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Dietary supplement

Ultra Omega 3-6-9 Ingredients & Drug Interactions

by KAL

Ultra Omega 3-6-9 label
See full label image
Softgel Capsule Category: Fat/fatty Acid
Most serious interaction: Moderate
Clinical methodology reviewed by · Updated Sep 9, 2026 · Label data from the NIH DSLD
What is this page for?

First and foremost: checking Ultra Omega 3-6-9 against your medications. The heart of this page is the interaction checker and the full interaction report — how this product’s ingredients may interact with prescription and over-the-counter medicines you may be taking.

Around that, we add a pharmacist’s high-level view of the product as a whole — what’s inside, the evidence for its stated use, how transparent the label is, and what safety data exists — so you can see the full picture in one place. It’s educational information from our licensed clinical databases and the clinical staff at HelloPharmacist — not medical advice — and we don’t sell or endorse products. Our editorial policy

The interaction bottom line Most serious interaction: Moderate

Ultra Omega 3-6-9 is a dietary supplement by KAL with 4 active ingredients. Its ingredients are commonly taken for general antioxidant support, skin and hair care, heart health.Based on those ingredients, 1,057 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Vitamin E, Fish Oil, organic Flax seed Oil. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

Jump to a section

Check Your Meds Against Ultra Omega 3-6-9 by KAL

Ask about any prescription or over-the-counter medication and we check it for interactions with Ultra Omega 3-6-9 by KAL — and tell you which ingredient is responsible.

Pharmacist-reviewed data Checks every ingredient Answer in seconds
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HelloPharmacist Scorecard of Ultra Omega 3-6-9 by KAL

Our pharmacy team’s full take, with four database checks built into the cards below — a summary of what is known, not a grade of the product itself.

From our pharmacy team — supplement deep dive

Generated from HelloPharmacist’s pharmacist-curated databases and editorial rules · Last generated Jul 11, 2026

What’s inside

Full disclosure
Ingredient Transparency · database check
Full

Every active ingredient lists its own amount on the label.

Why this rating?
  • The label discloses an exact amount for 7 of its 7 active ingredients.
  • “Borage seed Oil” is listed as a grouped ingredient — the label gives one combined amount (400 mg) without saying how much of each component you get.
  • “Fish Oil” is listed as a grouped ingredient — the label gives one combined amount (400 mg) without saying how much of each component you get.
  • “organic Flax seed Oil” is listed as a grouped ingredient — the label gives one combined amount (400 mg) without saying how much of each component you get.

Ultra Omega 3-6-9 has 7 active ingredients: three omega-3 fatty acids (eicosapentaenoic acid and docosahexaenoic acid from fish oil, plus alpha-linolenic acid from flax seed oil), three omega-6 and omega-9 fatty acids (gamma-linolenic acid from borage seed oil, linoleic acid, and oleic acid), plus vitamin E. Altogether, you're getting a blend of omega fatty acids — compounds your body can't make on its own — along with an antioxidant.

The product also contains gelatin and glycerin as inactive ingredients that help form and fill the softgel capsule.

Does it work?

Moderate evidence
Evidence for Intended Use · database check
By FDA rules, dietary supplements can’t claim to treat, cure, or prevent disease — so labels speak in careful marketing language. We discern each product’s intended use from its name, label claims, and label statements, then grade the clinical evidence for that use. How these ratings are computed
Moderate

Some clinical evidence supports this product's ingredients for its stated purpose, but it isn't conclusive.

Why this rating?
  • The label markets this product for: Heart health and omega fatty acid support.
  • We looked for evidence on: Atherosclerosis, Cardiovascular disease (CVD), Coronary heart disease (CHD), Congestive heart failure (CHF), Angina, Atrial fibrillation — and 4 related terms.
  • The strongest evidence on file: Oleic Acid is rated "Possibly Effective" for Coronary heart disease (CHD) (Natural Medicines).
  • Also on file: Vitamin E is rated "Possibly Ineffective" for Angina, Atherosclerosis, Congestive heart failure (CHF).
  • Also on file: Vitamin E is rated "Likely Ineffective" for Cardiovascular disease (CVD).

The evidence on file supports vitamin E for treating vitamin E deficiency and a rare genetic condition called ataxia with vitamin E deficiency (AVED). For Alzheimer disease, beta-thalassemia, glucose-6-phosphate dehydrogenase (G6PD) deficiency, and intracranial hemorrhage, vitamin E is rated possibly effective — the evidence exists but isn't yet conclusive.

We don't hold effectiveness data for the omega fatty acids in this product on file. Oleic acid shows possibly effective evidence for high cholesterol and coronary heart disease, but that's based on food amounts, and concentrated supplements are less well studied.

The evidence, ingredient by ingredient Vitamin E Borage Fish Oil Flaxseed Oil Oleic Acid

How safe is it?

Well-documented data
Safety Information · database check
Well characterized

Adverse-effect, pregnancy, and general safety data are on file for most of these ingredients.

Why this rating?
  • We hold adverse-effect (side-effect) data for 1 of the 2 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 2 of 2.
  • General safety write-ups exist for 2 of 2.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Vitamin E from food and normal dietary amounts is generally well tolerated. However, high-dose long-term supplements carry caution — they may increase bleeding risk and other potential harms.

The data shows vitamin E is generally well tolerated when taken orally or applied to skin, but rare serious side effects can include bleeding and hemorrhagic stroke. High doses appear to raise bleeding risk, especially in people with vitamin K deficiency or those already on blood thinners.

For pregnancy, amounts from food and prenatal vitamins are appropriate, but avoid high-dose supplements unless your doctor directs you to. While breastfeeding, normal dietary amounts are fine, but check with your doctor before taking high-dose supplements.

Oleic acid from food is safe, but concentrated supplements in pregnancy and lactation aren't well studied.

Side effects, ingredient by ingredient Vitamin E Borage Fish Oil Flaxseed Oil Oleic Acid

Meds to double-check

Moderate interaction found
Known Interaction Concern · database check
Moderate identified

The most serious documented interaction for these ingredients is Moderate. Check your medications for a personalized result.

Why this rating?
  • 2 of the 2 matched ingredients can interact with medications — Vitamin E, Oleic Acid.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; immunosuppressants / transplant drugs; cancer treatments; diabetes medications.
  • For scale: 845 individual medications appear in the full list. A big number alone doesn't make a product dangerous — what matters is whether YOUR medication is on it, so run yours through the interaction checker on this page.

Check with your pharmacist before taking this if you're on blood thinners or antiplatelet drugs — vitamin E may increase your bleeding risk. Also double-check if you take warfarin (Coumadin), chemotherapy drugs (alkylating agents or antitumor antibiotics), cyclosporine, diabetes medications, niacin, or selumetinib.

We could not check the omega fatty acid ingredients (eicosapentaenoic acid, docosahexaenoic acid, gamma-linolenic acid, linoleic acid, and alpha-linolenic acid) for interactions.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFully disclosed formula with some supporting evidence for its stated purpose. Moderate medication interactions have been identified, and safety information is well characterized.

This product works best if you're targeting omega fatty acid intake — though we don't have effectiveness data for those on file. Vitamin E is the most likely source of interactions, especially if you're on blood thinners, chemotherapy, or diabetes medications.

If you take any prescription medication, especially anticoagulants, antiplatelet agents, cancer drugs, or diabetes meds, check your exact medications with the tool on this page before you start, and talk with your pharmacist or doctor.

Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI

Assessment coverage: 2 of 7 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Oct 23, 2019.

