Policosanol

Policosanol/Drug Interactions:

  • Alzheimer's agentsAlzheimer's agents: Policosanol has been suggested as a potential therapy for use in slowing the progression of Alzheimer's disease (67). Concomitant use with other agents used for this may result in additive or synergistic effects.
  • Anticoagulants andantiplateletsAnticoagulants andantiplatelets: Several human and animal studies suggest a theoretical interaction with anticoagulant and antiplatelet agents due to policosanol's potential ability to inhibit platelet aggregation (42; 43; 44; 45; 46; 47; 48; 31; 46; 24; 27; 29; 39; 49). However, clinical significance is unclear.
  • Antidiabetic agentsAntidiabetic agents: Policosanol 10mg daily administered to elderly patients with type 2 hyperlipidemia significantly reduced glucose levels but was not found to influence glycemic control of patients with type 2 diabetes (30; 41).
  • Antilipemic agents, bile acid sequestrantsAntilipemic agents, bile acid sequestrants: Theoretically, concomitant use of antilipemic agents with policosanol may result in additive hypocholesterolemic effects. There is controversy in this area because several recent studies have not found significant changes in lipid levels with the use of policosanol (14; 15; 16; 13).
  • Beta-blockers, antihypertensivesBeta-blockers, antihypertensives: Several clinical studies have shown that policosanol decreased arterial pressure compared with placebo and a pharmacological interaction with beta-blockers has been shown (28; 3; 5). Pretreatment with high doses of policosanol significantly increased propranolol-induced hypotensive effects in animal study (63).
  • Calcium channel blockers (nifedipine)Calcium channel blockers (nifedipine): The activity of nifedipine remained unchanged in animals treated with a high dose of policosanol (200mg/kg) (63). Information regarding potential interactions with other calcium channel blockers is currently lacking.
  • Cardiovascular agentsCardiovascular agents: Numerous studies suggest that policosanol may reduce total cholesterol and LDL-C as well as ratios of LDL-C to HDL-C and total cholesterol to HDL-C and may increase HDL-C (11; 45; 23; 9; 25; 54; 26; 7; 4; 28; 29; 30; 31; 3; 18; 10; 8; 35; 36; 5; 37). Policosanol may also lower the risk of CHD by reducing systolic and diastolic blood pressure (28; 3).
  • Cytochrome P450 metabolized agentsCytochrome P450 metabolized agents: Experimental data indicate that potential DDI between policosanol and drugs metabolized through the cytochrome P450 hepatic system are not expected, but cannot be excluded (3).
  • Ezetimibe (Zetia?)Ezetimibe (Zetia?): Theoretically, the concomitant use of ezetimibe with policosanol may result in additive hypocholesterolemic effects (62).
  • Neurologic agentsNeurologic agents: Policosanol has been suggested as a potential therapy for use in slowing the progression of Alzheimer's disease (67). Concomitant use with other agents used for this may result in additive or synergistic effects.
  • Nicotinic acid, Acipimox? (synthetic nicotinic acid)Nicotinic acid, Acipimox? (synthetic nicotinic acid): Theoretically, the concomitant use of policosanol and acipimox may result in additive interactions, due to acipimox's cholesterol-lowering activity (11).
  • Nitrates (nitroprusside)Nitrates (nitroprusside): Because policosanol possesses an antioxidant effect and nitric oxide (NO) can be destroyed by oxygen-derived radicals, there is a theoretical interaction between policosanol and nitroprusside. Pretreatment with single doses of policosanol significantly increased the nitroprusside-induced hypotensive effect in rats (45).
  • Statins(Lovastatin, Atorvastatin, Simvastatin, Pravastatin)Statins(Lovastatin, Atorvastatin, Simvastatin, Pravastatin): Theoretically, concomitant use of policosanol and statins may result in additive hypocholesterolemic effects (7; 29; 30; 10; 36; 12). There is controversy in this area because several recent studies have not found significant changes in lipid levels with the use of policosanol (14; 15; 16; 13).

    • Policosanol/Herb/Supplement Interactions:

