policosanol (generic name)
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Adults (18 years and older):
Typical doses of policosanol are between 5-40 milligrams daily. Policosanol appears safe in these doses for up to three years. Based on the available evidence, this dose range is considered safe and effective in patients with coronary heart disease and for patients with type II hypercholesterolemia (high cholesterol). Doses as high as 80 grams of policosanol have been taken daily for 12 weeks to treat high cholesterol. For platelet aggregation, 10-40 milligrams daily has been taken. For intermittent claudication, 10-20 milligrams has been used, and for hypertension (high blood pressure), a lower dose of 5-10 milligrams daily has been taken.
Children (younger than 18 years):
There is no proven safe or effective dose for policosanol in children.
SafetyDISCLAIMER: Many complementary techniques are practiced by healthcare professionals with formal training, in accordance with the standards of national organizations. However, this is not universally the case, and adverse effects are possible. Due to limited research, in some cases only limited safety information is available.
Avoid in individuals with a known allergy or hypersensitivity to policosanol.
Side Effects and Warnings
Policosanol is generally regarded as safe and well tolerated. However, there are a few, minor drug-related clinical or biochemical adverse effects observed in clinical trials. Frequency of mild, moderate and serious adverse events, as well a death rate, has been shown to be lower in diabetic and non-diabetic individuals taking policosanol compared with placebo.
Policosanol may cause erythema (reddening of the skin), gum bleeding, headache, vertigo, or heartburn. Use cautiously in patients taking aspirin due to potential additive platelet inhibition and risk of bleeding. Also use caution in patients with high blood pressure or those taking agents to lower blood pressure due to a potential additive effect. Side effects of Octa-60g (a combination product including policosanol) may include skin rash, and increased glucose and alanine aminotransferase.
Pregnancy and Breastfeeding
Policosanol is not recommended in pregnant or breastfeeding women due to a lack of available scientific evidence. Although not well studied in humans, policosanol does not appear to affect reproductive performance, fetal/neonatal development, or breastfeeding. Additional study is needed in this area.
Interactions with Drugs
In theory, policosanol may interact additively with nicotinic acid (Acipimox®) or synthetic nicotinic acid due to Acipimox®'s cholesterol-lowering activity. Caution is advised in patients taking other cholesterol-lowering agents. In theory, bile acid sequestrants/resins, ezetimibe (Zetia®), or statins (lovastatin, atorvastatin, simvastatin, pravastatin) may have an additive cholesterol-lowering effect when given with policosanol.
Policosanol may increase the risk of bleeding when taken with drugs that increase the risk of bleeding. Some examples include aspirin, anti-platelet drugs such as clopidogrel (Plavix®), and non-steroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®, Aleve®). The addition of policosanol to warfarin therapy did not enhance the prolongation of the bleeding time induced by warfarin alone.
Policosanol may decrease arterial pressure, and thus may have additive effects with beta-blockers, or other blood pressure-lowering agents. Medication adjustments may be necessary.
Although not well studied in humans, the activity of nifedipine remained unchanged in animals treated with a high dose policosanol. There is no information regarding potential interaction with other calcium channel blockers.
Because policosanol possesses an antioxidant effect and nitric oxide can be destroyed by oxygen-derived radicals, there is a theoretical interaction between policosanol and nitroprusside and other nitrates. Consult with a qualified healthcare professional, including a pharmacist, to check for any interactions.
In theory, taking ticlopidine and policosanol together may cause an additive interaction.
Although not well studied in humans, policosanol may also interact with agents broken down by the liver, or agents taken for Alzheimer's disease, cardiovascular disorders, diabetes or neurologic disorders.
Interactions with Herbs and Dietary Supplements
In theory, there may be an additive hypotensive (blood pressure lowering) effect when policosanol is used with herbs that lower blood pressure.
In theory, additive hypocholesterolemic (cholesterol-lowering) effects may occur when policosanol is used with herbs that decrease cholesterol levels, such as plant sterols, plant stanols, polyphenols, psyllium, soy proteins, soy isoflavones, red yeast, or garlic powder.
Although not well studied in humans, policosanol may also interact with herbs and supplements broken down by the liver, or herbs and supplements taken for Alzheimer's disease, cardiovascular disorders, diabetes or neurologic disorders.