Policosanol: Benefits, Dosage, Contraindications
Other name(s)
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Family or group:
Phytosubstances
Active ingredients:
Octacosanol
Indications
Rating methodology
EFSA approval.
Intermittent Claudication ✪✪✪✪✪
Policosanol, taken orally for up to two years, has shown a significant improvement in walking distance in patients with intermittent claudication, surpassing placebo, lovastatin, and aspirin, and equaling ticlopidine (an antiplatelet drug). Studies have revealed that 10 mg/day of policosanol for 6 months increases both initial and absolute walking distance. Improvements have been observed with 20 mg/day over 6 to 12 months. Policosanol has proven to be as effective as ticlopidine for improving walking, and more effective than aspirin in a 10-week study.
Posologie
Oral route
10 - 20 mg
standardized extract
A long-term study of policosanol in the treatment of intermittent claudication
Effects of policosanol and lovastatin in patients with intermittent claudication: a double-blind comparative pilot study
A double-blind, placebo-controlled study of the effects of policosanol in patients with intermittent claudication
Effects of policosanol (10 mg/d) versus aspirin (100 mg/d) in patients with intermittent claudication: a 10-week, randomized, comparative study
Hypercholesterolemia ✪✪✪✪✪
Studies conducted by researchers in Cuba suggest that taking policosanol orally at a dose of 10 to 20 mg per day decreases total cholesterol by 9 to 29% and LDL cholesterol by 11 to 42%, and increases HDL cholesterol by 7 to 34%, in patients with hypercholesterolemia or dyslipidemia, with or without type 2 diabetes. A small number of studies conducted outside of Cuba have also found beneficial effects, notably in Argentina, Mexico, and China. However, the majority of research conducted outside of Cuba is contradictory. Research by German, Canadian, and Italian researchers has revealed that daily intake of 10 to 80 mg of policosanol derived from Cuban sugarcane does not significantly reduce total or LDL cholesterol. South African researchers found that taking a product containing policosanol derived from sugarcane manufactured in the United States at 20 mg per day for 12 weeks does not significantly reduce total or LDL cholesterol. American researchers also found that taking policosanol derived from U.S.-made sugarcane does not reduce total or LDL cholesterol compared to placebo. Researchers from the Netherlands found that policosanol derived from wheat germ, at 20 mg per day, did not significantly reduce cholesterol after 4 weeks of treatment. Several theories could explain this divergence, such as differences in purity and composition of different policosanol products, insufficient duration of trials, differences between subjects in trials, and of course, researcher bias. High-quality, independent, additional research is needed to clarify the potential benefits of policosanol.
Posologie
Oral route
10 - 80 mg
standardized extract
Comparative lipid-lowering effects of policosanol and atorvastatin: a randomized, parallel, double-blind, placebo-controlled trial
Effects of policosanol in patients with type II hypercholesterolemia and additional coronary risk factors
Effects of policosanol in older patients with type II hypercholesterolemia and high coronary risk
Sugar cane policosanol failed to lower plasma cholesterol in primitive, diet-resistant hypercholesterolemia: a double-blind, controlled study
Effect of sugar cane policosanol on lipid profile in primary hypercholesterolemia
Lack of cholesterol-lowering efficacy of Cuban sugar cane policosanols in hypercholesterolemic persons
Effect of policosanol on lipid levels among patients with hypercholesterolemia or combined hyperlipidemia: a randomized controlled trial
Effects of policosanol on older patients with hypertension and type II hypercholesterolemia
Policosanol for managing human immunodeficiency virus-related dyslipidemia in a medically underserved population: a randomized, controlled clinical trial
Effects of policosanol on postmenopausal women with type II hypercholesterolemia
Wheat germ policosanol failed to lower plasma cholesterol in subjects with normal to mildly elevated cholesterol concentrations
Low dose chromium-polynicotinate or policosanol is effective in hypercholesterolemic children only in combination with glucomannan
Comparative study of the efficacy and tolerability of policosanol and lovastatin in patients with hypercholesterolemia and noninsulin dependent diabetes mellitus
A comparative study of policosanol Versus acipimox in patients with type II hypercholesterolemia
Policosanol is ineffective in the treatment of hypercholesterolemia: a randomized controlled trial
Effects of a policosanol supplement on serum lipid concentrations in hypercholesterolemic and heterozygous familial hypercholesterolemic subjects
Modified-policosanol does not reduce plasma lipoproteins in hyperlipidemic patients when used alone or in combination with statin therapy
Effects of policosanol and lovastatin on lipid profile and lipid peroxidation in patients with dyslipidemia associated with type 2 diabetes mellitus
A comparison of the effects of D-003 and policosanol (5 and 10 mg/day) in patients with type II hypercholesterolemia: a randomized, double-blinded study
Antiplatelet effects of policosanol (20 and 40 mg/day) in healthy volunteers and dyslipidemic patients
Concomitant use of policosanol and beta-blockers in older patients
Properties
Anti-aggregate Platelets/Anticoagulant
Policosanol decreases platelet aggregation induced by arachidonic acid, adenosine diphosphate, and collagen. A clinical study showed that a dose of 20 mg/day of policosanol produces the same inhibitory effects on platelet aggregation as 100 mg of aspirin per day. A higher dose of 40 mg of policosanol seems not to produce additional antiplatelet effects according to another double-blind study. Thromboxane production, but not prostacyclin, induced by collagen is also inhibited by policosanol in clinical studies. Policosanol does not seem to have a significant effect on coagulation time.
