ZENTOKID OMEGA 3 DROPS (Each ml contains Omega-3 marine triglycerides: 463.8814 mg (Equivalent to Docosahexaenoic acid (DHA): 200.5 mg and Eicosapentaenoic acid (EPA): 42 mg)

Indications

• Hyperlipidemia
• Cardiovascular disease prevention
• Rheumatoid arthritis
• Inflammatory bowel disease
• Major depressive disorder

Dosage

Children: Refer to BNF for Children for specific dosing guidelines.

Adults: Refer to BNF for specific dosing guidelines, generally available in the form of supplements or prescription formulations.

Mechanism of action

Eicosapentaenoic acid works by influencing the production of eicosanoids, which are signaling molecules derived from fatty acids. It competes with arachidonic acid in the enzymatic pathways, leading to the production of less inflammatory eicosanoids. This shift in eicosanoid production is believed to contribute to reduced inflammation and improved cardiovascular outcomes.

Pharmacodynamics

The pharmacodynamic effects of EPA include the modulation of lipid levels, reduction of triglycerides, and anti-inflammatory effects. It has been shown to decrease platelet aggregation and may improve endothelial function, thus contributing to cardiovascular protection.

Pharmacokinetics

Eicosapentaenoic acid is readily absorbed from the gastrointestinal tract following oral administration. It undergoes metabolic processes in the liver and is incorporated into cell membranes, affecting cell signaling and inflammatory responses. The half-life of EPA is variable, influenced by dosage and individual metabolism, and it is primarily excreted in the urine and feces.

Adverse effects

• Nausea
• Diarrhea
• Abdominal pain
• Flatulence
• Rash

Precautions

• Use with caution in patients with known hypersensitivity to fish or shellfish.
• Monitor patients on anticoagulant therapy due to potential for increased bleeding risk.

Pregnancy

There are no adequate and well-controlled studies in pregnant women. Eicosapentaenoic acid should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

Breast-feeding

Eicosapentaenoic acid is excreted in breast milk. Caution should be exercised when administering to nursing mothers.

Storage

Store in a cool, dry place, away from direct sunlight. Keep out of reach of children.

Formulations

• Capsules
• Liquid formulations

Indications

• Cardiovascular disease prevention
• Hypertriglyceridemia
• Rheumatoid arthritis
• Cognitive health and neuroprotection
• Inflammatory bowel disease
• General health supplement

Dosage

Children: Due to variability in formulations and indications, it is recommended to refer to the BNF for Children for specific dosing information regarding

Adults: The dosage of marine-derived omega-3 fatty acids varies based on the indication and product formulation. General recommendations suggest 1 to 4 grams of combined EPA and DHA per day for cardiovascular benefits. It is advisable to refer to specific product guidelines for exact dosing.

Mechanism of action

The omega-3 fatty acids, particularly eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), exert their effects through various pathways, including the modulation of lipid metabolism and inflammatory responses. They influence cell membrane fluidity and play a critical role in the synthesis of eicosanoids, which are signaling molecules that can reduce inflammation and promote cardiovascular health.

Pharmacodynamics

Marine-derived omega-3 fatty acids have been shown to decrease triglyceride levels, lower blood pressure, and reduce the risk of cardiovascular events. They also exhibit anti-inflammatory effects, which can benefit conditions such as rheumatoid arthritis and inflammatory bowel disease. Additionally, DHA is an important structural component of neuronal membranes and is essential for brain development and function.

Pharmacokinetics

After ingestion, omega-3 fatty acids are absorbed in the small intestine and transported into the bloodstream, where they are incorporated into cell membranes. The bioavailability of these fatty acids can vary depending on the form of marine product consumed (such as triglycerides or ethyl esters). Metabolism primarily occurs in the liver, where they undergo beta-oxidation and can influence the synthesis of lipoproteins and other metabolites. The elimination half-life can vary, but regular consumption is generally recommended to maintain effective levels in the body.

Pregnancy

Safety during pregnancy has not been established. Consult a healthcare provider before use.

Breast-feeding

Consult a healthcare provider before use, as safety during breastfeeding is not well studied.

Storage

Store in a cool, dry place, away from direct sunlight.

Indications

• Hypertriglyceridemia
• Cardiovascular disease risk management
• Metabolic syndrome

Dosage

Children: In paediatric patients, management of elevated triglycerides should involve a thorough evaluation by a healthcare provider. Specific dosing will depend on the chosen pharmacotherapy and should be referred to established guidelines.

Adults: For adults, management of high triglycerides typically begins with lifestyle changes. If medication is indicated, the specific dosing regimen will depend on the drug selected and should be guided by clinical guidelines.

Mechanism of action

Triglycerides are primarily absorbed from dietary sources and synthesized in the liver. Their levels are regulated by hormones such as insulin and involve the action of lipoprotein lipase, which hydrolyzes triglycerides into free fatty acids for energy use. In pharmacological terms, certain medications such as fibrates and omega-3 fatty acids work by enhancing the clearance of triglycerides from the bloodstream.

Pharmacodynamics

Triglyceride levels are influenced by various factors including diet, physical activity, and hormonal regulation. High levels of triglycerides can lead to atherosclerosis, where plaque builds up in the arteries, potentially resulting in heart disease. Drugs that are used to lower triglyceride levels typically work by either reducing the synthesis of triglycerides in the liver or enhancing their breakdown and clearance.

Pharmacokinetics

Triglycerides are transported in the bloodstream as part of lipoproteins, mainly chylomicrons and very-low-density lipoproteins (VLDL). They are metabolized in peripheral tissues by lipoprotein lipase. The half-life of triglycerides in circulation is variable and depends on several factors including the type of lipoprotein and the individual’s metabolic state. The clearance and metabolism of triglycerides can also be affected by medications, lifestyle factors, and underlying health conditions.

Adverse effects

• Pancreatitis
• Abdominal pain
• Nausea
• Vomiting
• Fatigue
• Eruptive xanthomas
• Liver dysfunction

Precautions

• Use with caution in patients with a history of pancreatitis.
• Monitor liver function tests in patients receiving treatment that can affect triglyceride levels.
• Consider lifestyle modifications prior to pharmacological intervention.

Pregnancy

Elevated triglyceride levels can be common during pregnancy; however, significant increases should be monitored as they may pose risks for gestational diabetes and pancreatitis.

Breast-feeding

Some studies suggest that triglyceride levels may increase during lactation; however, clinical significance is typically low. Monitoring is advised.

Storage

Store in a cool, dry place away from light. Ensure that any medications related to triglycerides are stored according to the manufacturer's instructions.