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Supplement · Grade A

Omega-3 EPA and medications.

Every documented pair, every citation. Below: 6 documented pairs grouped by mechanism.

Omega-3 EPA is classified as a foundation supplement in the Distil database, evidence Grade A. The page below lists every medication we have explicitly assessed it against.

Below are the 6 documented pairs we have explicitly assessed for Omega-3 EPA: 6 amber. The pairs cluster around 1 mechanism: Additive antiplatelet effect. Every call is cited to either a clinical reference (PMID) or the British National Formulary. Anything not listed here is either still to be assessed or beyond our database scope. The checker beneath surfaces assessments by medication, and the missing-item form at the bottom of the page routes any uncatalogued medication into our next curation pass.

Documented interactions

Additive antiplatelet effect

Amber Aspirin

Standard supplement doses of fish oil (under 1 gram of EPA+DHA per day) add only marginally to the antiplatelet effect of aspirin. At higher cardiology doses (3 grams per day and above), the combination meaningfully increases bleeding risk. Tell your GP what dose you take.

BNF: Aspirin
Amber Clopidogrel

Standard supplement doses of fish oil (under 1 gram of EPA+DHA per day) add only marginally to the antiplatelet effect of clopidogrel. At higher cardiology doses (3 grams per day and above), the combination meaningfully increases bleeding risk.

BNF: Clopidogrel

High-dose omega-3 has a mild antiplatelet effect that adds to diclofenac's. At typical supplement doses and short-course NSAID use, the combined effect is usually mild. At high doses or for chronic NSAID use, the additive bleeding tendency is worth knowing about.

PMID 32478963 · PMID 29196903 · BNF: Diclofenac
Amber Ibuprofen

High-dose omega-3 (typically more than 3g of combined EPA plus DHA per day) has a mild antiplatelet effect that adds to ibuprofen's. At typical supplement doses of 1 to 2g and short-course NSAID use, the combined effect is usually mild. At high doses or for chronic NSAID use, the additive bleeding tendency is worth knowing about.

PMID 32478963 · PMID 29196903 · BNF: Ibuprofen
Amber Naproxen

High-dose omega-3 has a mild antiplatelet effect that adds to naproxen's. At typical supplement doses and short-course NSAID use, the combined effect is usually mild. At high doses or for chronic NSAID use, the additive bleeding tendency is worth knowing about.

PMID 32478963 · PMID 29196903 · BNF: Naproxen

At supplement doses below 1 gram per day, omega-3 fish oil has minimal effect on INR. At higher doses (3 grams per day and above) used for triglyceride lowering, the antiplatelet effect is more meaningful and INR can shift. Tell your GP what dose you take if you are on warfarin.

PMID 32478963 · BNF: Warfarin

What this list does not say. Pairs not flagged here are not implicitly safe. They are either not yet in our database, or fall outside our inclusion scope. Use the checker below to surface any medication, and submit a missing item if you take something we have not catalogued.

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For adults over 18. This tool gives evidence-graded information, not medical advice. Always discuss changes with your GP, especially if you take any medication, are pregnant, breastfeeding, or have a serious health condition.
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How we decide

How we grade severity, choose what's in scope, and what we exclude.

Every call on this page is reasoned. We publish the full rubric for severity tiers, the medication inclusion logic, the evidence grades we accept, and what we deliberately leave out. About three thousand words. Worth reading once if you use this tool more than occasionally.

Read the full methodology
Distil's interactions database is reviewed and updated every quarter. We grade evidence transparently and publish our methodology, including every database change, at /about/methodology. This tool is information, not a substitute for clinical judgement. If you take medication and supplements together, your GP or pharmacist can review your full regimen against your medical history. If you want a comprehensive personalised stack reasoned against this same database, the Distil report is the next step up.