Cod liver oil 400mg capsules
Cod liver oil is extracted from the liver of cod fish and mainly consists of omega-3 fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA).
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Suspected adverse reactions reported for Cod liver oil
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3 branded products available
Therapeutically similar medicines
Similarity based on WHO Anatomical Therapeutic Chemical (ATC) classification and NHS BNF section grouping. Source data: NHS dm+d via TRUD (OGL v3.0), WHO ATC/DDD Index.
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Clinical guidelines and formulary information
British National Formulary
Cod liver oil
Source: British National Formulary, NICE. Joint Formulary Committee. Contains public sector information licensed under the Open Government Licence v3.0.
NICE clinical guidance(1)
Source: National Institute for Health and Care Excellence (NICE). Contains public sector information licensed under the Open Government Licence v3.0.
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NHS UK identifiers
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Active and completed clinical studies from ClinicalTrials.gov
Source: ClinicalTrials.gov, a database of the U.S. National Library of Medicine (NLM), National Institutes of Health (NIH). Data accessed via ClinicalTrials.gov API v2. Trial information is provided for research purposes and does not constitute medical advice.
Pharmacology and chemical data from DrugBank
Key facts
Drug status
Approved
Major interactions
None known
Half-life
Not available
Mechanism
As cod liver oil consists of the component compounds of eicosapentaenoic acid (E…
Food interactions
None known
Human targets
None mapped
Data: DrugBank · CC BY-NC 4.0
Pharmacokinetics at a glance
Absorption
Half-life
Protein binding
Volume of distribution
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Elimination
Clearance
Pharmacokinetic data: DrugBank · CC BY-NC 4.0
[A27154][A33159][L2872]
Historically, cod liver oil was often given to children because the vitamin d content in the oil had been shown to prevent or treat vitamin D deficiency and condition of rickets associated with it .
[A33159]
Over time, this common use in children growing up may have conferred upon cod liver oil its identity as a healthy and useful all-purpose dietary supplement.
However, since cod liver oil is a composite of several other nutritional compounds including the omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) as well as vitamin A and vitamin D [A33159][L2872][L2871], the presence in varying amounts of all of these compounds at once makes it difficult to recommend or use cod liver oil as an appropriate supplement to confer any one particular health effect or for any one particular nutritional deficiency.
Regardless, because it does contain a combination of a number of important and healthy nutritional compounds, cod liver oil has sometimes been recommended in the literature for conferring the health effects of some of these compounds, such as the potential use of cod liver oil supplements in post-heart attack patients for secondary prophylaxis associated with the use of omega-3 fatty acids .
[A33165]
For example, one tablespoon of cod liver oil contains approximately 4,080 ug of retinol (vitamin A) and 34 ug (1,360 IU) of vitamin D [L2871]. Since the general dietary reference intake of vitamin A is only 900 ug per day for adult men, 700 ug per day for women, and 3000 ug per day as the tolerable upper intake level, the regular intake of cod liver oil as a regular supplement can result in harmful levels of vitamin A accumulating in the liver and sufficient to cause hypervitaminosis A [A33163], which is associated with various symptoms such as blurred vision, changes in consciousness, skin and hair changes, liver damage, among many others.
Moreover, while cod liver oil only contains a certain percentage of the omega-3 fatty acids EPA and DHA per amount of the oil [L2871], separate fish oils supplement products that exclusively consist of only EPA and DHA are available in a great variety of different percentage content formulations, even including prescription strength formulations should certain patients need such a level of therapy. Furthermore, such exclusive omega-3 fatty acid supplement products do not contain any vitamin A or D either, which allows patients to use the supplements without any concern about affecting their vitamin A or D levels or exposing themselves to the unnecessary excess intake of vitamins.
Subsequently, although cod liver oil contains a combination of healthy dietary supplements like EPA, DHA, vitamin A, and vitamin D, the presence in varying amounts of all of these compounds all at once makes it difficult to effectively titrate for appropriate amounts of intake for all the compounds involved when using cod liver oil as a general supplement, often resulting in either an excess or insufficient amount of one or more the aforementioned compounds.
Nevertheless, because cod liver oil does consist of the component compounds of EPA, DHA, vitamin A, and vitamin D, further information about the pharmacodynamics of these cod liver oil components can be found by searching for fish oil, vitamin A, and vitamin D on DrugBank.
How the body processes this drug — absorption, distribution, metabolism, and elimination
Chemical identifiers
CAS, UNII, InChI Key and database cross-references
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Chemical identifiers
CAS, UNII, InChI Key and database cross-references
Linked compound data from DrugBank Open Data (CC BY-NC 4.0)
Cod liver oil
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