This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed

At a glance

General information

Key facts about Ultra Omega 3-6-9, straight from the product label.

Brand KAL
Barcode (UPC) 021245107156
Net contents 200 Softgel(s)
Market status On market
Date entered into DSLD Oct 23, 2019
DSLD ID 207737
Product type Fat/fatty Acid
Supplement form Softgel Capsule
Dietary claims / uses Nutrient, All Other
Intended target group(s) Adult (18 - 50 Years)
From the label
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.

Supplement Facts

The label details for Ultra Omega 3-6-9 by KAL, sourced from the NIH Dietary Supplement Label Database.

Supplement Facts

Daily Value (DV) Target Group(s):
Adults and children 4 or more years of age
Minimum serving Sizes:
1 Softgel(s)
Maximum serving Sizes:
1 Softgel(s)
UPC/BARCODE
021245107156
IngredientAmount% DV
Calories15 Calorie(s)--
Calories from Fat10 Calorie(s)--
Eicosapentaenoic Acid72 mg--
Docosahexaenoic Acid48 mg--
Saturated Fat0 Gram(s)--
Trans Fat0 Gram(s)--
Cholesterol5 mg2%
Total Fat1 Gram(s)2%
Gamma-Linolenic Acid76 mg--
Vitamin E10 IU33%
Linoleic Acid47 mg--
Oleic Acid75 mg--
Alpha-Linolenic Acid212 mg--
Borage seed Oil400 mg--
Fish Oil400 mg--
organic Flax seed Oil400 mg--

Other ingredients: Gelatin, Glycerin

Tap any ingredient to jump to its full detail below.

Label statements
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
General Statements

Innovative quality Since 1932

Formula

Molecularly Distilled Fish Oil Borage/Fish/Flax

Discussion: Today's North American diet is typically low in Omega 3. A shortage of Omega 3 in the diet disrupts the balance of Essential Fatty Acids in the body. This formulation provides a delicate balance of Omega 3, Omega 6 and Omega 9 with added Vitamin E to help prevent oxidation.

Molecularly Distilled fish oil comes from cold water fish.

Suggested/Recommended/Usage/Directions

1 Daily

Directions: Use only as directed. Take 1 softgel up to 4 times daily with a meal or glass of water.

Seals/Symbols

Clear Quality

Precautions

Warning: Do not use if safety seal is broken or missing.

Keep out of reach of children.

Keep your licensed health care practitioner informed when using this product.

Directions: Use only as directed.

Storage

Store in a cool, dry place.

Formulation

Borage and organic flax seed oils are cold pressed and solvent free.

Borage and organic flax seed oils are cold pressed and solvent free.

KAL fish oils go through a purity process, including molecular distillation, to remove heavy metals, PCBs, dioxins, furans and other contaminants to meet superior fish oil standards.

KAL Guarantees that no ingredients other than those listed on this label have been added to this product.

Brand IP Statement(s)

2010

FDA Statement of Identity

Dietary Supplement

Is this label outdated? Report a formula or label change and our pharmacy team will review it.

See for yourself

Ultra Omega 3-6-9 by KAL label

The label scan from the NIH Dietary Supplement Label Database. Tap to enlarge.

Ultra Omega 3-6-9 label

Label images are published by the NIH Dietary Supplement Label Database for the version of this product on file. Always read your actual product label.

View the full label (PDF)
What’s inside

The Ingredients in Ultra Omega 3-6-9 by KAL

These are the 4 active ingredients this product is made of. Select any to open its full monograph.

Serving size1 Softgel(s) Dosage formSoftgel Capsule Amounts shown are per serving.

Most supplement products combine several ingredients, and a medication can interact with the product through any one of them. Each ingredient below shows whether it has known drug interactions.

Vitamin E

Interacts with
764 drugs
10 IU per serving Form: Mixed Tocopherols

Vitamin E is an essential fat-soluble vitamin and antioxidant that most people get in adequate amounts from a normal diet. Supplements can help correc...

Vitamin E monograph & interactions

Borage seed Oil

Interacts with
226 drugs
400 mg per serving

Borage is a Mediterranean herb whose seed oil is rich in gamma-linolenic acid (GLA), an omega-6 fatty acid studied mostly for skin conditions and arth...

Borage seed Oil monograph & interactions
  • › Gamma-Linolenic Acid

Fish Oil

Interacts with
327 drugs
400 mg per serving

Fish oil provides omega-3 fatty acids (EPA and DHA) that are best known for lowering high triglyceride levels. The evidence for other heart and health...

Fish Oil monograph & interactions
  • › Eicosapentaenoic Acid
  • › Docosahexaenoic Acid

Organic Flax seed Oil

Interacts with
293 drugs
400 mg per serving

Flaxseed oil is a plant-based source of the omega-3 fatty acid ALA, which the body can partly convert to the omega-3s found in fish oil. It may help s...

Organic Flax seed Oil monograph & interactions
  • › Linoleic Acid
  • › Oleic Acid
  • › Alpha-Linolenic Acid

Other (inactive) ingredients: Gelatin, Glycerin. These complete the product’s ingredient list but are not active constituents.

Interaction report

Ultra Omega 3-6-9 by KAL Drug Interactions

Want to check YOUR meds against Ultra Omega 3-6-9?

Ask about interactions with your drugs in plain English — “Can I take it with lisinopril?” — and we find you the answer in seconds, ingredient by ingredient.

 Go to the checker
1,057Drugs
1,056 Moderate 1 Minor

Ingredients driving the most interactions

Vitamin E 764
Fish Oil 327
organic Flax seed Oil 293
Borage seed Oil 226

Individual Drug Interactions

The ingredients in Ultra Omega 3-6-9 interact with 1,057 drugs. Click any drug to see the details.

4 of the 4 ingredients in Ultra Omega 3-6-9 interact with drugs. Each result below shows which ingredient is responsible. Vitamin E Fish Oil organic Flax seed Oil Borage seed Oil

Each ingredient & the kinds of drugs it affects

For each ingredient in Ultra Omega 3-6-9 with known interactions, here are the types of medications they can affect. Open any type for the detail — or search your exact drug in the checker above.

Vitamin E8 drug types · 764 drugs

Alkylating Agents

Theoretically, antioxidant effects of vitamin E might reduce the effectiveness of alkylating agents.
There's concern that antioxidants could reduce the activity of chemotherapy drugs which generate free radicals, such as cyclophosphamide, chlorambucil, carmustine, busulfan, and thiotepa. However, some researchers theorize that antioxidants might make chemotherapy more effective by reducing oxidative stress that might interfere with apoptosis (cell death) of cancer cells. More evidence is needed to determine what effect, if any, antioxidants such as vitamin E have on chemotherapy. Advise patients to consult their oncologist before using vitamin E supplements, especially in high doses.

Likelihood Possible Evidence D
Anticoagulant/Antiplatelet Drugs

Concomitant use of vitamin E and anticoagulant or antiplatelet agents might increase the risk of bleeding.
Vitamin E seems to inhibit of platelet aggregation and antagonize the effects of vitamin K-dependent clotting factors. These effects appear to be dose-dependent, and are probably only likely to be clinically significant with doses of at least 800 units daily. Mixed tocopherols, such as those found in food, might have a greater antiplatelet effect than alpha-tocopherol. RRR alpha-tocopherol (natural vitamin E) 1000 IU daily antagonizes vitamin K-dependent clotting factors. Advise patients to avoid high doses of vitamin E, especially in people with low vitamin K intake or other risk factors for bleeding.