Hypocholesterolemic
Policosanol may reduce cholesterol levels by inhibiting hepatic cholesterol synthesis and increasing the breakdown of low-density lipoproteins (LDL) cholesterol. In animal models, policosanol also seems to enhance the antioxidant, anti-glycation, and anti-atherosclerotic effects of high-density lipoprotein (HDL) cholesterol. Early human studies using Cuban sugarcane Policosanol showed a significant reduction in total cholesterol and LDL cholesterol; however, these results are questioned due to a multitude of negative clinical and experimental studies published since 2006, which have not been able to detect hypolipidemic activity for Cuban sugarcane Policosanol and other policosanol-based preparations.
Usages associés
Vascular Effect
Clinical research conducted in elderly patients with dyslipidemia shows that policosanol reduces circulating endothelial cell counts, which are a measure of vascular endothelial cell injury leading to atherosclerotic lesions. It also lowers homocysteine levels, thus reducing vascular inflammation and coronary lesions, and decreases C-reactive protein levels, indicating a reduction in chronic cardiovascular inflammation.
Usages associés
Safety dosage
Adult: 5 mg - 80 mg
Doses used in clinical trials range from 5 to 80 mg/day.
Interactions
Médicaments
Aspirin: moderate interaction
An increase in antiplatelet effects may develop - patients taking aspirin and policosanol together should be monitored for increased bleeding or bruising.
Warfarin: minor interaction
Some clinical research shows that taking policosanol at a dose of 10 to 50 mg per day for 7 to 15 days may inhibit platelet aggregation in healthy patients. A clinical trial (Carbajal et al 1998) showed that taking 10 mg of policosanol twice daily for two weeks before taking warfarin does not affect the pharmacokinetics of warfarin or the response to warfarin. Caution with doses > 10 mg/day.
Antiplatelet/Anticoagulant: moderate interaction
Some clinical research shows that taking policosanol at a dose of 10 to 50 mg per day for 7 to 15 days may inhibit platelet aggregation in healthy patients. In theory, taking policosanol with other antiplatelet or anticoagulant drugs could increase the risk of bruising and bleeding.
Selective beta-blocker: moderate interaction
Clinical research shows that policosanol, at a dose of 5 mg per day, may have additive hypotensive effects in hypertensive patients taking beta-blockers. Additionally, animal research shows that policosanol may enhance the hypotensive effects of propranolol. In theory, the concurrent use of policosanol and beta-blockers could have additive effects on lowering blood pressure.
Precautions
Surgical intervention: avoid
Policosanol has antiplatelet effects and may reduce blood glucose. Policosanol may cause excessive bleeding or increase the risk of hypoglycemia if used perioperatively. It is recommended to stop policosanol at least 2 weeks before surgery.
Blood clotting disorder: avoid
Policosanol has antiplatelet effects. Policosanol may cause excessive bleeding if used by patients with clotting disorders.
Pregnant women: avoid
No evidence of teratogenicity or any other embryotoxicity in animals.
Breastfeeding women: avoid
Avoid due to lack of information.
