Vascepa for High Triglycerides: Benefits, Dosage, and Safety

If your triglyceride levels are elevated, your healthcare provider will usually begin with lifestyle changes—such as improving your diet, increasing physical activity, losing weight, and controlling medical conditions like diabetes. However, when triglycerides remain high or reach dangerously elevated levels, medication may be necessary.

One of the most commonly prescribed triglyceride-lowering medications is Vascepa (icosapent ethyl).

What Is Vascepa?

Vascepa is a prescription omega-3 medication made from icosapent ethyl, a purified form of the omega-3 fatty acid EPA (eicosapentaenoic acid). It is FDA-approved to treat severe hypertriglyceridemia, defined as triglyceride levels of 500 mg/dL or higher.

Vascepa was approved by the FDA in July 2012 and is designed to be used alongside diet and lifestyle changes—not as a replacement for them.

How Well Does Vascepa Work?

The main clinical trial used to approve Vascepa, called the MARINE trial, studied people with triglyceride levels between 500 and 2,000 mg/dL.

After 12 weeks of treatment:

• Triglycerides were reduced by about 33%

• VLDL cholesterol was reduced by 27.9%

• LDL and HDL changed slightly, but not significantly

• Blood sugar, liver enzymes, and vital signs remained stable

These results showed that Vascepa effectively lowers triglycerides without worsening cholesterol levels.

How Vascepa Lowers Triglycerides

Vascepa works by:

• Reducing the amount of triglycerides produced in the liver

• Increasing the removal of triglycerides from circulating VLDL particles

While the exact mechanism is still being studied, EPA has been shown to improve fat metabolism and reduce inflammation.

Vascepa Dosage

The standard Vascepa dose is:

Two capsules twice daily (4 grams per day)

Important instructions:

• Take with food

• Do not crush, chew, or open the capsules

• Continue a triglyceride-lowering diet and exercise program

Possible Side Effects

Most people tolerate Vascepa well. The most common side effects include:

• Diarrhea

• Nausea

• Joint pain

• Sore throat

Let your healthcare provider know if side effects become persistent or disruptive.

Who Should Not Take Vascepa?

Vascepa may not be safe for everyone. You should avoid or use caution if you:

• Have a fish or shellfish allergy

• Have liver or kidney disease

• Are pregnant or breastfeeding

• Have had a previous allergic reaction to Vascepa

Your doctor may monitor liver enzymes and kidney function during treatment.

Drug Interactions

Vascepa has few known drug interactions, but high-dose omega-3s may affect blood clotting.

Tell your doctor if you take:

• Blood thinners (warfarin, aspirin, clopidogrel)

• Herbal supplements

• Any over-the-counter medications

Your anticoagulation levels may need to be monitored.

Bottom Line

Vascepa is a clinically proven medication for people with very high triglycerides (500 mg/dL or higher). It can significantly lower triglycerides when used along with:

• A heart-healthy diet

• Weight management

• Blood sugar control

• Regular exercise

High triglycerides increase the risk of heart disease and pancreatitis, so treatment is important. Recent studies also show that Vascepa reduces the risk of cardiovascular events in high-risk patients.