Likelihood Possible Evidence B
Antitumor Antibiotics

Theoretically, antioxidant effects of vitamin E might reduce the effectiveness of antitumor antibiotics.
There's concern that antioxidants could reduce the activity of antitumor antibiotic drugs such as doxorubicin, which generate free radicals. However, some researchers theorize that antioxidants might make chemotherapy more effective by reducing oxidative stress that might interfere with apoptosis (cell death) of cancer cells. More evidence is needed to determine what effect, if any, antioxidants such as vitamin E have on chemotherapy involving antitumor antibiotics. Advise patients to consult their oncologist before using vitamin E supplements, especially in high doses.

Likelihood Possible Evidence D
Cyclosporine (Neoral, Sandimmune)

A specific form of vitamin E might increase absorption and levels of cyclosporine.
There is some evidence that one specific formulation of vitamin E (D-alpha-tocopheryl-polyethylene glycol-1000 succinate, TPGS, tocophersolan, Liqui-E) might increase absorption of cyclosporine. This vitamin E formulation forms micelles which seems to increase absorption of cyclosporine by 40% to 72% in some patients. However, this interaction is unlikely to occur with the usual forms of vitamin E.

Likelihood Unlikely Evidence B
Cytochrome P450 3A4 (Cyp3A4) Substrates

Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.
Vitamin E appears to bind with the nuclear receptor, pregnane X receptor (PXR), which results in increased expression of CYP3A4. Although the clinical significance of this is not known, use caution when considering concomitant use of vitamin E and other drugs affected by these enzymes.

Likelihood Possible Evidence D
Selumetinib (Koselugo)

Taking selumetinib with vitamin E can result in a total daily dose of vitamin E that exceeds safe limits and therefore might increase the risk of bleeding.
Selumetinib contains 48-54 IU vitamin E per capsule. The increased risk of bleeding with vitamin E appears to be dose-dependent. Be cautious when using selumetinib in combination with supplemental vitamin E, especially in patients at higher risk of bleed, such as those with chronic conditions and those taking antiplatelet drugs.

Likelihood Possible Evidence D
Warfarin (Coumadin)

Using vitamin E with warfarin might increase the risk of bleeding.
Due to interference with production of vitamin K-dependent clotting factors, use of more than 400 IU of vitamin E daily with warfarin might increase prothrombin time (PT), INR, and the risk of bleeding,. At a dose of 1000 IU per day, vitamin E can antagonize vitamin K-dependent clotting factors even in people not taking warfarin. Limited clinical evidence suggests that doses up to 1200 IU daily may be used safely by patients taking warfarin, but this may not be applicable in all patient populations.

Likelihood Possible Evidence B
Niacin

Vitamin E might decrease the beneficial effects of niacin on high-density lipoprotein (HDL) cholesterol levels.
A combination of niacin and simvastatin (Zocor) effectively raises high-density lipoprotein (HDL) cholesterol levels in people with coronary disease and low HDL levels. Clinical research shows that taking a combination of antioxidants (vitamin C, vitamin E, beta-carotene, and selenium) along with niacin and simvastatin (Zocor) attenuates this rise in HDL, specifically the HDL-2 and apolipoprotein A1 fractions, by more than 50%. Vitamin E alone combined with a statin does not seem to decrease HDL levels. It is not known whether the adverse effect on HDL is due to one of the other antioxidants or to the combination. It also is not known whether it will occur in other patient populations.

Likelihood Possible Evidence A
Vitamin E full monograph & interactions

Fish Oil9 drug types · 327 drugs

Antihypertensive Drugs

Theoretically, taking fish oil with antihypertensive drugs might increase the risk of hypotension.
Clinical evidence indicates that fish oils can modestly lower blood pressure and might have additive effects in patients treated with antihypertensives.

Likelihood Probable Evidence B
Contraceptive Drugs

Theoretically, taking fish oil with contraceptive drugs might decrease the triglyceride-lowering effects of fish oil.
There is some evidence that contraceptive drugs might interfere with the triglyceride lowering effects of fish oils.

Likelihood Probable Evidence B
Cyclosporine (Neoral, Sandimmune)

Taking fish oil with cyclosporine might increase levels and adverse effects of cyclosporine.
In kidney transplant recipients on a general immunosuppressive regimen, taking omega-3 fatty acids daily seems to increase peak blood levels of cyclosporine when compared with placebo. This increase was as much as 20% after one month. However, the area under the curve was not significantly affected.

Likelihood Probable Evidence B
Orlistat (Xenical, Alli)

Theoretically, taking fish oil with orlistat might decrease the absorption of fish oil fatty acids.
Orlistat binds lipase in the gastrointestinal tract and reduces fat absorption. Theoretically, taking fish oil with orlistat might decrease absorption of fish oil fatty acids. To avoid this potential interaction, recommend separating administration of orlistat and fish oil by at least 2 hours.

Likelihood Probable Evidence D
Sirolimus (Rapamune)

Taking fish oil with sirolimus might increase levels and adverse effects of sirolimus.
Pharmacokinetic research shows that omega-3 fatty acids increase exposure to sirolimus in kidney transplant patients on a calcineurin inhibitor-free immunosuppressive regimen. A 25% dose reduction in sirolimus was required to keep patients within the expected trough-concentration window. Researchers hypothesize that this may be due to inhibition of cytochrome P450 3A4 (CYP3A4) by fish oil, although this has not been confirmed in clinical research.

Likelihood Probable Evidence B
Tacrolimus (Prograf)

Taking fish oil with tacrolimus might increase levels and adverse effects of tacrolimus.
In a small group of patients, taking fish oil 2.6 grams (Omacor) daily for 4 weeks increased the 8-hour area under the curve of tacrolimus by 25% when compared with baseline. Peak levels were increased by approximately 22%. Researchers hypothesize that this may be due either to an increase in bioavailability or to inhibition of cytochrome P450 3A4 (CYP3A4) by fish oil, although this has not been confirmed in clinical research.

Likelihood Probable Evidence B
Anticoagulant/Antiplatelet Drugs

Fish oil may have antiplatelet effects and may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs. However, evidence is conflicting.
While fish oil may not be a potent inhibitor of platelet function, high doses of fish oil might have antiplatelet effects. Theoretically, concomitant use of fish oil with anticoagulant or antiplatelet drugs may increase the risk of bleeding. However, the most rigorous research shows that short-term doses of fish oil 10 grams daily or long-term doses of 1.5 grams daily for up to 52 weeks does not increase the risk of bleeding or affect coagulation parameters in chronically ill and vulnerable patients. Other controlled research shows that fish oil does not affect platelet function or increase the risk of bleeding. Some research even suggests that perioperative fish oil use decreases bleeding risk. Some research suggests fish oil does not have additive antiplatelet effects when combined with aspirin, but other clinical evidence suggests that adding fish oil to low-dose aspirin treatment increases antiplatelet effects in patients who are aspirin-resistant. Also, some clinical research seems to show that fish oil has additive antiplatelet effects when used with aspirin and clopidogrel compared to aspirin and clopidogrel alone.

