Drug Interactions between Omega Essentials Basic and urokinase
This report displays the potential drug interactions for the following 2 drugs:
- Omega Essentials Basic (omega-3 polyunsaturated fatty acids)
- urokinase
Interactions between your drugs
omega-3 polyunsaturated fatty acids urokinase
Applies to: Omega Essentials Basic (omega-3 polyunsaturated fatty acids) and urokinase
MONITOR: Omega-3 fatty acids (e.g., fish oil) may potentiate the pharmacologic effects of anticoagulants and other drugs that affect hemostasis such as platelet inhibitors, thrombin inhibitors, thrombolytic agents, dextran, and nonsteroidal anti-inflammatory drugs (NSAIDs). The exact mechanism of interaction is unknown. Omega-3 fatty acids may possess mild antiplatelet and hypocoagulant activities. In some studies, these substances have been shown to reduce thrombin generation and plasma levels of fibrinogen, prothrombin, and coagulation factors V, VII, and X. Prolongation of bleeding time has been demonstrated, although it did not exceed normal limits and did not produce clinically significant bleeding. In a double-blind, placebo-controlled trial (n=8,179), bleeding events were reported in 11.8% of patients receiving icosapent ethyl compared to 9.9% in the placebo group, most commonly gastrointestinal bleeding, contusion, hematuria, and epistaxis. Serious bleeding events were reported more frequently in icosapent ethyl-treated patients who were also on concomitant antithrombotic therapy (3.4%) compared to placebo-treated patients (2.6%) but occurred at the same rate (0.2%) in patients not on such concomitant therapy. However, the interaction was suspected in a case report of a 67-year-old woman treated with warfarin for 1.5 years who exhibited an increase in INR from 2.8 the previous month to 4.3 approximately one week after doubling her fish oil dosage from 1000 to 2000 mg/day. Prior to the increase, her INR had been stable and therapeutic for 5 months on warfarin 1.5 mg/day. The patient was advised to reduce her fish oil consumption to 1000 mg/day, while her warfarin dose was withheld for one day and then reduced to 1 mg alternating with 1.5 mg per day. Eight days later, her INR was subtherapeutic at 1.6, so the warfarin dosage was increased back to 1.5 mg/day. The patient's INR subsequently returned to therapeutic range.
MANAGEMENT: In general, patients should consult a healthcare provider before taking any herbal or nutritional supplements. Patients using omega-3 fatty acid-containing medicines, including icosapent ethyl, in combination with anticoagulants or other drugs that affect hemostasis should be advised of the potential for increased risk of bleeding complications.
References (8)
- (2005) "Product Information. Omacor (omega-3 polyunsaturated fatty acids)." Abbott Pharmaceutical
- Vanschoonbeek K, Feijge MA, Paquay J, et al. (2004) "Variable hypocoagulant effect of fish oil intake in humans: modulation of fibrinogen level and thrombin generation." Arterioscler Thromb Vasc Biol, 24, p. 1734-40
- Buckley MS, Goff AD, Knapp WE (2004) "Fish oil interaction with warfarin." Ann Pharmacother, 38, p. 50-3
- (2012) "Product Information. Vascepa (icosapent)." Amarin Pharmaceuticals Inc
- Li XL, Steiner M (1990) "Fish oil: a potent inhibitor of platelet adhesiveness." Blood, 76, p. 938-45
- (2022) "Product Information. Vazkepa (icosapent ethyl)." Seqirus Pty Ltd
- (2024) "Product Information. Vazkepa (icosapent ethyl)." Amarin Pharmaceuticals Ireland Ltd
- (2023) "Product Information. Icosapent Ethyl (icosapent)." Amneal Pharmaceuticals LLC
Drug and food/lifestyle interactions
No alcohol/food interactions were found. However, this does not necessarily mean no interactions exist. Always consult your healthcare provider.
Disease interactions
urokinase Cerebral Vascular Disorder
Applies to: Cerebral Vascular Disorder
The use of thrombolytics is contraindicated in patients with an active bleed (internal), trauma/surgery (recent CPR/intracranial/intraspinal surgery within 2 months), bleeding diathesis, history of cerebrovascular (CV) accident, intracranial defect (aneurysm, arteriovenous malformation, neoplasm), or severe uncontrolled arterial hypertension (SBP>180/DBP>110). Risk versus benefit should be carefully considered in the following conditions and thrombolytic therapy administered with caution in patients with recent (10 days) serious GI bleed or recent (10 days) surgical procedure (coronary bypass graft, obstetrical delivery, organ biopsy, puncture of noncompressible vessel), left heart thrombus, subacute bacterial endocarditis, hemostatic defect, CV disease, diabetic hemorrhagic retinopathy, or pregnancy. Clinical monitoring of hematopoietic, bleeding and coagulation functions is recommended prior to initiation of thrombolytic therapy. Measures of fibrinolytic activity and/or coagulation functions during infusion do not correlate with efficacy or risk of bleeding.
