insufficient reliable information about the clinical effects of EPA for this condition.

Insufficient Reliable Evidence To Rate Attention deficit-hyperactivity disorder (ADHD)
Rating & evidence shown verbatim from Natural Medicines

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

Insufficient Reliable Evidence To Rate Behcet disease
Rating & evidence shown verbatim from Natural Medicines

Although there has been interest in using oral EPA for Behcet disease, there is insufficient reliable information about the clinical effects of EPA for this condition.

Insufficient Reliable Evidence To Rate Bipolar disorder
Rating & evidence shown verbatim from Natural Medicines

Oral fish oil in doses providing 1-2 grams EPA may be beneficial for symptoms of depression in patients with bipolar disorder. It is unclear if EPA alone is beneficial.

Insufficient Reliable Evidence To Rate Borderline personality disorder
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral EPA is beneficial for improving symptoms of borderline personality disorder.

Insufficient Reliable Evidence To Rate Cachexia
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral EPA is beneficial for maintaining lean body mass in patients undergoing chemotherapy.

Insufficient Reliable Evidence To Rate Chemotherapy-induced diarrhea
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral EPA is beneficial for preventing diarrhea during treatment with chemotherapy.

Insufficient Reliable Evidence To Rate Chemotherapy-induced nausea and vomiting (CINV)
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral EPA is beneficial for preventing nausea and vomiting during treatment with chemotherapy.

Insufficient Reliable Evidence To Rate Chemotherapy-induced peripheral neuropathy
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral EPA is beneficial for preventing peripheral neuropathy during treatment with chemotherapy.

Insufficient Reliable Evidence To Rate Chemotherapy-related fatigue
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral EPA is beneficial for preventing fatigue during treatment with chemotherapy.

Insufficient Reliable Evidence To Rate Cognitive function
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral EPA alone is beneficial for improving cognitive function.

Insufficient Reliable Evidence To Rate Colorectal adenoma
Rating & evidence shown verbatim from Natural Medicines

Taking oral EPA with aspirin might reduce the development of new colorectal adenomas. However, it is unclear if oral EPA alone is beneficial.

Insufficient Reliable Evidence To Rate Coronary heart disease (CHD)
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral EPA alone is beneficial for CHD.

Insufficient Reliable Evidence To Rate Cystic fibrosis
Rating & evidence shown verbatim from Natural Medicines

Although there has been interest in using oral EPA for cystic fibrosis, there is insufficient reliable information about the clinical effects of EPA for this condition.

Insufficient Reliable Evidence To Rate Diabetes
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral EPA is beneficial for glycemic control.

Insufficient Reliable Evidence To Rate Dysmenorrhea
Rating & evidence shown verbatim from Natural Medicines

Although there has been interest in using oral EPA for dysmenorrhea, there is insufficient reliable information about the clinical effects of EPA for this condition.

Insufficient Reliable Evidence To Rate Exercise-induced muscle damage
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral EPA alone is beneficial for preventing exercise-induced muscle damage.

Insufficient Reliable Evidence To Rate Fractures
Rating & evidence shown verbatim from Natural Medicines

Oral EPA has only been evaluated in combination with other ingredients; its effect when used alone is unclear.

Insufficient Reliable Evidence To Rate Huntington disease
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral EPA is beneficial for this condition.

Insufficient Reliable Evidence To Rate Hypercholesterolemia
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral EPA is beneficial for improving lipid levels.

Insufficient Reliable Evidence To Rate IgA nephropathy
Rating & evidence shown verbatim from Natural Medicines

Although there has been interest in using oral EPA for IgA nephropathy, there is insufficient reliable information about the clinical effects of EPA for this condition.

Insufficient Reliable Evidence To Rate Intrauterine growth restriction (IUGR)
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral EPA during pregnancy reduces the risk of IUGR.

Insufficient Reliable Evidence To Rate Lung cancer
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral EPA is beneficial for lung cancer treatment.

Insufficient Reliable Evidence To Rate Menopausal symptoms
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral EPA reduces hot flashes after menopause.

Insufficient Reliable Evidence To Rate Metabolic syndrome
Rating & evidence shown verbatim from Natural Medicines

Although there has been interest in using oral EPA for metabolic syndrome, there is insufficient reliable information about the clinical effects of EPA for this condition.

Insufficient Reliable Evidence To Rate Migraine headache
Rating & evidence shown verbatim from Natural Medicines

Although there has been interest in using oral EPA for migraine headache, there is insufficient reliable information about the clinical effects of EPA for this condition.