Likelihood Unlikely Evidence B
Platinum Agents

Theoretically, taking fish oil with platinum agents can cause resistance to platinum agents, potentially decreasing their effectiveness.
Platinum-induced fatty acids (PIFAs) are fatty acids secreted from human and mouse stem cells when exposed to platinum-based chemotherapy. Animal research suggests that PIFAs cause resistance to chemotherapy by stimulating lysophospholipid production in the spleen, which interferes with the DNA damage caused by certain chemotherapy drugs. One PIFA, known as 16:4(n-3), has been found in both raw fish and some commercially available fish oil products. Mackerel and herring have high PIFA concentrations, while salmon and tuna have low PIFA concentrations. Levels of PIFA in commercial fish oil products ranged from 0.2- 5.7 microMol. Animal research shows that PIFA-containing fish oil products cause resistance to cisplatin, fluorouracil, irinotecan, and oxaliplatin. It is unclear if all commercially available fish oil products contain PIFAs. Additionally, it is argued that levels of PIFA found in some fish oil products are too low to be of clinical concern. Furthermore, a lack of chemotherapy resistance in countries with high fish intake, such as Greenland, Japan, and Norway, suggest that this interaction may not be clinically significant.

Likelihood Unlikely Evidence D
Warfarin (Coumadin)

Fish oil may have antiplatelet effects and might increase the risk of bleeding if used with warfarin.
Fish oil has antiplatelet effects at high doses. Case reports show elevated INR in patients taking warfarin and fish oil 1-2 grams daily. However, some clinical research shows that taking fish oil 3-6 grams daily does not significantly increase INR in patients taking warfarin.

Likelihood Unlikely Evidence B
Fish Oil full monograph & interactions

organic Flax seed Oil3 drug types · 293 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, using flaxseed oil in combination with anticoagulant or antiplatelet drugs might have additive effects and increase the risk of bleeding.
Small clinical studies show that consuming flaxseed oil might decrease platelet aggregation and increase bleeding time.

Likelihood Possible Evidence D
Antihypertensive Drugs

Theoretically, combining flaxseed oil with other antihypertensive drugs might have additive effects and increase the risk of hypotension.
Some clinical evidence suggests that long-term consumption of flaxseed oil can modestly lower systolic and diastolic blood pressure, while other clinical research shows no effect.

Likelihood Possible Evidence D
Ezetimibe (Zetia)

Concomitant use of flaxseed oil and ezetimibe reduces the absorption of alpha-linolenic acid from flaxseed oil.
In one clinical study, concomitant consumption of ezetimibe 10 mg daily with flaxseed oil 2 grams providing 1 gram of alpha-linolenic acid daily blocked the absorption of alpha-linolenic acid, resulting in an overall reduction in alpha-linolenic plasma levels from baseline.

Likelihood Probable Evidence B
organic Flax seed Oil full monograph & interactions

Borage seed Oil3 drug types · 226 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, borage seed oil may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
In healthy individuals, borage seed oil supplementation does not seem to affect platelet aggregation. However, gamma-linolenic acid, a constituent of borage seed oil, seems to decrease platelet aggregation by 45% and increase the risk of bleeding by 40% in animal and clinical research.

Likelihood Possible Evidence B
Cytochrome P450 3A4 (Cyp3A4) Inducers

Theoretically, taking borage with drugs that induce CYP3A4 might increase levels of pyrrolizidine alkaloid (PA) toxic metabolites.
Although borage seed oil contains little to no PAs, some borage plant parts, such as the leaf, flower, and seed, can contain hepatotoxic PAs. Hepatotoxic PAs are substrates of CYP3A4, which converts these chemicals into toxic metabolites. Tell patients to avoid borage preparations that are not certified and labeled as hepatotoxic PA-free.

Likelihood Possible Evidence D
Phenothiazines

Theoretically, taking borage sed oil with phenothiazines might increase the risk of seizures.
Borage seed oil contains gamma-linolenic acid (GLA). There is concern that taking supplements containing GLA might cause seizures, or lower the seizure threshold, when taken with phenothiazines. This is based on limited data from two reports published in the 1980s. In one report, three patients with schizophrenia who had received phenothiazines developed EEG changes suggestive of temporal lobe epilepsy after starting treatment with evening primrose, another source of GLA. However, none experienced an actual seizure. In the other report, two patients with schizophrenia who were stabilized on phenothiazines developed seizures when evening primrose 4 grams daily was added. One of these patients had a prior history of seizures. It is unclear whether evening primrose had any additive epileptogenic effects with the phenothiazines, but there is no evidence that taking GLA-containing supplements alone can cause seizures.

Likelihood Possible Evidence D
Borage seed Oil full monograph & interactions
The maker

Brand information

Manufacturer and brand details for Ultra Omega 3-6-9, from the product label.

KAL

See all KAL products
Name
KAL
City
Park City
State
UT
ZipCode
84060
Phone Number
(800) 365-5966
Web Address
www.kalvitamins.com
Pharmacist Counseling Corner

Ultra Omega 3-6-9 by KAL: Common Questions

Does Ultra Omega 3-6-9 by KAL interact with any medications?
Yes. Based on its ingredients, Ultra Omega 3-6-9 has a known interaction with 1,057 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Ultra Omega 3-6-9 contains 4 active ingredients, and an interaction can come from any of them. We check every ingredient, combine the results into one list per medication, and show which ingredient and mechanism is responsible.
Where does this information come from?
The product label data comes from the NIH Dietary Supplement Label Database (DSLD); the interaction data is built on the Natural Medicines database and reviewed by HelloPharmacist pharmacists.
What are the omega fatty acids in this product actually for?
Omega-3, omega-6, and omega-9 fatty acids are building blocks your body needs but can't make on its own — they support heart, brain, and overall cell health. This product blends them from fish oil, flax seed oil, and borage seed oil to give you a broad spectrum of these essential fats.
Is vitamin E safe to take every day?
Vitamin E from regular food amounts and typical supplements is generally well tolerated. That said, high-dose long-term supplements may raise the risk of bleeding and other harms, so it's worth checking the dose on your bottle and talking with your pharmacist about whether it's right for your situation.
Can I take this while I'm pregnant?
The amounts of vitamin E from food and prenatal vitamins are appropriate, but avoid high-dose supplements unless your doctor directs you to. For the oleic acid in this product, concentrated supplement-level doses aren't well studied in pregnancy, so discuss it with your doctor or pharmacist before starting.
Does this product have fillers or other stuff I don't need?
The product contains gelatin and glycerin as inactive ingredients — those are the binders and capsule materials that hold it together. There's nothing else listed, but talk with your pharmacist if you have allergies or sensitivities to gelatin or glycerin.
What happens if I take this with my blood thinner?
Vitamin E may increase your bleeding risk when combined with blood thinners or antiplatelet drugs, and the risk appears to depend on how much vitamin E you take. If you're on a blood thinner, run your medications through the interaction checker on this page or ask your pharmacist before you start.
Can this product help lower my cholesterol?
Oleic acid in this product is rated possibly effective for high cholesterol and coronary heart disease, but that evidence is based on food amounts — concentrated supplements are less well studied. It's not a substitute for prescribed cholesterol medications.

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

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Label information is sourced from the NIH Dietary Supplement Label Database and reflects the product version on file; always read your actual product label. This page is for education only and is not a substitute for professional medical advice. Confirm with your pharmacist or doctor before combining supplements and medications.

Ultra Omega 3-6-9 label
Go deeper

The Full Monographs Behind Ultra Omega 3-6-9’s Ingredients

Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.

Herb & supplement monograph

Vitamin E

Interacts with 764 drugs

Vitamin E is an essential fat-soluble vitamin and antioxidant that most people get in adequate amounts from a normal diet. Supplements can help correct a true deficiency, but high-dose vitam...

