Fish Oil Capsules for IgA Nephropathy
What is it?
Fish oil contains omega-3 fatty acids. There are two different types of omega-3 fatty
acids: EPA and DHA.
Fish oil is NOT the same as cod liver oil or halibut liver oil. These fish liver oils contain
large amounts of vitamin A. Large amounts of vitamin A are not recommended for people
with kidney disease.
Why did my doctor prescribe or recommend it?
You have a kidney disease called IgA Nephropathy. Most people with this condition
maintain normal kidney function. However, in some patients (about 30%), kidney function
may get worse over time. Your doctor (nephrologist) thinks you may be one of those
people whose kidneys may worsen over the years. Fish oil therapy may prevent or slow
down the worsening.
Is it Effective?
Fish oil is used to slow the progression of kidney disease in people with IgA nephropathy.
While fish oil capsules may be effective in many patients, some patients do not respond to
it.
How does it work?
The omega-3 fatty acids in fish oil prevent inflammation in the kidney to slow down
progression of kidney disease.
How will you know if it is working?
Your blood tests may show a decrease in the creatinine level (creatinine measures kidney
function). Please note that fish oil does not usually decrease the amount of protein in the
urine. Certain blood pressure pills and prednisone pills are used to decrease protein in the
urine.
An additional benefit is that fish oil may lower the level of fats called triglycerides in your
blood.
2
Are there safety concerns?
Fish oil is generally safe and most people do not experience any side effects. Others may
notice belching, fishy-smelling breath, heartburn or diarrhea. Taking your fish oil capsules
with meals can decrease these side effects.
Are there any interactions with medications?
Medications that slow blood clotting (e.g. aspirin, clopidogrel (Plavix
®
), warfarin
(Coumadin
®
)):
Fish oils may slow blood clotting. Taking fish oils along with medications that also slow
clotting may increase the chances of bruising and bleeding.
Medications for high blood pressure:
Fish oils may decrease blood pressure. Taking fish oils along with medications for high
blood pressure may cause your blood pressure to go too low. Fish oil also might improve
your blood pressure if it is too high. Good blood pressure control is an important part of
treating IgA nephropathy. Target blood pressure for people with kidney disease is 130/80
mm Hg or lower.
What doses are recommended?
We recommend that you take a total of 1000-1200 mg DHA and 1800-2000 mg EPA.
This means taking 5-10 capsules of fish oil each day.
How should you take?
It is best to divide your capsules two or three times per day with meals (e.g. if 10 capsules
required each day, take 4 with breakfast, 3 with lunch, 3 with supper).
What products are recommended?
See table on the following page.
The product you are using should specify on the label exactly how much DHA and EPA are
present in each capsule.
If you are using a product other than one listed in the table, please bring it with you to your
next Renal Health Clinic appointment so we can verify that it is appropriate.
Fish oil products available:
Product Name Store* DHA/EPA Content
(mg)/capsule
Required dose Cost** Cost/month**
Health Balance 100% Wild Salmon
& Fish Oils 1000 mg
Costco 120/180 10 capsules $12.59/300
$0.04/capsule
$12.60
Exact Salmon & Fish Oils Superstore 120/180 10 capsules $7.97/120
$0.06/capsule
$18.00
Webber Naturals Omega 3 Super
Concentrate
Costco 200/400 5 capsules $18.99/120
$0.158/capsule
$23.70
Holista Premium Fish Oil 1000 mg Superstore 120/180 10 capsules $9.47/120
$0.08/capsule
$24.00
Health First Omega First Triple Fish
Oil (liquid)
Vita Health 550/850 per teaspoon
(5 mL)
2 teaspoons
(10 mL)
$21.99/250 mL $26.39
Webber Naturals Wild Salmon &
Fish Oils
Superstore 120/180 10 capsules $13.99/150
$0.09/capsule
$27.00
Jamieson Salmon Oil Omega 3
Complex
Superstore 120/180 10 capsules $10.47/120
$0.09/capsule
$27.00
Quest Triple Fish Oil 1000 mg Superstore 120/180 10 capsules $12.99/120
$0.11/capsule
$33.00
Life Salmon Oil 1000 mg Shoppers Drug
Mart
120/180 10 capsules $7.49/60 capsules
$0.125/capsule
$37.50
Quest Omega-3 Complete Triple
Fish Oil Blend 1000 mg
Vita Health 200/400 5 capsules $14.99/60 capsules
$0.25/capsule
$37.50
* Product may also be available at other stores.
**Prices as of Feb. 2005
Prepared by: Lori Wazny, Pharm.D., May 2005