Insufficient Reliable Evidence To Rate Muscle strength
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral EPA is beneficial for increasing muscle strength.

Insufficient Reliable Evidence To Rate Physical performance
Rating & evidence shown verbatim from Natural Medicines

Taking EPA does not seem to improve physical performance in patients requiring mechanical ventilation. It is unclear if oral EPA is beneficial for increasing physical performance in older adults.

Insufficient Reliable Evidence To Rate Postoperative infection
Rating & evidence shown verbatim from Natural Medicines

Oral EPA has only been evaluated in combination with other ingredients; its effect when used alone is unclear.

Insufficient Reliable Evidence To Rate Postoperative recovery
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral EPA helps to maintain postoperative lean body mass.

Insufficient Reliable Evidence To Rate Pregnancy-induced hypertension
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral EPA during pregnancy reduces the risk of hypertension.

Insufficient Reliable Evidence To Rate Prostate cancer
Rating & evidence shown verbatim from Natural Medicines

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

Insufficient Reliable Evidence To Rate Psoriasis
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral EPA is beneficial in psoriasis.

Insufficient Reliable Evidence To Rate Quality of life
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral EPA is beneficial for improving quality of life in patients with cancer.

Insufficient Reliable Evidence To Rate Schizophrenia
Rating & evidence shown verbatim from Natural Medicines

Evidence for the use of oral EPA in schizophrenia is conflicting.

Insufficient Reliable Evidence To Rate Systemic lupus erythematosus (SLE)
Rating & evidence shown verbatim from Natural Medicines

Although there has been interest in using oral EPA for SLE, there is insufficient reliable information about the clinical effects of EPA for this condition.

Insufficient Reliable Evidence To Rate Systemic lupus erythematosus (SLE) nephritis
Rating & evidence shown verbatim from Natural Medicines

Although there has been interest in using oral EPA for SLE nephritis, there is insufficient reliable information about the clinical effects of EPA for this condition.

Insufficient Reliable Evidence To Rate Ulcerative colitis
Rating & evidence shown verbatim from Natural Medicines

It is unclear if oral EPA is beneficial for ulcerative colitis prevention and treatment.

Insufficient Reliable Evidence To Rate Wound healing
Rating & evidence shown verbatim from Natural Medicines

Although there has been interest in using oral EPA for wound healing, there is insufficient reliable information about the clinical effects of EPA for this condition.

Source & disclaimer. Effectiveness ratings and evidence summaries are provided by Natural Medicines (Therapeutic Research Center) and shown as licensed. Where Natural Medicines hasn’t rated a use, HelloPharmacist’s pharmacists may add their own reviewed rating and evidence (each such entry is labeled). This is educational information, not medical advice — talk with your pharmacist or doctor before starting, stopping, or changing a supplement.

Safety & precautions

EPA is generally considered safe for most adults when taken at usual supplement doses. People who are allergic to fish or shellfish should be cautious and may prefer algae-based products.

If you take medicines that thin the blood or you have a bleeding disorder, talk with your doctor before using higher-dose omega-3 products, since they may slightly affect clotting. Let your surgical team know if you take EPA before any planned surgery.

For pregnancy and breastfeeding, omega-3s are commonly recommended from food and prenatal supplements, but you should confirm the right product and dose with your doctor. Choose purified products to limit exposure to mercury and other contaminants.

Side effects

The most common side effects are mild and involve the stomach. These include fishy burps or aftertaste, nausea, bloating, loose stools, or heartburn. Taking the supplement with food or using an enteric-coated product may help.

At higher doses, EPA may slightly increase the risk of bleeding or easy bruising. Some studies have noted a possible increase in an irregular heartbeat called atrial fibrillation with high-dose omega-3 use. If you notice unusual symptoms, stop and check with your doctor.

Eicosapentaenoic Acid (epa): Reported Adverse Effects

Documented safety reports on Eicosapentaenoic Acid (epa) from the evidence-graded Natural Medicines (TRC Healthcare) database, shown word-for-word from the licensed record.

Orally, prescription EPA or EPA derived from fish oil is generally well tolerated in doses of up to 3 grams daily. Agal oil providing EPA seems to be well tolerated. Doses of EPA greater than 3 grams daily are possibly unsafe.

Intravenously, fish oil or omega-3 fatty acid lipid emulsions containing EPA seem to be well tolerated.