Read the full Vitamin E monograph → Herb & supplement monograph

Borage

Interacts with 226 drugs

Borage is a Mediterranean herb whose seed oil is rich in gamma-linolenic acid (GLA), an omega-6 fatty acid studied mostly for skin conditions and arthritis with mixed results. The plant's le...

Read the full Borage monograph → Herb & supplement monograph

Fish Oil

Interacts with 327 drugs

Fish oil provides omega-3 fatty acids (EPA and DHA) that are best known for lowering high triglyceride levels. The evidence for other heart and health benefits is mixed, and it is generally...

Read the full Fish Oil monograph → Herb & supplement monograph

Flaxseed Oil

Interacts with 293 drugs

Flaxseed oil is a plant-based source of the omega-3 fatty acid ALA, which the body can partly convert to the omega-3s found in fish oil. It may help support heart health and provide healthy...

Read the full Flaxseed Oil monograph → Herb & supplement monograph

Oleic Acid

Interacts with 86 drugs

Oleic acid is a heart-healthy monounsaturated fat found mainly in olive oil, canola oil, avocados, and nuts. As part of a Mediterranean-style diet, it is widely viewed as a healthier replace...

Read the full Oleic Acid monograph →
Sources

Sources & How We Checked

Ultra Omega 3-6-9's label data comes from the NIH Dietary Supplement Label Database; the ingredient interaction data is from the Natural Medicines database, reviewed by our pharmacists.

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

The 272 references behind this product’s interaction data

Every citation that drives the interaction findings for this product’s ingredients, from the evidence-graded Natural Medicines (TRC Healthcare) database. Open an ingredient to browse its citations — links open the study on PubMed or the publisher’s site.

