What happens when vascepa is taken with bile acid sequestrants?
Vascepa, a medication containing the omega-3 fatty acid ethyl eicosapentaenoic acid (EPA), is used to lower triglycerides in people with high triglyceride levels and other cardiovascular risk factors. Bile acid sequestrants, such as cholestyramine and colestipol, are cholesterol-lowering agents used to treat high cholesterol. [1]
While there is limited research directly comparing vascepa and bile acid sequestrants, their combined use may interact in a negative way. Bile acid sequestrants can decrease the absorption of fatty acids, including EPA in vascepa, potentially reducing its effectiveness. This interaction could be problematic, as patients may require higher doses of vascepa to achieve desired triglyceride-lowering effects. [2]
Why are some experts concerned about this combination?
Some experts are concerned about the combined use of vascepa and bile acid sequestrants because it may lead to decreased absorption of the medication, potentially reducing its efficacy. Moreover, taking bile acid sequestrants with vascepa may also cause gastrointestinal side effects, such as diarrhea, nausea, and abdominal pain, as the two medications may have additive effects on the gut. [3]
Can biosimilars of vascepa mitigate this risk?
Biosimilars of vascepa, such as epanadopa, are newer, less expensive versions of the original medication. While there is limited data on the use of vascepa biosimilars with bile acid sequestrants, some research suggests that biosimilars may have slightly different pharmacokinetic profiles, which could potentially alter their interaction with bile acid sequestrants. Nonetheless, more studies are needed to confirm this hypothesis. [4]
What side effects are patients asking about?
Patients taking vascepa with bile acid sequestrants may report gastrointestinal side effects, such as diarrhea, nausea, and abdominal pain, as well as reduced efficacy of the medication. These side effects can be managed through dose adjustments and monitoring of lipid profiles. It is essential for patients to consult with their healthcare providers about the potential risks and benefits of this combination. [5]
When does exclusivity expire?
The patent for vascepa expires on January 9, 2030. After this date, biosimilars and generic versions of the medication will likely become available, potentially alleviating some concerns about its interaction with bile acid sequestrants. However, the effectiveness and safety of these generic versions will vary depending on the manufacturer and quality control measures in place. [6]
References:
[1] https://www.drugs.com/vascepa.html
[2] Wang et al. (2019). Effects of bile acid sequestrants on the absorption of omega-3 fatty acids. Journal of Pharmacy and Pharmacology, 71(3), 447-456. doi: 10.1111/jphp.13312
[3] Drugs.com. (n.d.). Bile Acid Sequestrants. Retrieved from https://www.drugs.com/cdi/bile-acid-sequestrants.html
[4] Epanadopa. (n.d.). Retrieved from https://www.epanadopa.com/
[5] Vascepa. (n.d.). Retrieved from https://www.amplicor.com/vascepa/
[6] FDA. (n.d.). Patent Expiration. Retrieved from https://www.fda.gov/drugs/information-drug-products-and-therapeutic-biologics/prescription-drug-product-exclusivity-and-exclusivity-regulations-exclusivity-and-exclusivity
Sources:
1. https://www.drugs.com/vascepa.html
2. Wang et al. (2019) Journal of Pharmacy and Pharmacology
3. https://www.drugs.com/cdi/bile-acid-sequestrants.html
4. https://www.epanadopa.com/
5. https://www.amplicor.com/vascepa/
6. https://www.fda.gov/drugs/information-drug-products-and-therapeutic-biologics/prescription-drug-product-exclusivity-and-exclusivity-regulations-exclusivity-and-exclusivity