Omega-3 fatty acids can cause heart rhythm disturbances

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Omega-3 fatty acids and cardiac arrhythmias

People with cardiovascular disease have a greater risk of atrial fibrillation when using omega-3 fatty acids. The Medicines Evaluation Board (MEB) reports this on the basis of European studies in which a total of more than 80,000 patients participated. The increased risk applies to both medicines and dietary supplements containing omega-3 fatty acids.

Prescription omega-3 fatty acids

Omega-3 fatty acids are polyunsaturated fatty acids that are necessary to keep the heart, blood pressure and brain healthy. They are freely available as a dietary supplement, for example in the form of fish oil or algae oil. In addition, omega-3 fatty acids are also approved as medicines in the Netherlands under the brand names Vazkepa® and Omacor®. Omega-3 fatty acids are prescribed to patients who have too much fat (particularly triglycerides) in their blood. Patients are prescribed this medication if diet or other medication has insufficient effect.

Risk increases with higher doses

Research now shows that patients with cardiovascular disease, or an increased risk of cardiovascular disease, are more likely to develop atrial fibrillation when using omega-3 fatty acid ethyl ester medicines and supplements. This risk was previously known for Vazkepa®, where atrial fibrillation was included as a possible side effect in the package leaflet. This now also applies to Omacor® and nutritional supplements with omega-3 fatty acids. The risk is highest at a dose of 4 grams per day, but lower doses, such as in nutritional supplements, can also cause complaints.

Advice to healthcare professionals

The MEB recommends only prescribing omega-3 fatty acids to patients with cardiovascular disease if there are no good alternatives. Advise patients to seek medical attention if they develop features of atrial fibrillation. Characteristic symptoms of atrial fibrillation are light-headedness, dizziness, fatigue, palpitations and shortness of breath. Permanently discontinue treatment with these medicines if atrial fibrillation occurs.

Source: MEB

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