  • Alzheimer's herbsAlzheimer's herbs: Policosanol has been suggested as a potential therapy for slowing the progression of Alzheimer's disease (67). Concomitant use with other herbs used for this may result in additive or synergistic effects.
  • Anticoagulants and antiplateletsAnticoagulants and antiplatelets: Several human and animal studies suggest a theoretical interaction with anticoagulant and antiplatelet agents due to policosanol's potential ability to inhibit platelet aggregation (42; 43; 44; 45; 46; 47; 48; 31; 46; 24; 27; 29; 39; 49). However, clinical significance is unclear.
  • Antilipemics (plant sterols, plant stanols, polyphenols, psyllium, soy proteins, soy isoflavones, red yeast, garlic powder)Antilipemics (plant sterols, plant stanols, polyphenols, psyllium, soy proteins, soy isoflavones, red yeast, garlic powder): Theoretically, additive hypocholesterolemic effects of antilipemics are possible when used with herbs that decrease cholesterol levels (9; 25; 26; 10; 35; 36; 5; 37). However, there is controversy in this area because several more recent studies have not found significant changes in lipid levels with the use of policosanol (14; 15; 16; 13).
  • Cardiovascular herbs and supplementsCardiovascular herbs and supplements: Numerous studies suggest that policosanol may reduce total cholesterol and LDL-C as well as ratios of LDL-C to HDL-C and total cholesterol to HDL-C; it may also increase HDL-C (11; 45; 23; 9; 25; 54; 26; 7; 4; 28; 29; 30; 31; 3; 18; 10; 8; 35; 36; 5; 37). Policosanol may also lower the risk of CHD by reducing systolic and diastolic blood pressure (28; 3).
  • Cytochrome P450 metabolized herbs and supplementsCytochrome P450 metabolized herbs and supplements: Experimental data indicate that potential DDI between policosanol and drugs metabolized through the cytochrome P450 hepatic system are not expected, but cannot be excluded (3).
  • ExcipientsExcipients: No chemical interaction has been shown between policosanol and excipients (68). Excipients are inert substances added to a drug to give suitable consistency or form to the drug.
  • HypoglycemicsHypoglycemics: Policosanol 10mg daily administered to elderly patients with type 2 hyperlipidemia significantly reduced glucose levels but was not found to influence glycemic control of patients with type 2 diabetes (30; 41).
  • HypotensivesHypotensives: Theoretically, additive hypotensive effects are possible when used with herbs that lower blood pressure (28; 3; 5).
  • Neurologic herbs and supplementsNeurologic herbs and supplements: Policosanol has been suggested as a potential therapy for slowing the progression of Alzheimer's disease (67). Concomitant use with other herbs used for this may result in additive or synergistic effects.
  • Omega-3 fatty acids/fish oilOmega-3 fatty acids/fish oil: Concurrent therapy with policosanol and omega-3 fatty acids has shown an additive lowering effect on the lipid profile and platelet aggregation in rabbits (58).

    • Policosanol/Food Interactions:

  • FishFish: Concurrent therapy with policosanol and omega-3 fatty acids, derived from fish, has shown an additive lowering effect on the lipid profile and platelet aggregation in rabbits (58).
  • Potato pulp fermented with , vegan foods, oat bran, flaxseed, garlicPotato pulp fermented with Rhizopus oryzae, vegan foods, oat bran, flaxseed, garlic: Theoretically, additive hypocholesterolemic effects are possible with policosanol, due to the significant amounts of policosanol found in these products (69; 70).

    • Policosanol/Lab Interactions:

  • ASTAST: Policosanol 10mg administered to elderly patients with type II hyperlipidemia significantly reduced AST levels (30).
  • Blood pressureBlood pressure: Reductions in systolic and diastolic blood pressure were observed in patients taking 5-10mg of policosanol (28; 3; 5). However, single doses of policosanol (25, 50, and 200mg/kg) orally administered to spontaneously hypertensive rats (SHR) did not significantly change arterial pressure (63).
  • Coagulation panelCoagulation panel: Several human and animal studies suggest a theoretical interaction with anticoagulants and antiplatelets due to policosanol's potential ability to inhibit platelet aggregation (42; 43; 44; 45; 46; 47; 48; 31; 46; 24; 27; 29; 39; 49). However, clinical significance is unclear.
  • Creatine phosphokinase (CPK)Creatine phosphokinase (CPK): Policosanol 10mg administered to elderly patients with type 2 hyperlipidemia significantly reduced CPK levels (30).
  • GlucoseGlucose: Policosanol 10mg daily administered to elderly patients with type 2 hyperlipidemia significantly reduced glucose levels but was not found to influence glycemic control of patients with type 2 diabetes (30; 41).
  • 6-keto-PGF1 alpha (prostacyclin)6-keto-PGF1 alpha (prostacyclin): In animal study, policosanol significantly increased 6-keto-PGF1 alpha levels (42; 48). A two-week human study of 10mg policosanol found no effect on the level of prostacyclin (46).
  • Lipid panelLipid panel: In clinical study, policosanol 5-40mg significantly reduced total cholesterol, LDL-C, and the ratios of LDL-C to HDL-C and total cholesterol to HDL-C and increased HDL-C (11; 45; 23; 9; 25; 54; 26; 7; 4; 28; 29; 30; 31; 3; 18; 10; 8; 35; 36; 5; 37). However, there is controversy in this area because other studies have not found significant changes in lipid levels (14; 15; 16; 13).
  • Malondialdehyde (MDA)Malondialdehyde (MDA): Policosanol reduced malondialdehyde (MDA) serum levels in animals and humans (45).
  • Serum creatinineSerum creatinine: Policosanol has been shown to significantly reduce creatinine values (11).
  • Specific activity scaleSpecific activity scale: A test of cardiovascular capacity was significantly improved in patients after a year of therapy with policosanol 5-10mg (27).
  • ThromboxaneThromboxane: Policosanol reduced thromboxane A (2) serum levels in animals and humans (42; 45).
  • TriglyceridesTriglycerides: No change in triglyceride levels was observed in a several clinical trials (23; 26; 31; 10). In a three year clinical trial, triglyceride levels decreased in patients treated with policosanol 5mg (30; 3). Policosanol 10mg administered to patients for eight weeks decreased serum triglycerides (7).