Vitamin E 64 references
  1. Kim JM, White RH. Effect of vitamin E on the anticoagulant response to warfarin. Am J Cardiol 1996;77:545-6. PubMed
  2. Corrigan JJ Jr. The effect of vitamin E on warfarin-induced vitamin K deficiency. Ann N Y Acad Sci 1982;393:361-8. PubMed
  3. Corrigan JJ Jr. Coagulation problems relating to vitamin E. Am J Pediatr Hematol Oncol 1979;1:169-73.
  4. Corrigan JJ Jr, Marcus FI. Coagulopathy associated with vitamin E ingestion. JAMA 1974;230:1300-1. DOI
  5. Labriola D, Livingston R. Possible interactions between dietary antioxidants and chemotherapy. Oncology 1999;13:1003-8.
  6. Chang T, Benet LZ, Hebert MF. The effect of water-soluble vitamin E on cyclosporine pharmacokinetics in healthy volunteers. Clin Pharmacol Ther 1996;59:297-303. PubMed
  7. Pan SH, Lopez RR Jr, Sher LS, et al. Enhanced oral cyclosporine absorption with water-soluble vitamin E early after liver transplantation. Pharmacother 1996;16:59-65. DOI
  8. Anon. Dietary supplementation with n-3 polyunsaturated fatty acids and vitamin E after myocardial infarction: results of the GISSI-Prevenzione trial. Gruppo Italiano per lo Studio della Soprawivenza nell'Infarto miocardico. Lancet 1999;354:447-55. DOI
  9. Chappell LC, Seed PT, Briley AL, et al. Effect of antioxidants on the occurrence of pre-eclampsia in women at increased risk: a randomised trial. Lancet 1999;354:810-6. DOI
  10. Yusuf S, Dagenais G, Pogue J, et al. Vitamin E supplementation and cardiovascular events in high-risk patients. The heart outcomes prevention evaluation study investigators. N Engl J Med 2000;342:154-60. PubMed
  11. Stephens NG, Parsons A, Schofield PM, et al. Randomised controlled trial of vitamin E in patients with coronary disease: Cambridge Heart Antioxidant Study. Lancet 1996;347:781-6.
  12. The Alpha-Tocopherol, Beta Carotene Cancer Prevention Study Group. The effect of vitamin E and beta carotene on the incidence of lung cancer and other cancers in male smokers. N Engl J Med 1994;330:1029-35. PubMed
  13. Takahashi O. Haemorrhagic toxicity of a large dose of alpha-, beta-, gamma- and delta-tocopherols, ubiquinone, beta-carotene, retinol acetate and L-ascorbic acid in the rat. Food Chem Toxicol 1995;33:121-8.
  14. Briggs GB, Freeman RK, Yaffe SJ. Drugs in Pregnancy and Lactation. 5th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 1998.
  15. Sano M, Ernesto C, Thomas RG, et al. A controlled trial of selegiline, alpha-tocopherol, or both as treatment for Alzheimer's disease. The Alzheimer's Disease Cooperative Study. N Engl J Med 1997;336:1216-22. PubMed
  16. Liede KE, Haukka JK, Saxen LM, Heinonen OP. Increased tendency towards gingival bleeding caused by joint effect of alpha-tocopherol supplementation and acetylsalicylic acid. Ann Med 1998;30:542-6.
  17. Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium, and Carotenoids. Washington, DC: National Academy Press, 2000. Available at: http://www.nap.edu/books/0309069351/html/.
  18. Brown BG, Zhao XQ, Chait A, et al. Simvastatin and niacin, antioxidant vitamins, or the combination for the prevention of coronary disease. N Engl J Med 2001;345:1583-93. DOI
  19. Liu M, Wallmon A, Olsson-Mortlock C, et al. Mixed tocopherols inhibit platelet aggregation in humans: potential mechanisms. Am J Clin Nutr 2003;77:700-6. PubMed
  20. Sokol RJ, Johnson KE, Karrer FM, et al. Improvement of cyclosporin absorption in children after liver transplantation by means of water-soluble vitamin E. Lancet 1991;338:212-4.. PubMed
  21. Stein JH, Carlsson CM, Papcke-Benson K, et al. The effects of lipid-lowering and antioxidant vitamin therapies on flow-mediated vasodilation of the brachial artery in older adults with hypercholesterolemia. J Am Coll Cardiol 2001;38:1806-13.. PubMed
  22. Carlsson CM, Papcke-Benson K, Carnes M, et al. Health-related quality of life and long-term therapy with pravastatin and tocopherol (vitamin E) in older adults. Drugs Aging 2002;19:793-805. . PubMed
  23. Cheung MC, Zhao XQ, Chait A, et al. Antioxidant supplements block the response of HDL to simvastatin-niacin therapy in patients with coronary artery disease and low HDL. Arterioscler Thromb Vasc Biol 2001;21:1320-6. PubMed
  24. Schrogie JJ. Coagulopathy and fat-soluble vitamins (letter). JAMA 1975;232:19. DOI
  25. Celestini A, Pulcinelli FM, Pignatelli P, et al. Vitamin E potentiates the antiplatelet activity of aspirin in collagen-stimulated platelets. Haematologica 2002;87:420-6.
  26. Stampfer MJ, Jakubowski JA, Faigel D, et al. Vitamin E supplementation effect on human platelet function, arachidonic acid metabolism, and plasma prostacyclin levels. Am J Clin Nutr 1988;47:700-6. PubMed
  27. Jandak J, Steiner M, Richardson PD. Alpha-tocopherol, an effective inhibitor of platelet adhesion. Blood 1989;73:141-9. DOI
  28. Freedman JE, Farhat JH, Loscalzo J, Keaney JF. Alpha-tocopherol inhibits aggregation of human platelets by a protein kinase C-dependent mechanism. Circulation 1996;94:2434-40. PubMed
  29. Steiner M. Vitamin E, a modifier of platelet function: rationale and use in cardiovascular and cerebrovascular disease. Nutr Rev 1999;57:306-9. PubMed
  30. Brodkin RH, Bleiberg J. Sensitivity to topically applied vitamin E. Arch Dermatol 1965;92:76-7. DOI
  31. Booth SL, Golly I, Sacheck JM, et al. Effect of vitamin E supplementation on vitamin K status in adults with normal coagulation status. Am J Clin Nutr 2004;80:143-8. PubMed
  32. Miller ER 3rd, Pastor-Barriuso R, Dalal D, et al. Meta-analysis: High-dosage vitamin E supplementation may increase all-cause mortality. Ann Intern Med 2005;142:60520-53. PubMed
  33. Lonn E, Bosch J, Yusuf S, et al. HOPE and HOPE-TOO Trial Investigators. Effects of long-term vitamin E supplementation on cardiovascular events and cancer: a randomized controlled trial. JAMA 2005;293:1338-47. PubMed
  34. Landes N, Pfluger P, Kluth D, et al. Vitamin E activates gene expression via the pregnane X receptor. Biochem Pharmacol 2003;65:269-73. . PubMed
  35. Brigelius-Flohe R. Vitamin E and drug metabolism. Biochem Biophys Res Commun 2003;305:737-40. PubMed
  36. Prasad KN. Rationale for using high-dose multiple dietary antioxidants as an adjunct to radiation therapy and chemotherapy. J Nutr 2004;134:3182S-3S. PubMed
  37. Conklin KA. Cancer chemotherapy and antioxidants. J Nutr 2004;134:3201S-3204S. PubMed
  38. Schurks M, Glynn RJ, Rist PM, et al. Effects of vitamin E on stroke subtypes: meta-analysis of randomized controlled trials. BMJ 2010;341: c5702. doi: 10.1136/bmj.c5702.
  39. Lawson KA, Wright ME, Subar A, et al. Multivitamin use and risk of prostate cancer in the National Institutes of Health-AARP Diet and Health Study. J Natl Cancer Inst 2007;99:754-64. PubMed
  40. Gaziano JM, Glynn RJ, Christen WG, et al. Vitamins E and C in the prevention of prostate total cancer in men: the physicians' health study II randomised controlled trial. JAMA 2009;301:52-62.
  41. Hayden KM, Welsh-Bohmer KA, Wengreen HJ, et al; Cache County Investigators. Risk of mortality with vitamin E supplements: the Cache County study. Am L Med 2007;120:180-4. PubMed
  42. Smedts HP, de Vries JH, Rakhshandehroo M, et al. High maternal vitamin E intake by diet or supplements is associated with congenital heart defects in the offspring. BJOG 2009;116:416-23. PubMed
  43. Klein EA, Thompson IM Jr, Tangen CM, et al. Vitamin E and the risk of prostate cancer: the Selenium and Vitamin E Cancer Prevention Trial (SELECT). JAMA 2011;306:1549-56. PubMed
  44. Huang, H. Y., Caballero, B., Chang, S., Alberg, A. J., Semba, R. D., Schneyer, C. R., Wilson, R. F., Cheng, T. Y., Vassy, J., Prokopowicz, G., Barnes, G. J., and Bass, E. B. The efficacy and safety of multivitamin and mineral supplement use to prevent ca
  45. Sesso, H. D., Buring, J. E., Christen, W. G., Kurth, T., Belanger, C., MacFadyen, J., Bubes, V., Manson, J. E., Glynn, R. J., and Gaziano, J. M. Vitamins E and C in the prevention of cardiovascular disease in men: the Physicians' Health Study II randomiz
  46. Papaioannou, D., Cooper, K. L., Carroll, C., Hind, D., Squires, H., Tappenden, P., and Logan, R. F. Antioxidants in the chemoprevention of colorectal cancer and colorectal adenomas in the general population: a systematic review and meta-analysis. Colorec PubMed
  47. Cooper, K., Squires, H., Carroll, C., Papaioannou, D., Booth, A., Logan, R. F., Maguire, C., Hind, D., and Tappenden, P. Chemoprevention of colorectal cancer: systematic review and economic evaluation. Health Technol.Assess. 2010;14(32):1-206. PubMed
  48. Mathew, M. C., Ervin, A. M., Tao, J., and Davis, R. M. Antioxidant vitamin supplementation for preventing and slowing the progression of age-related cataract. Cochrane.Database.Syst.Rev. 2012;6:CD004567. PubMed
  49. Rahimi, R., Nikfar, S., Rezaie, A., and Abdollahi, M. A meta-analysis on the efficacy and safety of combined vitamin C and E supplementation in preeclamptic women. Hypertens.Pregnancy. 2009;28(4):417-434. PubMed
  50. Soares, K. V. and McGrath, J. J. Vitamin E for neuroleptic-induced tardive dyskinesia. Cochrane.Database.Syst.Rev. 2001;(4):CD000209. DOI
  51. Roed-Petersen, J. and Hjorth, N. Contact dermatitis from antioxidants. Br.J.Dermatol. 1976;94(3):233-241. PubMed
  52. Brion, L. P., Bell, E. F., Raghuveer, T. S., and Soghier, L. What is the appropriate intravenous dose of vitamin E for very-low-birth-weight infants? J.Perinatol. 2004;24(4):205-207. PubMed
  53. Manny, T., Pettus, J., Hemal, A., Marks, M., and Mirzazadeh, M. Penile sclerosing lipogranulomas and disfigurement from use of "1Super Extenze" among Laotian immigrants. J.Sex Med. 2011;8(12):3505-3510. PubMed
  54. Musso, G., Cassader, M., Rosina, F., and Gambino, R. Impact of current treatments on liver disease, glucose metabolism and cardiovascular risk in non-alcoholic fatty liver disease (NAFLD): a systematic review and meta-analysis of randomised trials. Diabe PubMed
  55. Bell, E. F. Upper limit of vitamin E in infant formulas. J.Nutr. 1989;119(12 Suppl):1829-1831. PubMed
  56. Manzano, D., Aguirre, A., Gardeazabal, J., Eizaguirre, X., and Diaz Perez, J. L. Allergic contact dermatitis from tocopheryl acetate (vitamin E) and retinol palmitate (vitamin A) in a moisturizing cream. Contact Dermatitis 1994;31(5):324.
  57. Barak, Y., Swartz, M., Shamir, E., Stein, D., and Weizman, A. Vitamin E (alpha-tocopherol) in the treatment of tardive dyskinesia: a statistical meta-analysis. Ann.Clin.Psychiatry 1998;10(3):101-105.
  58. Chae CU, Albert CM, Moorthy MV, et al. Vitamin E supplementation and the risk of heart failure in women. Circ Heart Fail. 2012;5(2):176-82. PubMed
  59. Rumbold A, Ota E, Hori H, Miyazaki C, Crowther CA. Vitamin E supplementation in pregnancy. Cochrane Database Syst Rev. 2015;(9):CD004069. PubMed
  60. Prescribing information: KOSELUGO (selumetinib) capsules. U.S. Food and Drug Administration. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2020/213756s000lbl.pdf.
  61. Warshaw EM, Ruggiero JL, DeKoven JG, et al. Patch testing with tocopherol and tocopherol acetate: the North American Contact Dermatitis Group experience, 2001 to 2016. Dermatitis. 2021;32(5):308-18. PubMed
  62. US Preventive Services Task Force, Mangione CM, Barry MJ, et al. Vitamin, Mineral, and Multivitamin Supplementation to Prevent Cardiovascular Disease and Cancer: US Preventive Services Task Force Recommendation Statement. JAMA 2022;327(23):2326-2333. PubMed
  63. Abrol R, Kaushik R, Goel D, Sama S, Kaushik RM, Kala M. Vitamin E-induced coagulopathy in a young patient: a case report. J Med Case Rep 2023;17(1):107. PubMed
  64. Abtahi-Naeini B, Rastegarnasab F, Saffaei A. Liquid vitamin E injection for cosmetic facial rejuvenation: A disaster report of lipogranuloma. J Cosmet Dermatol 2022;21(11):5549-5554. PubMed

