Policosanol belongs to a family of wax-like phytochemicals prevalent throughout nature. This substance is used in the dietary supplement industry sourced from several foods that include: sugar cane, rice bran, beeswax, broccoli, spinach, alfalfa and oats.
Sugar cane derived policosanol is a new face on the cholesterol scene in the United States but is a popular hypocholesterolemic in other countries. The main policosanol form in sugar cane is octacosanol, a long-chain fatty alcohol found in the waxy film that covers the leaves and fruit of the plants that contain it.
Policosanol is a hypocholesterolemic compound that protects LDL cholesterol against oxidation, inhibits thromboxane, discourages blood clot formation when inhibits platelet aggregation, and increases exercise tolerance. Policosanol, at clinically evaluated dosages, has shown cholesterol-lowering properties comparable to low to medium dosage levels of the statins. According to several studies, policosanol has also shown antiplatelet effects, it prevents lipoprotein peroxidation, and beneficially affects atherosclerosis development. It has good tolerability and a low rate of clinical and laboratory adverse effects.
Policosanol is an effective alternative to lowering cholesterol for many people. In a study, 20 mg a day (over a 6- to 12-week period) resulted in the following lipid improvements: LDL cholesterol reduced about 28%, total cholesterol about 20%, and HDL increased by 7-10%. Triglycerides were unaffected. During the course of the trial, participants continued on a low cholesterol diet. In other studies policosanol was shown to lower triglycerides as well as lowering total and LDL cholesterol and raising HDL cholesterol.
Aleman CL, Mas R, Hernandez C, et al. A 12 months study of policosanol oral toxicity in Sprague-Dawley rats. Toxicol Lett 1994;70: 77-87.
Arruzazabala M.L.; Molina V.; Mas R.; Fernández L.; Carbajal D.; Valdés S.; Castaño G. Antiplatelet effects of policosanol (20 and 40 mg/day) in healthy volunteers and dyslipidaemic patients, Clinical and Experimental Pharmacology and Physiology, Volume 29, Number 10, October 2002, pp. 891-897(0).
Canetti MM, Moreira M, Mas R, et al. Effects of policosanol on primary hypercholesterolemia: a 3-year open extension follow-up. Curr Ther Res 1997;58:868-75.
Castaño G.; Mas R.; Fernández L.; Illnait J.; Mesa M.; Alvarez E.; Lezcay M. Comparison of the Efficacy and Tolerability of Policosanol with Atorvastatin in Elderly Patients with Type II Hypercholesterolaemia, Drugs & Aging, Volume 20, Number 2, 2003, pp. 153-163(11).
Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Summary of the second report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel II). JAMA 1993;269:3015-23.
Expert Panel. Report of the National Cholesterol Education Program Expert Panel on detection, evaluation, and treatment of high blood cholesterol in adults. Arch Intern Med 1988;148:36-69.
Gonzales Canavaciolo VL, Magraner Hernandez J. Validation of a gas chromatographic method for determining fatty alcohols that compose policosanol in five-milligram film-coated tablets. J AOAC Int 1999;82:834-9.
Gonzales-Bravo D, Magraner-Hernandez J, Acosta-Gonzales PC, et al. Analytical procedure for the determination of 1-octacosanol in plasma by solvent extraction and capillary gas chromatography. J Chromatr 1996;682:359-63.
Gould AL, Rossouw JE, Santanello NC, et al. Cholesterol reduction yields clinical benefit: a new look at old data. Circulation 1995; 91:2274-82.
Ichihara K, Kusunose E, Noda Y, et al. Some properties of the fatty alcohol oxidation system and reconstitution of microsomal oxidation activity in intestinal mucosa. Biochim Biophys Acta 1986;878: 412-8.
Ioanna Gouni-Berthold , MD ,a and Heiner K. Berthold, MD, PhDb, Policosanol: Clinical pharmacology and therapeutic significance of a new lipid-lowering agent. Rotenburg an der Fulda and Bonn, Germany. American Heart Journal, February 2002.
Jenkins AJ. Might money spent on statins be better spent? BMJ, Oct 2003; 327: 933-b.
Kabir Y, Kimura S. Biodistribution and metabolism of orally administered octacosanol in rats. Ann Nutr Metab 1993;37:33-8.
Kannel WB, Castelli WP, Gordon T, et al. Lipoprotein cholesterol in the prediction of atherosclerotic disease: new perspectives based on the Framingham Heart Study. Ann Intern Med 1995;90:85-91.
