In a double-blind, randomized, cross over study with six healthy volunteers, the combination of aspirin (40 mg/day) and omega-3 fatty acids (5.3 g) decreased fibrinolytic response to venous occlusion (Iacoviello et al. 1992). The combination could be helpful in the treatment of some forms of coronary artery disease.

Rats receiving cardiac allografts that were fed a diet high in omega-3 polyunsaturated fatty acids had a significantly prolonged median graft survival rate (12 days) compared to animals fed either lab chow or a diet high in monounsaturated fatty acids and saturated fat (Haw et al. 1995). When the rats were treated with cyclosporine, myocardial blood flow was greatest in the omega-3 group. Omega-3 fatty acids also exhibited immunosuppressive effects because lymphocyte responses were suppressed to a greater extent in animals treated with these fatty acids.

In a double-blind, randomized, placebo-controlled study with 30 patients, treatment with alpha-tocopherol (3.7 mg); an immunosuppressive regimen consisting of cyclosporine (6 mg/kg body weight), azathioprine (2mg/kg/day), and prednisolone (0.2 mg/kg/day); and omega-3 fatty acids (4 g/day: 46.5% eicosapentaenoic acid (EPA) and 37.8% docosahexaenoic acid (DHA)) decreased systolic pressure and increased diastolic pressure after 6 months (Andreassen et al. 1997). An earlier study involving 20 cardiac transplant patients who received omega-3 fatty acids (3 g/day: 1500 mg each EPA and DHA) with cyclosporine and antihypertensive medications for 12 weeks supports these findings (Ventura et al. 1993). The mechanism for the interaction between cyclosporine and omega-3 fatty acids may be decreased systemic vascular resistance. Prophylactic administration of a combination of omega-3 fatty acids and cyclosporine may effectively control hypertension in cardiac transplant patients.

Another placebo-controlled, prospective, double-blind, randomized study involving 26 liver transplant patients evaluated the effects of omega-3 fatty acids (12 g/day: 18% EPA and 12% DHA) on cyclosporine-induced nephrotoxicity (Badalamenti et al. 1995). After 2 months, renal plasma flow increased by 22%, the glomerular filtration rate (GFR) increased by 33%, renal blood flow increased by 17%, and renal vascular resistance decreased by 20%. Kidney transplant recipients also benefited from supplementation with omega-3 fatty acids (6 g: 30% EPA and 20% DHA) during cyclosporine therapy in a double-blind, placebo-controlled, prospective, randomized clinical trial involving 24 subjects (Homan van der Heide et al. 1990). After 3 months, blood pressure decreased, and GFR and renal plasma flow increased by 20.3% and 16.4%, respectively. However, another double-blind, randomized, controlled study found that 25 renal transplant patients did not derive clinically significant benefits after one year of treatment with omega-3 fatty acids (6 g) (Kooijmans-Coutinho et al. 1996).

A randomized, open study evaluated the effects of highly-purified eicosapentaenoic acid (1800 mg/day) combined with low-dose etretinate (0.3 to 0.5 mg/kg/day) for 12 weeks in patients with chronic, stable psoriasis vulgaris (Danno and Sugie 1998). Patients continued to be treated with a topical corticosteroid that had previously been ineffective. Clinical improvement was noted in all patients receiving etretinate with EPA, whereas only 90% of patients responded to etretinate monotherapy. Reports of adverse events were similar for both groups.

Omega-3 fatty acids (5 and 10 mL/kg) significantly protected the gastric mucosa against ulcerative agents, including NSAIDs, in rats (Al-Harbi et al. 1995).

Al-Harbi MM, Islam MW, Al-Shabanah OA, Al-Gharably NM. Effect of Acute Administration of Fish Oil (Omega-3 Marine Triglyceride) on Gastric Ulceration and Secretion Induced by Various Ulcerogenic and Necrotizing Agents in Rats. Fed Chem. Toxic. 1995;33(7):555-558.

Andreassen AK, Hartmann A, Offstad J, Geiran O, Kvernebo K, Simonsen S. Hypertension prophylaxis with omega-3 fatty acids in heart transplant recipients. J Am Coll Cardiol 1997;29:1324-1331.

Badalamenti S, Salerno F, Lorenzano E, et al. Renal Effects of Dietary Supplementation With Fish Oil in Cyclosporine-Treated Liver Transplant Patients. Hepatol. 1995;2(6):1695-1701.

Danno K, Sugie N. Combination therapy with low-dose etretinate and eicosapentaenoic acid for psoriasis vulgaris. J Dermatol. 1998;25:703-705.

Haw M, Linnebjerg H, Chavali SR, Forse RA. The effect of dietary polyunsaturated fatty acids (PUFA) on acute rejection and cardiac allograft blood flow in rats. Transplantation. 1995;60(6):570-577.

Homan van der Heide JJ, Bilo HJ, Tegzess AM, Donker AJ. The effects of dietary supplementation with fish oil on renal function in cyclosporine-treated renal transplant recipients. Transplantation. 1990;49:523-527.

Iacoviello K, Amore C, De Curtis A, et al. Modulation of fibrinolytic response to venous occlusion in humans by a combination of low-dose aspirin and n-3 polyunsaturated fatty acids. Arterioscler Thromb 1992;12(10):1191-1197.

Kooijmans-Coutinho MF, Rischen-Vos J, Hermans J, Arndt JW, van der Woude FJ. Dietary fish oil in renal transplant recipients treated with cyclsporin-A: no beneficial effects shown. J Am Soc Nephrol. 1996;7(3):513-518.

Ventura HO, Milani RV, Lavie CJ, Smart FW, Stapleton DD, Toups TS, Price HL. Cyclosporine induced hypertension. Efficacy of omega-3 fatty acids in patients after cardiac transplantation. Circ. 1993;88(5 Pt 2):II281-285.