The benefits of Omega-3 fatty acid treatments like Lovaza may come with the drawback of an increased risk of excessive bleeding events such as subdural hematomas.

Research for over 30 years showed that certain ethnic populations, such as Native Alaskans, who had diets high in omega-3 fatty acids and other polyunsaturated fatty acids also had lower incidence of cardiovascular disease.

Further research confirmed a link between increased intake of omega-3 fatty acids and a lower risk of premature death from cardiovascular disease. Other studies have also shown that omega-3 fatty acids can decrease triglyceride levels, slow the growth of atherosclerotic plaque, and slightly lower blood pressure.

However, omega-3 fatty acids also inhibit the function of platelets, which are part of the mechanism that makes blood clot properly. Inhibition of platelet function leads to longer bleeding time in patients taking omega-3 fatty acid supplements such as Lovaza, and that aggravates the risks of complications associated with bleeding events such as subdural hematomas.

The human body doesn’t make its own omega-3 fatty acids, so it’s essential to get at least a little in one’s diet. The American Heart Association recommends doing so by eating at least two servings of fish per week.

Omega-3 content is highest in oily fish like salmon, tuna and herring. Other foods that provide naturally-occurring omega-3 fatty acids include flaxseed, walnuts and canola oil.

However, treating coronary artery disease or high triglycerides may require more omega-3 fatty acids than diet can provide. The American Heart Association recommends at least one gram of fish oil per day for patients with coronary artery disease and two to four grams per day for patients with hypertriglyceridemia.

To increase intake to that level, sometimes physicians prescribe omega-3 supplements like Lovaza.

Lovaza was first approved by the FDA in November 2004. It’s approved as a treatment to reduce triglyceride levels in adult patients with severe hypertriglyceridemia. It comes in capsules containing two grams of omega-3 fatty acids each.

The current FDA-approved label for Lovaza mentions that studies have shown increased bleeding time with omega-3 acids. Although the combined effect of Lovaza and anticoagulant drugs has not been fully evaluated, the FDA advises patients taking Lovaza simultaneous with an anticoagulant drug or other drugs that could affect blood clotting to do so under regular medical supervision.

Likewise, the American Heart Association recommends that patients taking more than three grams per day do so only under a physician’s supervision, due to the possibility of excessive bleeding. The daily dose of Lovaza is four grams per day.

Medications that inhibit the blood’s ability to clot may increase a patient’s risk of subdural hematoma. A subdural hematoma is an abnormal collection of blood within the layers of tissue that surround the brain, between the outer layer (the dura) and the middle layer (the arachnoid membrane). As blood accumulates in a subdural hematoma, pressure on the brain increases.

The increase in pressure is what causes subdural hematoma symptoms. These symptoms can include cognitive and behavioral abnormalities like confusion, apathy or other behavioral changes. The patient may experience headache, dizziness, nausea and vomiting, lethargy, or weakness.

More advanced subdural hematomas can result in unconsciousness or even death. It’s sometimes necessary to administer machine-supported breathing and other types of life support. Surgical intervention may be necessary to remove the pooled blood and relieve pressure on the brain.

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