Policosanol

Last Editorial Review: 6/11/2021
Other Name(s):

32-C, Dotriacontanol, Heptacosanol, Hexacosanol, Nonacosanol, Octacosanol, Tetracosanol, Tétracosanol, Tetratriacontanol, Tétratriacontanol, Triacontanol.

Overview

Policosanol is a chemical obtained from sugar cane and other sources.

Policosanol is used for many conditions, but so far, there isn't enough scientific evidence to determine whether or not it is effective for any of them.

Policosanol is used for conditions that affect the health of the heart and blood vessels including high cholesterol, leg pain due to poor circulation (intermittent claudication), and narrowing of the blood vessels that serve the heart.

How does work?

Policosanol seems to decrease cholesterol production in the liver and to increase the break down of LDL (low-density lipoprotein or "bad") cholesterol. It also decreases the stickiness of particles in the blood known as platelets, which might help reduce blood clots.

QUESTION

Next to red peppers, you can get the most vitamin C from ________________. See Answer

Uses

Likely Effective for...

  • Leg pain due to poor blood circulation (intermittent claudication). Taking policosanol by mouth seems to improve the distance people with intermittent claudication can walk without pain.

Insufficient Evidence to Rate Effectiveness for...

  • Clogged arteries. Early research suggests that taking policosanol daily, alone or together with aspirin for 20 months, can reduce heart disease-related events in people with clogged arteries.
  • Inherited high cholesterol (familial hypercholesterolemia). Limited research suggests that taking policosanol does not reduce total cholesterol or “bad cholesterol” (low-density lipoprotein (LDL) cholesterol) in people with an inherited tendency to have high cholesterol.
  • High cholesterol. Research findings disagree about the effectiveness of policosanol in treating high cholesterol. There have been some studies that find it effective. However, all of these studies were done in Cuba, where the sugar cane that is used to make policosanol is grown. Research done outside Cuba (in Germany, Canada, and South Africa) found that policosanol does not lower cholesterol.
  • Other conditions.
More evidence is needed to rate policosanol for these uses.

Side Effects

Policosanol is POSSIBLY SAFE for most people when taken by mouth in doses of 5-80 mg daily for up to 3 years. It can cause skin redness and rash, migraines, insomnia or drowsiness, irritability, dizziness, upset stomach, increased appetite, trouble urinating, weight loss, nose and gum bleeds, and other side effects.

Precautions

Pregnancy and breast-feeding: There is not enough reliable information about the safety of taking policosanol if you are pregnant or breast-feeding. Stay on the safe side and avoid use.

Bleeding disorders: Policosanol can slow blood clotting and might increase the chance of bleeding in people with bleeding disorders.

Surgery: Policosanol can slow blood clotting. There is a concern that it might increase the chance of extra bleeding during and after surgery. Stop using policosanol at least 2 weeks before a scheduled surgery.

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Interactions


Medications that slow blood clotting (Anticoagulant / Antiplatelet drugs)Interaction Rating: Major Do not take this combination.

Policosanol might slow blood clotting. Taking policosanol along with medications that also slow clotting might increase the chances of bruising and bleeding.

Some medications that slow blood clotting include aspirin, clopidogrel (Plavix), diclofenac (Voltaren, Cataflam, others), ibuprofen (Advil, Motrin, others), naproxen (Anaprox, Naprosyn, others), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, warfarin (Coumadin), and others.


Medications for high blood pressure (Antihypertensive drugs)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.

Policosanol might decrease blood pressure in some people. Taking policosanol along with medications used for lowering high blood pressure might cause your blood pressure to go too low. Do not take too much policosanol if you are taking medications for high blood pressure.

Some medications for high blood pressure include captopril (Capoten), enalapril (Vasotec), losartan (Cozaar), valsartan (Diovan), diltiazem (Cardizem), Amlodipine (Norvasc), hydrochlorothiazide (HydroDIURIL), furosemide (Lasix), and many others.

Dosing

The appropriate dose of policosanol depends on several factors such as the user's age, health, and several other conditions. At this time, there is not enough scientific information to determine an appropriate range of doses for policosanol. Keep in mind that natural products are not always necessarily safe and dosages can be important. Be sure to follow relevant directions on product labels and consult your pharmacist or physician or other healthcare professional before using.

Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, and Insufficient Evidence to Rate (detailed description of each of the ratings).

