Omacor (omega-3-acid ethyl esters; Reliant Pharmaceuticals, Inc., Liberty Corner, NJ) is a highly purified, prescription omega-3 fatty acid formulation with high concentrations of eicosapentaenoic acid (EPA) (465 mg) and docosahexaenoic acid (DHA) (375 mg) in each 1-g capsule, along with 4 mg (6 IU) of vitamin E. At a typical dose of 4 capsules/day, Omacor significantly lowers plasma triglyceride levels either as monotherapy or in combination with 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors (statins) or fibrates. Omacor also modestly increases plasma levels of low-density lipoprotein cholesterol, increases high-density lipoprotein cholesterol levels, and has favorable effects on lipoprotein particle size and subclass distribution. Omacor is well tolerated, with few side effects other than mild gastrointestinal symptoms. Hyperglycemia, abnormal bleeding, elevations in muscle or liver enzymes, and/or abnormalities in kidney or nerve function have not been reported. Through its intensive purification process, Omacor has minimal "fishy" smell and taste, and it has not been reported to cause hypervitaminosis or illness due to exposure to environmental toxins. Omacor provides a safe, effective, well-tolerated approach to management of hypertriglyceridemia.