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policosanol

C10AX08

Forms & Strengths

Oral tablets: 5 mg
Oral tablets: 10 mg
Oral tablets: 20 mg
Capsules: 10 mg
Capsules: 20 mg

Adult Dosing

Hypercholesterolemia: 10 mg to 20 mg orally once daily with an evening meal
Maximal studied dose: 20 mg orally once daily
Note: Efficacy and regulatory status vary significantly by jurisdiction as it is primarily marketed as a dietary supplement

Pediatric Dosing

Safety and efficacy not established in pediatric patients
Not recommended for use in children

Indications

Adjunct to dietary therapy for hypercholesterolemia
Reduction of serum total cholesterol and low-density lipoprotein cholesterol (LDL-C)
Commonly used as an over-the-counter nutraceutical or dietary supplement for lipid management

Mechanism of Action

Derived primarily from sugar cane wax (or beeswax, yam)
Inhibits hepatic cholesterol biosynthesis at a step upstream of HMG-CoA reductase
Upregulates hepatic LDL receptor processing to enhance LDL clearance from circulation
Exhibits mild antiplatelet activity via inhibition of thromboxane formation

Contraindications

Known hypersensitivity to policosanol or any component of the formulation
Pregnancy and lactation due to lack of safety data
Active liver disease or unexplained persistent elevations of serum transaminases

Adverse Reactions

Gastrointestinal: abdominal pain, nausea, diarrhea, dyspepsia
Nervous system: headache, dizziness, insomnia
Dermatologic: rash, pruritus
Musculoskeletal: myalgia (rare)

Drug Interactions

Anticoagulants and antiplatelet agents (e.g., aspirin, warfarin, clopidogrel): potential additive antiplatelet effects and increased bleeding risk
HMG-CoA reductase inhibitors (statins): potential additive lipid-lowering effects, though clinical synergy is not robustly established
CYP450 substrates: minimal known interactions, as policosanol does not significantly induce or inhibit major CYP enzymes

Curated Content: Needs Vetting Before Put to Clinical Use