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Note: Virtually all statements regarding the safety of policosanol derive from studies reported by the patent-holding Cuban research group. Since the reliability of these researchers is now in question, all of the statements below are similarly open to question.
Given the above caveat, policosanol is said to be safe at the maximum recommended dose. In double-blind trials, only mild short-term side effects have been reported, such as nervousness, headache, diarrhea, and insomnia. A safety study of 27,879 people followed for 2 to 4 years showed that use of policosanol produced adverse effects in only 0.31% of participants, primarily weight loss, excessive urination, and insomnia. 1 In animal studies, no toxic signs were seen even at 620 times the maximum recommended dose. 2 In addition, policosanol does not adversely affect the liver. 3 Finally, policosanol does not interact with three types of medications used for high blood pressure: calcium-channel antagonists, diuretics, and beta-blockers. 4 On the other hand, policosanol may be a "blood thinner," 5 and it appears to enhance the blood-thinning effects of aspirin, 6 though at least one study failed to confirmed this adverse effect. 7 Still, to be on the safe side, policosanol should not be combined with aspirin or other blood-thinning drugs, such as warfarin (Coumadin), heparin , clopidogrel (Plavix), ticlopidine (Ticlid), or pentoxifylline (Trental). There is also at least a remote chance that it might cause excessive bleeding if combined with natural supplements that thin the blood, such as garlic , ginkgo , and high-dose vitamin E . Similarly, individuals with clotting problems should avoid policosanol, and the supplement should not be used during the period immediately prior to or following surgery or labor and delivery.
One non-Cuban report suggests that policosanol might increase the action of levodopa, a medication used for Parkinson's disease, leading to increased side effects called dyskinesias.
The maximum safe dosages for young children, pregnant or nursing women, or individuals with severe liver or kidney disease have not been established.
Interactions You Should Know About
Do not use policosanol except on medical advice if you are taking:
- Blood-thinning medications, for example:
- Aspirin , warfarin (Coumadin) , heparin , clopidogrel (Plavix), ticlopidine (Ticlid), or pentoxifylline (Trental)
- Natural supplements that thin the blood, for example:
Keep in mind that policosanol may increase both the effects and side effects of:
- Fernandez L, Mas R, Illnait J, et al. Policosanol: results of a postmarketing surveillance control on 27,879 patients. Curr Ther Res. 1998;59:717-722.
- Rodriguez-Echenique C, Mesa R, Mas R, et al. Effects of policosanol chronically administered in male monkeys (Macaca arctoides). Fd Chem Toxic. 1994;32:565-575.
- Zardoya R, Tula L, Castano G, et al. Effects of policosanol on hypercholesterolemic abnormal serum biochemical indicators of hepatic function. Curr Ther Res. 1996;57:568-577.
- Castano G, Tula L, Canetti M, et al. Effects of policosanol in hypertensive patients with type II hypercholesterolemia. Curr Ther Res. 1996;57:691-699.
- Castaño G, Más R, Arruzazabala ML, Noa M, Illnait J, Fernández JC, Molina V, Menéndez A. Effects of policosanol and pravastatin on lipid profile, platelet aggregation and endothelemia in older hypercholesterolemic patients. Int J Clin Pharmacol Res. 19(4):105-16.
- Arruzazabala ML, Valdés S, Más R, Carbajal D, Fernández L. Comparative study of policosanol, aspirin and the combination therapy policosanol-aspirin on platelet aggregation in healthy volunteers. Pharmacol Res. 36(4):293-7.
- Reiner Z, Tedeschi-Reiner E. Rice policosanol does not have any effects on blood coagulation factors in hypercholesterolemic patients. Coll Antropol. 2007;31:1061-1064.
- Snider SR. Octacosanol in parkinsonism [letter]. Ann Neurol. 1984;16:723.