Tier A

EPA (Eicosapentaenoic Acid · Pure / High-EPA Formulations)

Also known as: Eicosapentaenoic acid · Pure EPA · High-EPA omega-3 · Icosapent ethyl (prescription form)

1 PMID anchor · CARDIO · CELL · Last reviewed 2026-06-04

Read full dossier → JSON (epa.json)

Mechanism of action

Omega-3 C20:5 PUFA · membrane phospholipid integration
Substrate for E-series Resolvins (specialised pro-resolving mediators)
Competes with arachidonic acid for COX/LOX enzymes (anti-eicosanoid effect)
Triglyceride-lowering via hepatic VLDL secretion modulation

Molecular + tissue targets

Plasma triglycerides
Cardiovascular composite outcomes in elevated-triglyceride statin-treated populations
Inflammatory pathway resolution

Dosage range

REDUCE-IT (Bhatt 2019 PMID 30415628 NEJM n=8,179 statin-treated with elevated triglycerides) used 4 g/day icosapent ethyl (prescription EPA ester) for a 25% reduction in the primary cardiovascular composite endpoint (CV death + nonfatal MI + nonfatal stroke + coronary revascularization + hospitalised unstable angina) over median 4.9 years. Dietary supplement pure EPA at 1-2 g/day is widely used but does not replicate the prescription 4 g/day evidence base

Safety notes

Atrial fibrillation signal observed at the 4 g/day icosapent ethyl dose (REDUCE-IT secondary analysis); modest bleeding risk at very high doses (anticoagulant interaction); the high-EPA frame is distinct from the EPA+DHA blend frame and should not be conflated with dietary fish-oil RDAs

Cross-market regulatory status

🇺🇸 FDA

Icosapent ethyl (Vascepa) is a prescription drug indicated as an adjunct to statin therapy for CV risk reduction in elevated-triglyceride adults; dietary supplement EPA is GRAS · DSHEA framework · qualified health claims under the omega-3 framework when EPA+DHA blend dose threshold met

🇪🇺 EFSA

Authorized claim Reg 432/2012 EPA+DHA cardiovascular (EPA component contributes within blend threshold); no standalone EPA-only authorized claim

🇧🇷 ANVISA

RDC 243/2018 dietary supplement · IN 28/2018 Anexo V alegação funcional verbatim: "Os ácidos graxos ômega 3 EPA e DHA auxiliam na redução dos triglicerídeos." (≥ 1.500 mg EPA+DHA/dia · EPA-only formulations meet the EPA+DHA combined threshold when dose adequate)

Authorized claims · verbatim (2)

Direct quotes from each jurisdiction's framework · never paraphrased · with framework reference and conditions of use.

🇪🇺 EFSA · 1 claim

Reg 432/2012

EPA and DHA contribute to the normal function of the heart.

Conditions: Reg 1924/2006 art 10(2): claim may be used only for food which provides a daily intake of at least 250 mg of EPA and DHA; consumer informed that the beneficial effect is obtained with a daily intake of 250 mg of EPA and DHA

Authorized 2012

🇧🇷 ANVISA · 1 claim

IN 28/2018 Anexo V alegação funcional

Os ácidos graxos ômega 3 EPA e DHA auxiliam na redução dos triglicerídeos.

Conditions: IN 28/2018 Anexo V: alegação restrita a suplementos que forneçam ao menos 1.500 mg de EPA + DHA por dia

Authorized 2018

Common use cases

triglyceride lowering and cardiovascular risk reduction in statin-treated adults with elevated triglycerides (per icosapent ethyl evidence base)
targeted EPA dosing when whole-fish-oil EPA+DHA blend not desired
high-EPA inflammation framework

Cross-reference

Health goals: heart health inflammation relief

Lifestyles: senior 60 plus

Full dossier: /ingredients/epa/

Machine-readable JSON: /api/nc/epa.json