See these in context on the Vitamin E monograph →

Oleic Acid 19 references
  1. Madigan C, Ryan M, Owens D, et al. Dietary unsaturated fatty acids in type 2 diabetes: higher levels of postprandial lipoprotein on a linoleic acid-rich sunflower oil diet compared with an oleic acid-rich olive oil diet. Diabetes Care 2000;23:1472-7. PubMed
  2. Gillingham, L. G., Gustafson, J. A., Han, S. Y., Jassal, D. S., and Jones, P. J. High-oleic rapeseed (canola) and flaxseed oils modulate serum lipids and inflammatory biomarkers in hypercholesterolaemic subjects. Br J Nutr 2011;105(3):417-427. PubMed
  3. Jones PJ, Senanayake VK, Pu S, Jenkins DJ, Connelly PW, Lamarche B, Couture P, Charest A, Baril-Gravel L, West SG, Liu X, Fleming JA, McCrea CE, Kris-Etherton PM. DHA-enriched high-oleic acid canola oil improves lipid profile and lowers predicted cardiova
  4. Cater, N. B., Heller, H. J., and Denke, M. A. Comparison of the effects of medium-chain triacylglycerols, palm oil, and high oleic acid sunflower oil on plasma triacylglycerol fatty acids and lipid and lipoprotein concentrations in humans. Am.J Clin.Nutr PubMed
  5. Mozaffarian D, Clarke R. Quantitative effects on cardiovascular risk factors and coronary heart disease risk of replacing partially hydrogenated vegetable oils with other fats and oils. Eur J Clin Nutr. 2009;63(Suppl 2):S22-33. PubMed
  6. Cao Y, Hou L, Wang W. Dietary total fat and fatty acids intake, serum fatty acids and risk of breast cancer: A meta-analysis of prospective cohort studies. Int J Cancer. 2016;138(8):1894-904. doi: 10.1002/ijc.29938. PubMed
  7. FDA completes review of qualified health claim petition for oleic acid and the risk of coronary heart disease. November 2018. Available at: www.fda.gov/Food/NewsEvents/ConstituentUpdates/ucm624758.htm. Accessed January 25, 2019.
  8. Liu X, Kris-Etherton PM, West SG, et al. Effects of canola and high-oleic-acid canola oils on abdominal fat mass in individuals with central obesity. Obesity. 2016;24(11):2261-2268. PubMed
  9. Bowen KJ, Kris-Etherton PM, West SG, et al. Diets enriched with conventional or high-oleic acid canola oils lower atherogenic lipids and lipoproteins compared to a diet with a western fatty acid profile in adults with central adiposity. J Nutr. 2019;149(3 PubMed
  10. Steffen BT, Duprez D, Szklo M, Guan W, Tsai MY. Circulating oleic acid levels are related to greater risks of cardiovascular events and all-cause mortality: The Multi-Ethnic Study of Atherosclerosis. J Clin Lipidol. 2018;12(6):1404-1412. PubMed
  11. Banim PJ, Luben R, Khaw KT, Hart AR. Dietary oleic acid is inversely associated with pancreatic cancer - Data from food diaries in a cohort study. Pancreatology. 2018;18(6):655-660. PubMed
  12. Morin SJ, Gaziano JM, Djoussé L. Relation between plasma phospholipid oleic acid and risk of heart failure. Eur J Nutr. 2018;57(8):2937-2942. PubMed
  13. Samieri C, Féart C, Proust-Lima C, et al. Olive oil consumption, plasma oleic acid, and stroke incidence: the Three-City Study. Neurology. 2011;77(5):418-25. PubMed
  14. Compher CW, Kinosian BP, Rubesin SE, Ratcliffe SJ, Metz DC. Energy absorption is reduced with oleic acid supplements in human short bowel syndrome. JPEN J Parenter Enteral Nutr. 2009;33(1):102-8. PubMed
  15. Ben Fradj MK, Ouanes Y, Hadj-Taieb S, et al. Decreased oleic acid and marine n?-?3 polyunsaturated fatty acids in Tunisian patients with urothelial bladder cancer. Nutr Cancer. 2018;70(7):1043-1050.
  16. de Silva PS, Luben R, Shrestha SS, Khaw KT, Hart AR. Dietary arachidonic and oleic acid intake in ulcerative colitis etiology: a prospective cohort study using 7-day food diaries. Eur J Gastroenterol Hepatol. 2014;26(1):11-8. PubMed
  17. Higashi K, Shige H, Ito T, et al. Effect of a low-fat diet enriched with oleic acid on postprandial lipemia in patients with type 2 diabetes mellitus. Lipids. 2001;36(1):1-6. PubMed
  18. Lin HC, van Citters GW, Heimer F, Bonorris G. Slowing of gastrointestinal transit by oleic acid: a preliminary report of a novel, nutrient-based treatment in humans. Dig Dis Sci. 2001;46(2):223-9. PubMed
  19. Li D, Tong Y, Li Y. Associations between dietary oleic acid and linoleic acid and depressive symptoms in perimenopausal women: The Study of Women's Health Across the Nation. Nutrition. 2020 Mar;71:110602. PubMed

See these in context on the Oleic Acid monograph →

Borage 11 references
  1. Guivernau M, Meza N, Barja P, Roman O. Clinical and experimental study on the long-term effect of dietary gamma-linolenic acid on plasma lipids, platelet aggregation, thromboxane formation, and prostacyclin production. Prostaglandins Leukot Essent Fatty A PubMed
  2. WHO working group. Pyrrolizidine alkaloids. Environmental Health Criteria, 80. WHO: Geneva, 1988.
  3. Fan YY, Chapkin RS. Importance of dietary gamma-linolenic acid in human health and nutrition. J Nutr 1998;128:1411-4.
  4. Takwale A, Tan E, Agarwal S, et al. Efficacy and tolerability of borage oil in adults and children with atopic eczema: randomised, double blind, placebo controlled, parallel group trial. BMJ 2003;327:1385. PubMed
  5. Chojkier M. Hepatic sinusoidal-obstruction syndrome: toxicity of pyrrolizidine alkaloids. J Hepatol 2003;39:437-46. PubMed
  6. Roeder E. Medicinal plants in Europe containing pyrrolizidine alkaloids. Pharmazie 1995;50:83-98.
  7. Wang YP, Yan J, Fu PP, Chou MW. Human liver microsomal reduction of pyrrolizidine alkaloid N-oxides to form the corresponding carcinogenic parent alkaloid. Toxicol Lett 2005;155:411-20. PubMed
  8. Holman CP and Bell AF. A trial of evening primrose oil in the treatment of chronic schizophrenia. J Orhtomolecular Psych 1983;12:302-304.
  9. Vaddadi KS. The use of gamma-linolenic acid and linoleic acid to differentiate between temporal lobe epilepsy and schizophrenia. Prostaglandins Med 1981;6(4):375-379. PubMed
  10. Bard, J. M., Luc, G., Jude, B., Bordet, J. C., Lacroix, B., Bonte, J. P., Parra, H. J., and Duriez, P. A therapeutic dosage (3 g/day) of borage oil supplementation has no effect on platelet aggregation in healthy volunteers. Fundam.Clin.Pharmacol. 1997;1
  11. Puri BK. The safety of evening primrose oil in epilepsy. Prostaglandins Leukotrienes Essential Fatty Acids 2007;77:101-3. PubMed

