Contraindications
Individuals with an allergy to fish or seafood should use caution, though fish oil is rarely allergenic. Both benefit and risk have been documented for those at risk of or being treated for cardiac arrhythmias, with close supervision indicated.24 Pregnant and nursing women are often advised to consume a minimum of 300 mg of DHA per day. Although DHA is recognized as essential to neurological development, no suggested daily intakes have been made for children.
Drug Interactions
Fish oil may potentially reduce the need or dosage for blood pressure medications in some individuals, and patients should be closely monitored. Because fish oil may have an antithrombotic effect, caution has traditionally been advised for those on anticlotting, antiplatelet or anticoagulant medications, or those at high risk of bleeding. However, a multinational randomized and controlled trial found that fish oil did not increase perioperative bleeding.25,26 In amounts greater than 3 g per day, hyperglycemia has been observed in diabetics and those with hypertriglyceridemia and close monitoring of patients on antidiabetic medication is recommended.27
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