Vascepa Side Effects: What to Expect and When to Call Your Doctor

Vascepa (icosapent ethyl) is generally well tolerated, especially compared to many other cardiovascular medications. However, like all prescription drugs, it carries a specific side effect profile that patients should understand before starting treatment. This guide walks through what to expect — from mild nuisances to the serious side effects that require immediate medical attention.

Common Side Effects of Vascepa (Icosapent Ethyl)

In the REDUCE-IT cardiovascular outcomes trial (N=8,179 patients), the most commonly reported side effects of Vascepa occurring at a rate at least 1% higher than placebo were:

• Musculoskeletal pain (4% Vascepa vs. 3% placebo) — muscle aches, joint pain
• Peripheral edema (7% vs. 5%) — swelling in the hands, legs, or feet
• Constipation (5% vs. 4%)
• Gout (4% vs. 3%) — joint inflammation and uric acid flares
• Atrial fibrillation (5% vs. 4%) — discussed in more detail below

In the hypertriglyceridemia trials (shorter duration), additional side effects reported more frequently with Vascepa included:

• Arthralgia — joint pain
• Oropharyngeal pain — throat or mouth discomfort

Serious Side Effect 1: Increased Bleeding Risk

In the REDUCE-IT trial, 12% of patients taking Vascepa experienced a bleeding event compared to 10% of patients taking placebo. Serious bleeding events occurred in 3% of Vascepa patients versus 2% of placebo patients.

Bleeding risk is higher if you are also taking:

• Anticoagulants (blood thinners) such as warfarin (Coumadin), apixaban (Eliquis), rivaroxaban (Xarelto), or dabigatran (Pradaxa)
• Antiplatelet agents such as aspirin, clopidogrel (Plavix), or ticagrelor (Brilinta)

Call your doctor immediately or seek emergency care if you experience:

• Unusual or excessive bleeding (cuts that won't stop, prolonged nosebleeds, bleeding gums)
• Blood in urine (pink or red urine)
• Vomiting blood or coughing up blood
• Black, tarry, or blood-tinged stools (signs of GI bleeding)

Serious Side Effect 2: Atrial Fibrillation and Atrial Flutter

Vascepa is associated with an increased risk of atrial fibrillation (AFib) and atrial flutter requiring hospitalization. In the REDUCE-IT trial, 3% of Vascepa patients had atrial fibrillation or flutter requiring hospitalization versus 2% of placebo patients. The risk was higher in patients with a previous history of atrial fibrillation.

Contact your doctor right away if you notice:

• Heart beating fast, fluttering, or irregularly (palpitations)
• Lightheadedness or dizziness
• Shortness of breath or difficulty breathing
• Chest discomfort or pressure
• Fainting or near-fainting

Potential Allergic Reactions (Especially for Fish/Shellfish Allergy)

Vascepa is derived from fish oil. It is not known whether patients with fish or shellfish allergies are at increased risk of allergic reactions to Vascepa. If you have a known fish or shellfish allergy, discuss this with your doctor before starting. Signs of an allergic reaction requiring immediate attention: hives, rash, difficulty breathing, swelling of the face/lips/tongue/throat, or severe dizziness.

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How to Minimize Side Effects

Most patients tolerate Vascepa well. A few practical tips:

• Always take with food. Vascepa was administered with or following a meal in all clinical studies. This can reduce GI side effects.
• Swallow capsules whole. Do not break, crush, dissolve, or chew Vascepa capsules.
• Tell your doctor about all your medications. Especially blood thinners and antiplatelet drugs that interact with Vascepa's bleeding risk.
• Report new symptoms promptly. Especially any unusual bleeding or heart rhythm changes.

How Long Do Vascepa Side Effects Last?

Vascepa's active ingredient, EPA, has a plasma elimination half-life of approximately 89 hours (nearly 4 days). Minor side effects like constipation, joint pain, and swelling typically fade within that timeframe after stopping the medication. Most side effects should resolve within three weeks of discontinuation. Serious events like bleeding complications or AFib may require longer medical management.

For a detailed review of how Vascepa interacts with other medications, see our article on Vascepa drug interactions. If you're having trouble accessing your prescription to manage these questions, medfinder.com can help you locate it at a pharmacy near you.