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References

Alcocer, L., Fernandez, L., Campos, E., and Mas, R. A comparative study of policosanol Versus acipimox in patients with type II hypercholesterolemia. Int.J.Tissue React. 1999;21(3):85-92. View abstract.

Aleman, C. L., Mas, R., Hernandez, C., Rodeiro, I., Cerejido, E., Noa, M., Capote, A., Menendez, R., Amor, A., Fraga, V., and . A 12-month study of policosanol oral toxicity in Sprague Dawley rats. Toxicol.Lett. 1994;70(1):77-87. View abstract.

Aleman, C. L., Puig, M. N., Elias, E. C., Ortega, C. H., Guerra, I. R., Ferreiro, R. M., and Brinis, F. Carcinogenicity of policosanol in mice: an 18-month study. Food Chem.Toxicol. 1995;33(7):573-578. View abstract.

Arruzazabala, M. L., Carbajal, D., Mas, R., Molina, V., Valdes, S., and Laguna, A. Cholesterol-lowering effects of policosanol in rabbits. Biol.Res 1994;27(3-4):205-208. View abstract.

Arruzazabala, M. L., Carbajal, D., Mas, R., Valdes, S., and Molina, V. Pharmacological Interaction Between Policosanol and Nitroprusside in Rats. J Med Food 2001;4(2):67-70. View abstract.

Arruzazabala, M. L., Molina, V., Carbajal, D., Valdes, S., and Mas, R. Effect of policosanol on cerebral ischemia in Mongolian gerbils: role of prostacyclin and thromboxane A2. Prostaglandins Leukot.Essent.Fatty Acids 1993;49(3):695-697. View abstract.

Arruzazabala, M. L., Noa, M., Menendez, R., Mas, R., Carbajal, D., Valdes, S., and Molina, V. Protective effect of policosanol on atherosclerotic lesions in rabbits with exogenous hypercholesterolemia. Braz.J Med Biol.Res 2000;33(7):835-840. View abstract.

Barocci, S., Ginevri, F., Valente, U., Torre, F., Gusmano, R., and Nocera, A. Correlation between angiotensin-converting enzyme gene insertion/deletion polymorphism and kidney graft long-term outcome in pediatric recipients: a single-center analysis. Transplantation 2-27-1999;67(4):534-538. View abstract.

Cabrera, L., Rivero, B., Magraner, J., Sierra, R., Gonzalez, V., Uribarri, E., Laguna, A., Cora, M., Tejeda, Y., Rodriguez, E., and Velazquez, C. Stability studies of tablets containing 5 mg of policosanol. Boll.Chim.Farm. 2003;142(7):277-284. View abstract.

Cabrera, L., Uribarri, E., Laguna, A., Sierra, R., Mederos, D., Gonzalez, M., and Gonzalez, V. Study of the interaction between policosanol and excipients. Boll.Chim.Farm. 2002;141(2):138-142. View abstract.

Carbajal, D., Arruzazabala, M. L., Mas, R., Molina, V., and Valdes, S. Effect of policosanol on experimental thrombosis models. Prostaglandins Leukot.Essent.Fatty Acids 1994;50(5):249-251. View abstract.

Castano, G., Mas, Ferreiro R., Fernandez, L., Gamez, R., Illnait, J., and Fernandez, C. A long-term study of policosanol in the treatment of intermittent claudication. Angiology 2001;52(2):115-125. View abstract.

Castano, G., Mas, R., Fernandez, L., Gamez, R., and Illnait, J. Effects of policosanol and lovastatin in patients with intermittent claudication: a double-blind comparative pilot study. Angiology 2003;54(1):25-38. View abstract.

Castano, G., Mas, R., Gamez, R., Fernandez, L., and Illnait, J. Effects of policosanol and ticlopidine in patients with intermittent claudication: a double-blinded pilot comparative study. Angiology 2004;55(4):361-371. View abstract.

Cholesterol-lowering action of policosanol compares well to that of pravastatin and lovastatin. Cardiovasc.J.S.Afr. 2003;14(3):161. View abstract.

Fontani, G., Maffei, D., and Lodi, L. Policosanol, reaction time and event-related potentials. Neuropsychobiology 2000;41(3):158-165. View abstract.

Gamez, R., Aleman, C. L., Mas, R., Noa, M., Rodeiro, I., Garcia, H., Hernandez, C., Menendez, R., and Aguilar, C. A 6-Month Study on the Toxicity of High Doses of Policosanol Orally Administered to Sprague-Dawley Rats. J Med Food 2001;4(2):57-65. View abstract.