Most Common Adverse Effects:

Orally: Belching, diarrhea, epigastric discomfort, fishy aftertaste, and nausea.

Serious Adverse Effects (Rare):

Orally: Some case reports raise concerns about increased risk of bleeding with high doses.

Reports by condition
Atrial fibrillation Cardiovascular

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.

  1. 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].
Bleeding Hematologic

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. To reduce this risk, the US Food and Drug Administration (FDA) recommends that consumers limit intake of EPA plus DHA to 3 grams daily, with no more than 2 grams daily from a dietary supplement. The prescription ethyl-EPA product (Vascepa, Amarin) 4 grams daily has been linked to bleeding in 12% of patients, compared with 10% in the placebo group. Serious bleeding occurred in 3% of the Vascepa group compared to 2% in the placebo group.

  1. 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.
  2. 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.
  3. 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. 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. 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].
Diarrhea Gastrointestinal

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.

  1. 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.
  2. 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
  3. 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
  4. 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. 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.
Pain Musculoskeletal

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). However, in another study, slightly fewer patients taking ethyl-EPA 1.8 grams daily experienced joint, lumbar, or muscle pain compared to placebo (1.6% vs 2.0%, respectively).

  1. 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
  2. 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.
Pruritus Dermatologic

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

  1. 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.
DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.

Adverse-effects data: Natural Medicines, Therapeutic Research Center

Dosing

There is no single standard dose of EPA for everyone, and the right amount depends on why you are taking it. Doses used for triglycerides are usually much higher than general wellness doses.

The best approach is to follow the product label and check with your pharmacist or doctor, especially if you are using a high-dose or prescription product. Look at the actual amount of EPA listed on the label, since total fish oil is not the same as EPA content.

Pregnancy & Breastfeeding

Eicosapentaenoic Acid (epa) & Pregnancy

Insufficient reliable information

Insufficient reliable information available; avoid using.

Eicosapentaenoic Acid (epa) & Breastfeeding

Insufficient reliable information

Insufficient reliable information available; avoid using.

DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.

© 2026 Therapeutic Research Center

Pregnancy & lactation ratings: Natural Medicines, Therapeutic Research Center

References & further reading

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.
Keep reading

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.

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

Pharmacist Counseling Corner

Eicosapentaenoic Acid (epa): Common Questions

What is Eicosapentaenoic Acid (epa) used for, and does it work?
People use Eicosapentaenoic Acid (epa) for many reasons, but the evidence varies by use. According to the Natural Medicines database, there is at least some clinical evidence supporting Eicosapentaenoic Acid (epa) for Hypertriglyceridemia, Depression and Myocardial infarction (MI). For most other uses it has been studied for, the evidence is currently insufficient to rate. See the graded list on this page, and always confirm with your pharmacist or doctor.
Does Eicosapentaenoic Acid (epa) interact with prescription medications?
Yes. We list 289 medications with a known interaction with Eicosapentaenoic Acid (epa). Use the checker above to see how Eicosapentaenoic Acid (epa) interacts with a specific drug.
How are Eicosapentaenoic Acid (epa) interactions rated?
Each interaction is graded major, moderate, or minor based on how clinically significant it is and the strength of the evidence behind it. Major interactions are the most serious and are best avoided, or used only under close professional supervision.
Is it safe to take Eicosapentaenoic Acid (epa) with my medications?
It depends on the specific medication. Some combinations are fine, while others call for monitoring, timing changes, or should be avoided. Check your exact drug above and confirm with your pharmacist or doctor before starting, stopping, or changing anything.
Where does this Eicosapentaenoic Acid (epa) interaction information come from?
Our interaction data is built on the Natural Medicines database — an evidence-graded reference for vitamins, herbs, and supplements — and is reviewed by licensed HelloPharmacist pharmacists, who may add clinical context.
What is EPA used for?
EPA is most often used to help lower high triglycerides and support heart health, and some people use it for inflammation or mood. The evidence is strongest for triglycerides and more mixed for other uses.
What is the difference between EPA and DHA?
Both are omega-3 fats found in fish oil. EPA is more linked to inflammation and triglyceride effects, while DHA is important for the brain and eyes; many supplements contain both.
Can I get EPA without eating fish?
Yes. Algae-based omega-3 supplements can provide EPA and are a good option for vegetarians, vegans, or people with fish allergies.
Is it safe to take EPA every day?
For most adults, daily use at typical supplement doses is generally well tolerated. Talk to your pharmacist or doctor if you take blood thinners, have a bleeding disorder, or use high-dose products.

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

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