Kawamura N, Moser HW, Kishimoto Y. Very long chain fatty acid oxidation in rat liver. Biochem Biophys Res Commun 1981;99: 1216-25.
Más R.; Castaño G.; Fernández L.; Illnait J.; Fernández J.; Alvarez E. Effects of Policosanol on Lipid Profile and Cardiac Events in Older Hypercholesterolaemic Patients with Coronary Disease, Clinical Drug Investigation, Volume 21, Number 7, 1 July 2001, pp. 485-497(13).
Menendez R, Amor AM, Gonzalez RM, et al. Effect of policosanol on the hepatic cholesterol biosynthesis of normocholesterolemic rats. Biol Res 1996;29:253-7.
Menendez R, Arruzazabala L, Mas R, et al. Cholesterol-lowering effect of policosanol on rabbits with hypercholesterolaemia induced by a wheat starch-casein diet. Br J Nutr 1997;77:923-32.
Menendez R, Fernandez SI, Del Rio A, et al. Policosanol inhibits cholesterol biosynthesis and enhances low density lipoprotein processing in cultured human fibroblasts. Biol Res 1994;27:199-203.
Menendez R, Sotolongo V, Fraga V, et al. Plasma levels and excretion of total radioactivity in healthy volunteers after oral administration of 3H-octacosanol. Rev CNIC Cien Biol 1996;27:32-5.
Pearson TA, Laurora I, Chu H, et al. The lipid treatment assessment project (L-TAP)—a multicenter survey to evaluate the percentages of low-density lipoprotein cholesterol goals. Arch Intern Med 2000; 160:459-67.
Pons P, Rodriguez M, Robaina C, et al. Effects of successive dose increases of policosanol on the lipid profile of patients with type II hypercholesterolemia and tolerability to treatment. Int J Clin Pharm Res 1994; 14:27-33.
Rizzo WB, Craft DA, Dammann AL, et al. Fatty alcohol metabolism in cultured human fibroblasts: evidence for a fatty alcohol cycle. J Biol Chem 1987;262:17412-9.
Rodriguez MD, Garcia H. Evaluation of peri- and post-natal toxicity of policosanol in rats. Teratog Carcinog Mutagen 1998;18: 1-7.
Rodriguez MD, Garcia H. Teratogenic and reproductive studies of policosanol in the rat and rabbit. Teratog Carcinog Mutagen 1994;14:107-13.
Rodriguez MD, Sanchez M, Garcia H. Multigenerational reproduction study of policosanol in rats. Toxicol Lett 1997;90:97-106.
Sacks FM, et al. The Effect of Pravastatin on Coronary Events after Myocardial Infarction in Patients with Average Cholesterol Levels. New England Journal of Medicine, Oct 3, 1996; 335 (14): 1001-1009.
Scandinavian Simvastatin Survival Study Group. Randomized trial of cholesterol lowering in 4444 patients with coronary heart disease: the Scandinavian Simvastatin Survival Study (4S). Lancet, 1994. 344; 1383-1389.
Sempos CT, Cleeman JI, Carroll MD, et al. Prevalence of high blood cholesterol among US adults: an update based on guidelines from the second report of the National Cholesterol Education Program Adult Treatment Panel. JAMA 1993;269:3009-14.
Sever PS, et al. Prevention of coronary and stroke events with atorvastatin in hypertensive patients who have average or lower-than-average cholesterol concentrations, in the Anglo-Scandinavian Cardiac Outcomes Trial--Lipid Lowering Arm (ASCOT-LLA): a multicentre randomized controlled trial. Lancet, 2003 Apr 5;361(9364):1149-58.
Singh H, Derwas N, Poulos A. Very long chain fatty acid beta-oxidation by rat liver mitochondria and peroxisomes. Arch Biochem Biophys 1987;259:382-90.
The Long-Term Intervention with Pravastatin In ischemic Disease (LIPID) Study Group. Prevention of cardiovascular events and death with pravastatin in patients with coronary heart disease and a broad range of initial cholesterol levels. New England Journal of Medicine, 1998. Vol. 339: 1349-1357.
Zardoya R, Tula L, Castano G, et al. Effects of policosanol on hypercholesterolemic patients with abnormal serum biochemical indicators of hepatic function. Curr Ther Res 1996;57:568-77.