Gamez, R., Maz, R., Arruzazabala, M. L., Mendoza, S., and Castano, G. Effects of concurrent therapy with policosanol and omega-3 fatty acids on lipid profile and platelet aggregation in rabbits. Drugs R.D. 2005;6(1):11-19. View abstract.

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Illnait, J., Castano, G., Alvarez, E., Fernandez, L., Mas, R., Mendoza, S., and Gamez, R. Effects of policosanol (10 mg/d) versus aspirin (100 mg/d) in patients with intermittent claudication: a 10-week, randomized, comparative study. Angiology 2008;59(3):269-277. View abstract.

Janikula, M. Policosanol: a new treatment for cardiovascular disease? Altern.Med.Rev. 2002;7(3):203-217. View abstract.

Kassis, A. N. and Jones, P. J. Changes in cholesterol kinetics following sugar cane policosanol supplementation: a randomized control trial. Lipids Health Dis 2008;7:17. View abstract.

Kassis, A. N. Evaluation of cholesterol-lowering and antioxidant properties of sugar cane policosanols in hamsters and humans. Appl Physiol Nutr Metab 2008;33(3):540-541. View abstract.

Mas, R., Castano, G., Fernandez, J., Gamez, R. R., Illnait, J., Fernandez, L., Lopez, E., Mesa, M., Alvarez, E., and Mendoza, S. Long- term effects of policosanol on older patients with Type 2 diabetes. Asia Pac.J Clin Nutr. 2004;13(Suppl):S101. View abstract.

McCarty, M. F. An ezetimibe-policosanol combination has the potential to be an OTC agent that could dramatically lower LDL cholesterol without side effects. Med Hypotheses 2005;64(3):636-645. View abstract.

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Menendez, R., Amor, A. M., Gonzalez, R. M., Fraga, V., and Mas, R. Effect of policosanol on the hepatic cholesterol biosynthesis of normocholesterolemic rats. Biol.Res 1996;29(2):253-257. View abstract.

Menendez, R., Fraga, V., Amor, A. M., Gonzalez, R. M., and Mas, R. Oral administration of policosanol inhibits in vitro copper ion-induced rat lipoprotein peroxidation. Physiol Behav. 8-1-1999;67(1):1-7. View abstract.

Menendez, R., Marrero, D., Mas, R., Fernandez, I., Gonzalez, L., and Gonzalez, R. M. In vitro and in vivo study of octacosanol metabolism. Arch Med Res 2005;36(2):113-119. View abstract.

Menendez, R., Mas, R., Amor, A. M., Gonzalez, R. M., Fernandez, J. C., Rodeiro, I., Zayas, M., and Jimenez, S. Effects of policosanol treatment on the susceptibility of low density lipoprotein (LDL) isolated from healthy volunteers to oxidative modification in vitro. Br.J.Clin.Pharmacol. 2000;50(3):255-262. View abstract.

Menendez, R., Mas, R., Amor, A. M., Ledon, N., Perez, J., Gonzalez, R. M., Rodeiro, I., Zayas, M., and Jimenez, S. Inhibition of rat lipoprotein lipid peroxidation by the oral administration of D003, a mixture of very long-chain saturated fatty acids. Can J Physiol Pharmacol. 2002;80(1):13-21. View abstract.

Mesa, A. R., Mas, R., Noa, M., Hernandez, C., Rodeiro, I., Gamez, R., Garcia, M., Capote, A., and Aleman, C. L. Toxicity of policosanol in beagle dogs: one-year study. Toxicol.Lett. 1994;73(2):81-90. View abstract.

Mirkin, A., Mas, R., Martinto, M., Boccanera, R., Robertis, A., Poudes, R., Fuster, A., Lastreto, E., Yanez, M., Irico, G., McCook, B., and Farre, A. Efficacy and tolerability of policosanol in hypercholesterolemic postmenopausal women. Int.J.Clin.Pharmacol.Res. 2001;21(1):31-41. View abstract.

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Noa, M., Mas, R., and Mesa, R. Effect of policosanol on intimal thickening in rabbit cuffed carotid artery. Int J Cardiol 12-1-1998;67(2):125-132. View abstract.

Noa, M., Mas, R., Mendoza, S., Gamez, R., Mendoza, N., and Gonzalez, J. Policosanol prevents bone loss in ovariectomized rats. Drugs Exp.Clin Res 2004;30(3):117-123. View abstract.

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