Safety has not yet been established in pregnancy, although studies with experimental models suggest it is safe. Furthermore, EPO combined with fish oils has been used successfully to reduce the incidence of pre-eclampsia (D'Almeida et al 1992).
PRACTICE POINTS/PATIENT COUNSELLING
• Evening primrose oil contains a number of EFAs, most notably GLA, which is thought to be the most important for exerting pharmacological activity.
• It is suspected that GLA supplementation results in increased production of useful metabolites such as PGE17 which inhibits inflammation, regulates immunity, causes vasodilation and reduces blood pressure, improves flexibility of red blood cell membranes, induces insulin receptors and inhibits platelet aggregation and thrombosis.
• Evening primrose oil appears beneficial in the treatment of diabetic neuropathy, RA and cardiovascular disease.
• In many disorders, EPO is combined with fish oils (EPA) for best results.
ANSWERS TO PATIENTS' FREQUENTLY ASKED QUESTIONS
What is EPO?
Evening primrose oil is the oil from the seed of the plant known as evening primrose. A similar oil is made from borage seeds. The oil contains high amounts of GLA, which is the main active compound. What will this supplement do for me?
Current evidence supports the use of EPO in the treatment of diabetic neuropathy, RA and cardiovascular disease. When will it start to work?
Beneficial effects have been reported in some studies within 2-4 weeks' continuous use. However, long-term use is necessary for chronic diseases such as RA. Are there any safety issues?
Evening primrose oil is generally well tolerated. Only minor gastrointestinal upset may occur. Should this happen it is recommended the capsules be taken with meals. EPO should be avoided by some people taking anti-epileptic medicines and blood thinning medicines.
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