urokinase Gastrointestinal Hemorrhage
Applies to: Gastrointestinal Hemorrhage
The use of thrombolytics is contraindicated in patients with an active bleed (internal), trauma/surgery (recent CPR/intracranial/intraspinal surgery within 2 months), bleeding diathesis, history of cerebrovascular (CV) accident, intracranial defect (aneurysm, arteriovenous malformation, neoplasm), or severe uncontrolled arterial hypertension (SBP>180/DBP>110). Risk versus benefit should be carefully considered in the following conditions and thrombolytic therapy administered with caution in patients with recent (10 days) serious GI bleed or recent (10 days) surgical procedure (coronary bypass graft, obstetrical delivery, organ biopsy, puncture of noncompressible vessel), left heart thrombus, subacute bacterial endocarditis, hemostatic defect, CV disease, diabetic hemorrhagic retinopathy, or pregnancy. Clinical monitoring of hematopoietic, bleeding and coagulation functions is recommended prior to initiation of thrombolytic therapy. Measures of fibrinolytic activity and/or coagulation functions during infusion do not correlate with efficacy or risk of bleeding.
urokinase Hypertension
Applies to: Hypertension
The use of thrombolytics is contraindicated in patients with an active bleed (internal), trauma/surgery (recent CPR/intracranial/intraspinal surgery within 2 months), bleeding diathesis, history of cerebrovascular (CV) accident, intracranial defect (aneurysm, arteriovenous malformation, neoplasm), or severe uncontrolled arterial hypertension (SBP>180/DBP>110). Risk versus benefit should be carefully considered in the following conditions and thrombolytic therapy administered with caution in patients with recent (10 days) serious GI bleed or recent (10 days) surgical procedure (coronary bypass graft, obstetrical delivery, organ biopsy, puncture of noncompressible vessel), left heart thrombus, subacute bacterial endocarditis, hemostatic defect, CV disease, diabetic hemorrhagic retinopathy, or pregnancy. Clinical monitoring of hematopoietic, bleeding and coagulation functions is recommended prior to initiation of thrombolytic therapy. Measures of fibrinolytic activity and/or coagulation functions during infusion do not correlate with efficacy or risk of bleeding.
urokinase Infectious Endocarditis
Applies to: Infectious Endocarditis
The use of thrombolytics is contraindicated in patients with an active bleed (internal), trauma/surgery (recent CPR/intracranial/intraspinal surgery within 2 months), bleeding diathesis, history of cerebrovascular (CV) accident, intracranial defect (aneurysm, arteriovenous malformation, neoplasm), or severe uncontrolled arterial hypertension (SBP>180/DBP>110). Risk versus benefit should be carefully considered in the following conditions and thrombolytic therapy administered with caution in patients with recent (10 days) serious GI bleed or recent (10 days) surgical procedure (coronary bypass graft, obstetrical delivery, organ biopsy, puncture of noncompressible vessel), left heart thrombus, subacute bacterial endocarditis, hemostatic defect, CV disease, diabetic hemorrhagic retinopathy, or pregnancy. Clinical monitoring of hematopoietic, bleeding and coagulation functions is recommended prior to initiation of thrombolytic therapy. Measures of fibrinolytic activity and/or coagulation functions during infusion do not correlate with efficacy or risk of bleeding.
urokinase Retinal Hemorrhage
Applies to: Retinal Hemorrhage
The use of thrombolytics is contraindicated in patients with an active bleed (internal), trauma/surgery (recent CPR/intracranial/intraspinal surgery within 2 months), bleeding diathesis, history of cerebrovascular (CV) accident, intracranial defect (aneurysm, arteriovenous malformation, neoplasm), or severe uncontrolled arterial hypertension (SBP>180/DBP>110). Risk versus benefit should be carefully considered in the following conditions and thrombolytic therapy administered with caution in patients with recent (10 days) serious GI bleed or recent (10 days) surgical procedure (coronary bypass graft, obstetrical delivery, organ biopsy, puncture of noncompressible vessel), left heart thrombus, subacute bacterial endocarditis, hemostatic defect, CV disease, diabetic hemorrhagic retinopathy, or pregnancy. Clinical monitoring of hematopoietic, bleeding and coagulation functions is recommended prior to initiation of thrombolytic therapy. Measures of fibrinolytic activity and/or coagulation functions during infusion do not correlate with efficacy or risk of bleeding.
omega-3 polyunsaturated fatty acids Arrhythmias
Applies to: Arrhythmias
Cases of recurrent atrial fibrillation (AF) or flutter have been reported with the use of omega-3 fatty acids in patients with a symptomatic paroxysmal AF or persistent AF. This condition is more apparent within the first 2 to 3 months after the initiation of therapy. Therapy with these agents should be administered cautiously in patients with cardiac conduction disorders.
omega-3 polyunsaturated fatty acids Liver Disease
Applies to: Liver Disease
Increases in alanine aminotransferase (ALT) and/or aspartate aminotransferase (AST) levels have been observed in patients receiving omega-3 fatty acids. Therapy with omega-3 fatty acid preparations should be administered cautiously in patients with hepatic impairment. Serum liver enzyme levels should be monitored periodically.
urokinase Liver Disease
Applies to: Liver Disease
Urokinase undergoes extensive clearance and degradation by the liver. The pharmacokinetic disposition of urokinase has not been fully determined, however it is expected that the half-life of urokinase would be prolonged in patients with hepatic impairment. Therapy with urokinase should be administered cautiously in patients with compromised hepatic function. Clinical monitoring of bleeding functions should be determined prior to initiation of therapy. Measures of fibrinolytic activity and/or coagulation functions during infusion do not correlate with efficacy or risk of bleeding.
Therapeutic duplication warnings
No warnings were found for your selected drugs.
Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.
See also
Report options
Drug Interaction Classification
| Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
| Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
| Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. | |
| No interaction information available. |
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.