Policosanol

Other names: Octacosanol, 1-Octacosanol, N-Octacosanol, Octacosyl Alcohol

Definition:
Policosanol (or polycosanol) is the generic term for a natural extract of plant waxes. It is used as a nutritional supplement to lower (bad) LDL cholesterol and increase (good) HDL cholesterol and to help prevent atherosclerosis. Independent clinical trials have failed to prove its efficacy.

Physical properties
Policosanol is a mixture of a few fatty alcohols derived from the waxes of such plants as sugar cane and yams, as well as beeswax. The most prevalent alcohol in policosanol is octacosanol, followed by triacontanol.(Formula CH3-(CH2)n-CH2OH n=24-34 )

There is a much lower concentration of several other fatty alcohols: behenyl alcohol, lignoceryl alcohol, ceryl alcohol, 1-heptacosanol, 1-nonacosanol, 1-dotriacontanol, and geddyl alcohol.

Policosanol is marketed by Cuba as a natural way to treat high cholesterol levels.

Modulation of HMG-CoA reductase and bile acid absorption inhibition have been proposed as mechanisms.

Policosanol, a dietary supplement, is a mixture of alcohols isolated from Cuban sugarcane wax. It contains about 60% octacosanol.

Because patent issue and the US trade embargo against Cuba, sugarcane policosanol is not widely available in the United States. Instead, policosanol products sold in the US are generally derived from beeswax and wheat germ.

Studies
Published studies have come to conflicting conclusions regarding the efficacy of policosanol in lowering LDL (i.e., “bad cholesterol”) or raising HDL (i.e., “good cholesterol”). Despite a number of studies funded by the Cuban government (which also produces and markets the drug), no independent clinical trials have found any evidence of the efficacy of Policosanol.

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Evidence for Policosanol
Policosanol has been touted as a dietary supplement that can lower cholesterol as well as statin drugs, without the side effects. Studies indicate that it works by inhibiting cholesterol formation in the liver.

However, almost all of the 80+ double-blind studies on sugarcane policosanol were conducted by a single research group in Cuba that owns the policosanol patent.

An independent study published in the Journal of the American Medical Association in 2006 did not find any benefit of policosanol, even at high doses, on cholesterol profile. This finding has casted some doubt on the reliability of the Cuban research on policosanol.

Dosage Information
A typical dosage of policosanol used in studies has been 5 to 10 mg two times a day. Studies generally found that it can take up to two months to notice benefits.

Side Effects of Policosanol
Although the reliability of the Cuban studies has been questioned, side effects of policosanol reported in the trials have generally been mild and short-term. They have included indigestion, skin rash, headache, insomnia, and weight loss.

Possible Drug Interactions
Policosanol may increase the effect of medications that interfere with blood clotting or anti-platelet drugs, such as aspirin, warfarin (Coumadin), heparin, clopidogrel (Plavix), ticlopidine (Ticlid), or pentoxifylline (Trental), or supplements such as garlic, ginkgo, or high-dose vitamin E.

Policosanol may increase the effects and side effects of levodopa, a medication used for Parkinson’s disease.

Production
Policosanol (PPG) is produced, promoted and studied extensively in Cuba, where pharmaceutical research and sugar cane farms both exist in abundance. The supplement is used as a panacea by some Cubans.

Resources:
http://en.wikipedia.org/wiki/Policosanol
http://altmedicine.about.com/od/policosanol/a/policosanol.htm

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