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Omega\u20103 fatty acids, also known as fish oil, have been used for hyperlipidemia, coronary heart disease, hypertension, and other conditions. Some studies have demonstrated that consumption of fish oil concentrate, n\u20103 polyunsaturated fatty acid (n\u20103 PUFA), results in cardiovascular benefits that include reductions in mortality, sudden death, nonfatal myocardial infarction, and thrombotic stoke, as well as improvement in graft patency. The mechanism of action of n\u20103 PUFA is not completely understood, but a dual antiplatelet and anticoagulant effect has been proposed. Few data exist on whether or not fish oil can be used safely with other antiplatelet or anticoagulant drugs. We report the case of a patient who after a minor fall developed a subdural hematoma requiring craniotomy that likely was precipitated by concomitant use of high\u2010dose omega\u20103 fatty acids 6 g\/day with both aspirin and warfarin. These findings are important because of the wide availability of omega\u20103 fatty acids and the propensity for use of complementary and alternative medicine in patients with cardiovascular disease who are already taking antiplatelet and\/or anticoagulant agents. Judicious use of these combinations is advised, and pharmacists can play an important role in educating patients and other health care providers about the bleeding risks associated with combination therapy.<\/jats:p>","DOI":"10.1592\/phco.27.1.152","type":"journal-article","created":{"date-parts":[[2006,12,28]],"date-time":"2006-12-28T07:34:50Z","timestamp":1167291290000},"page":"152-160","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":40,"title":["Subdural Hematoma After a Fall in an Elderly Patient Taking High\u2010Dose Omega\u20103 Fatty Acids with Warfarin and Aspirin: Case Report and Review of the Literature"],"prefix":"10.1002","volume":"27","author":[{"given":"Elizabeth M.","family":"McClaskey","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth Landrum","family":"Michalets","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2012,1,6]]},"reference":[{"key":"e_1_2_1_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/00043798-199710000-00011"},{"key":"e_1_2_1_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000014682.14181.F2"},{"key":"e_1_2_1_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/0049-3848(89)90201-6"},{"key":"e_1_2_1_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/0952-3278(94)90156-2"},{"key":"e_1_2_1_6_2","volume-title":"Omacor (omega\u20103\u2010acid ethyl esters) package insert","author":"Reliant Pharmaceuticals, Inc.","year":"2005"},{"key":"e_1_2_1_7_2","unstructured":"American Heart Association.AHA recommendation on fish and omega\u20103 fatty acids. 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