Comparison of Bleeding Complications With Omega-3 Fatty Acids + Aspirin + Clopidogrel—Versus—Aspirin + Clopidogrel in Patients With Cardiovascular Disease

Dyslipidemia after allogeneic hematopoietic stem cell transplantation: evaluation and management

“…51 Omega-3 fatty acids have also been shown to be safe in patients on dual antiplatelet therapy with aspirin and clopidogrel, with no clinically significant increase in bleeding. 52 In patients with hypertriglyceridemia, uncontrolled diabetes and hyperglycemia can markedly worsen triglyceride levels, so treatment of diabetes should be intensified.…”

Increased bruising with the combination of long-chain omega-3 fatty acids, flaxseed oil and clopidogrel

“…[9][10][11][12]14 In fact, some studies even conclude a lack of risk. 13,16 The present case demonstrates that clinically significant increased bleeding may occur with concurrent use of these natural health products. Caution is warranted when patients are taking flaxseed and other omega-3 fatty acids alone and especially in combination with other antiplatelet drugs such as clopidogrel.…”

“…11 Further study demonstrated larger pores in the fibrin network, increased clot susceptibility to lysis and decreased thrombin formation when patients undergoing percutaneous coronary intervention were given the same combination as in the study above. 12 Alternatively, Watson et al 13 retrospectively investigated reports of bleeding complications in patients treated with ASA (mean ± SD dose 161 ± 115 mg), clopidogrel (mean dose 75 mg) and high-dose fish oil (mean ± SD dose 3 ± 1.25 g) and found no significant increase in the risk of bleeding compared with those taking aspirin and clopidogrel alone.…”

Omega-3 Fatty Acids for Cardiovascular Disease Prevention

“…& In 2004, the US Food and Drug Administration (FDA) concluded that up to 3 g/d of EPA + DHA is safe, although most data are limited to less than 6 months [51]. These conclusions are supported further by a recent case-control study of 182 adults taking aspirin, clopidogrel, and high-dose omega-3 fatty acid supplementation (mean 3 g/d) and 182 age-and gender-matched controls treated with aspirin and clopidogrel alone [52]. After a mean treatment duration of 33 months, no difference was found between cases and controls with regard to major bleeding (in only one subject taking omega-3) and minor bleeding (in four subjects taking omega-3 vs seven controls).…”