See these in context on the Borage monograph →

Fish Oil 157 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. Allard JP, Kurian R, Aghdassi E, Muggli R, et al. Lipid peroxidation during n-3 fatty acid and vitamin E supplementation in humans. Lipids 1997;32:535-41.. PubMed
  3. 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.
  4. Onwude JL, Lilford RJ, Hjartardottir H, et al. A randomised double blind placebo controlled trial of fish oil in high risk pregnancy. Br J Obstet Gynaecol 1995;102:95-100. PubMed
  5. Bulstra-Ramakers MT, Huisjes HJ, Visser GH. The effects of 3g eicosapentaenoic acid daily on recurrence of intrauterine growth retardation and pregnancy induced hypertension. Br J Obstet Gynaecol 1995;102:123-6. PubMed
  6. 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.
  7. 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
  8. Hawthorne AB, Daneshmend TK, Hawkey CJ, et al. Treatment of ulcerative colitis with fish oil supplementation: a prospective 12 month randomised controlled trial. Gut 1992;33:922-8. PubMed
  9. D'Almeida A, Carter JP, Anatol A, Prost C. Effects of a combination of evening primrose oil (gamma linolenic acid) and fish oil (eicosapentaenoic + docahexaenoic acid) versus magnesium, and versus placebo in preventing pre-eclampsia. Women Health 1992;19 PubMed
  10. 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
  11. Montori VM, Farmer A, Wollan PC, Dinneen SF. Fish oil supplementation in type 2 diabetes: a quantitative systemic review (abstract). Diabetes Care 2000;23:1407-15.
  12. Anon. Dietary supplementation with n-3 polyunsaturated fatty acids and vitamin E after myocardial infarction: results of the GISSI-Prevenzione trial. Gruppo Italiano per lo Studio della Soprawivenza nell'Infarto miocardico. Lancet 1999;354:447-55. DOI
  13. Adler A, Holub BJ. Effect of garlic and fish-oil supplementation on serum lipid and lipoprotein concentrations in hypercholesterolemic men. Am J Clin Nutr 1997;65:445-50. PubMed
  14. Higdon JV, Liu J, Du S, et al. Supplementation of postmenopausal women with fish oil rich in eicosapentaenoic acid and docosahexaenoic acid is not associated with greater in vivo lipid peroxidation compared with oils rich in oleate and linoleate as asses
  15. Kastrup EK. Drug Facts and Comparisons. 1998 ed. St. Louis, MO: Facts and Comparisons, 1998.
  16. Belluzzi A, Brignola C, Campieri M, et al. Effect of an enteric-coated fish-oil preparation on relapses in Crohn's disease. N Engl J Med 1996;334:1557-60. PubMed
  17. Belluzzi A, Brignola C, Campieri M, et al. Effects of new fish oil derivative on fatty acid phospholipid-membrane pattern in a group of Crohn's disease patients. Dig Dis Sci 1994;39:2589-94. PubMed
  18. Mahan LK, Escott-Stump S. Krause's Food, Nutrition, and Diet Therapy. 9th edition. W.B. Saunders Co., Philadelphia, PA, 1996.
  19. Yetiv JZ. Clinical applications of fish oils. JAMA 1988;260:665-70. DOI
  20. de Deckere EAM, Korver O, Verschuren PM, Katan MB. Health aspects of fish and n-3 polyunsaturated fatty acids from plant and marine origin. Eur J Clin Nutr 1998;52:749-53. PubMed
  21. Sorensen NS, Marckmann P, Hoy CE, et al. Effect of fish-oil-enriched margarine on plasma lipids, low-density-lipoprotein particle composition, size, and susceptibility to oxidation. Am J Clin Nutr 1998;68:235-41. PubMed
  22. Kelley DS, Rudolph IL. Effect of individual fatty acids of omega-6 and omega-3 type on human immune status and role of eicosanoids. Nutrition 2000;16:143-5.
  23. Meydani SN, Dinarello CA. Influence of dietary fatty acids on cytokine production and its clinical implications. Nutr Clin Pract 1993;8:65-72. PubMed
  24. Caicoya M. Fish consumption and stroke: a community case-control study in Asturias, Spain. Neuroepidemiology 2002;21:107-14. PubMed
  25. Leaf A. On the reanalysis of the GISSI-Prevenzione. Circulation 2002;105:1874-5. PubMed
  26. Dewailly E, Blanchet C, Lemieux S, et al. n-3 Fatty acids and cardiovascular disease risk factors among the Inuit of Nunavik. Am J Clin Nutr 2001;74:464-73. PubMed
  27. Connor WE. n-3 Fatty acids from fish and fish oil: panacea or nostrum? Am J Clin Nutr 2001;74;415-6. PubMed
  28. Maresta A, Balduccelli M, Varani E, et al. Prevention of postcoronary angioplasty restenosis by omega-3 fatty acids: main results of the Esapent for Prevention of Restenosis Italian Study (ESPRIT). Am Heart J 143:E5. PubMed
  29. Deutch B, Jorgensen EB, Hansen JC. n-3 PUFA from fish or seal oil reduce atherogenic risk indicators in Danish women. Nutr Res 2000;20:1065-77. DOI
  30. Higgins S, McCarthy SN, Corridan BM, et al. Measurement of free cholesterol, cholesteryl esters and cholesteryl linoleate hydroperoxide in copper-oxidised low density lipoprotein in healthy volunteers supplemented with a low dose of n-3 polyunsaturated f
  31. Calder PC. N-3 polyunsaturated fatty acids, inflammation and immunity: pouring oil on troubled waters or another fishy tale? Nutr Res 2001;21:309-41. DOI
  32. Lacaille B, Julien P, Deshaies Y, et al. Responses of plasma lipoproteins and sex hormones to the consumption of lean fish incorporated in a prudent-type diet in normolipidemic men. J Am Coll Nutr 2000;19:745-53. PubMed
  33. Pedersen HS, Mulvad G, Seidelin KN, et al. N-3 fatty acids as a risk factor for haemorrhagic stroke. Lancet 1999;353:812-3. PubMed
  34. Higdon JV, Du SH, Lee YS, et al. Supplementation of postmenopausal women with fish oil does not increase overall oxidation of LDL ex vivo compared to dietary oils rich in oleate and linoleate. J Lipid Res 2001;42:407-18. DOI
  35. Olsen SF, Sorensen JD, Secher NJ, et al. Randomised controlled trial of effect of fish-oil supplementation on pregnancy duration. Lancet 1992;339:1003-7. PubMed
  36. Ito Y, Suzuki K, Imai H, et al. Effects of polyunsaturated fatty acids on atrophic gastritis in a Japanese population. Cancer Lett 2001;163:171-8. PubMed
  37. Bender NK, Kraynak MA, Chiquette E, et al. Effects of marine fish oils on the anticoagulation status of patients receiving chronic warfarin therapy. J Thromb Thrombolysis 1998;5:257-61.. PubMed
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See these in context on the Flaxseed Oil monograph →

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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.

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