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{{SI}}
{{Drugbox
| verifiedrevid = 447377111
| IUPAC_name = Octacosanol, triacontanol, etc.
| image = Fatty alcohol - generic.png


{{CMG}} {{AE}}{{SS}}
<!--Clinical data-->
| tradename = 
| Drugs.com = {{drugs.com|international|policosanol}}
| pregnancy_AU = <!-- A / B1 / B2 / B3 / C / D / X -->
| pregnancy_US = <!-- A / B            / C / D / X -->
| pregnancy_category = 
| legal_AU = <!-- S2, S3, S4, S5, S6, S7, S8, S9 or Unscheduled-->
| legal_CA = <!-- Schedule I, II, III, IV, V, VI, VII, VIII -->
| legal_UK = <!-- GSL, P, POM, CD, or Class A, B, C -->
| legal_US = <!-- OTC / Rx-only / Schedule I, II, III, IV, V -->
| legal_status = 
| routes_of_administration =


{{Editor Join}}
<!--Pharmacokinetic data-->
| bioavailability = 
| protein_bound = 
| metabolism = 
| elimination_half-life = 
| excretion =


==Overview==
<!--Identifiers-->
'''Policosanol''' (or '''polycosanol''') is the generic term for a natural extract of plant [[wax]]es. It is used as a [[nutritional supplement]] to lower (bad) [[LDL cholesterol]] and increase (good) [[HDL cholesterol]] and to help prevent [[atherosclerosis]].
| CAS_number_Ref = {{cascite|correct|??}}
| CAS_number = 142583-61-1
| ATC_prefix = C10
| ATC_suffix = AX08
| PubChem =
| DrugBank_Ref = {{drugbankcite|correct|drugbank}}
| DrugBank =
 
<!--Chemical data-->
| chemical_formula = CH<sub>3</sub>-(CH<sub>2</sub>)<sub>n</sub>-CH<sub>2</sub>OH n=24-34
 
| molecular_weight = (variable)
}}
 
'''Policosanol'''{{Pronunciation-needed}} (or '''polycosanol''') is the generic term for a natural mixture of long chain alcohols extracted from plant [[wax]]es. It is used as a [[nutritional supplement]] intended to lower [[LDL cholesterol]] ("bad" cholesterol) and increase [[HDL cholesterol]] ("good" or "healthy" cholesterol) and to help prevent [[atherosclerosis]], though some studies have raised questions about the effectiveness of policosanol.


== Physical properties ==
== Physical properties ==


Policosanol is a mixture of a few [[fatty alcohol]]s 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]].  
Policosanol is a mixture of a few [[fatty alcohol]]s derived from the waxes of such plants as [[sugar cane]]<ref name="pmid17298709">{{cite journal |author=Marinangeli CP, Kassis AN, Jain D, Ebine N, Cunnane SC, Jones PJ |title=Comparison of composition and absorption of sugarcane policosanols |journal=[[Br. J. Nutr.]] |volume=97 |issue=2 |pages=381–8 |year=2007 |pmid=17298709 |doi=10.1017/S0007114507336763 |url=http://journals.cambridge.org/abstract_S0007114507336763 |format=abstract}}</ref> and [[yam (vegetable)|yams]], as well as [[beeswax]].{{cn|date=October 2013}}{{clarify|reason=beeswax contains very little free alcohol|date=October 2013}} The most prevalent alcohol in policosanol is [[octacosanol]],<ref name="pmid18385828">{{cite journal |author=Ohta Y, Ohashi K, Matsura T, Tokunaga K, Kitagawa A, Yamada K |title=Octacosanol attenuates disrupted hepatic reactive oxygen species metabolism associated with acute liver injury progression in rats intoxicated with carbon tetrachloride |journal=J Clin Biochem Nutr |volume=42 |issue=2 |pages=118–25 |year=2008 |pmid=18385828 |doi=10.3164/jcbn.2008017 |url= |pmc=2266062}}</ref> followed by [[triacontanol]].
 
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]].


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.
Modulation of [[HMG-CoA reductase]]<ref name="pmid16714400">{{cite journal |author=Singh DK, Li L, Porter TD |title=Policosanol inhibits cholesterol synthesis in hepatoma cells by activation of AMP-kinase |journal=J. Pharmacol. Exp. Ther. |volume=318 |issue=3 |pages=1020–6 |year=2006 |pmid=16714400 |doi=10.1124/jpet.106.107144 |url=http://jpet.aspetjournals.org/cgi/pmidlookup?view=long&pmid=16714400}}</ref> and [[bile acid]] absorption inhibition<ref name="pmid16076108">{{cite journal |author=Ng CH, Leung KY, Huang Y, Chen ZY |title=Policosanol has no antioxidant activity in human low-density lipoprotein but increases excretion of bile acids in hamsters |journal=J. Agric. Food Chem. |volume=53 |issue=16 |pages=6289–93 |year=2005 |pmid=16076108 |doi=10.1021/jf051269a}}</ref> have been proposed as mechanisms.


== Studies ==
== Studies ==
Policosanol is touted as a natural way to treat high cholesterol levels.  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").<ref name="negative">{{cite journal
Published studies have come to conflicting conclusions regarding the [[efficacy]] of policosanol in lowering [[Low-density lipoprotein|LDL]] (i.e., "bad cholesterol") or raising [[High density lipoprotein|HDL]] (i.e., "good cholesterol").,<ref name="negative">{{cite journal
  | author = Heiner K. Berthold, MD, PhD; Susanne Unverdorben, MD; Ralf Degenhardt, PhD; Michael Bulitta, Dipl-Stat; Ioanna Gouni-Berthold, MD  
  | author = Heiner K. Berthold, MD, PhD; Susanne Unverdorben, MD; Ralf Degenhardt, PhD; Michael Bulitta, Dipl-Stat; Ioanna Gouni-Berthold, MD  
  | date = May 17, 2006
  | date = May 17, 2006
Line 22: Line 57:
  | volume = 295
  | volume = 295
  | issue = 19
  | issue = 19
  | pages = 2262-2269
  | pages = 2262–2269
  | url = http://jama.ama-assn.org/cgi/content/abstract/295/19/2262
  | url = http://jama.ama-assn.org/cgi/content/abstract/295/19/2262
| accessdate = 2006-10-03
| pmid = 16705107
| doi = 10.1001/jama.295.19.2262
  }}</ref><ref name="positive">{{cite journal
  }}</ref><ref name="positive">{{cite journal
  | author = Pons P, Rodriguez M, Robaina C, Illnait J, Mas R, Fernandez L, Fernandez JC.
  | author = Pons P, Rodriguez M, Robaina C, Illnait J, Mas R, Fernandez L, Fernandez JC.
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  | volume = 14
  | volume = 14
  | issue = 1
  | issue = 1
  | pages = 27-33
  | pages = 27–33
  | id = PMID 7927958
  | pmid = 7927958
  }}</ref> Many of the studies that have found positive effects of policosanol have come from one group in Cuba, whose research has been funded by Dalmer Laboratories (aka Laboratorios Dalmer).  This company was created by the National Center for Scientific Research in Havana, Cuba specifically to market policosanol.  Cuba produces sugar cane, one of the sources of policosanol.  A German study failed to find evidence of cholesterol-lowering effects. In this study, 143 participants with hypercholesterolemia or combined hyperlipidemia were randomly assigned to policosanol at doses of 10, 20, 40 or 80 milligrams daily or placebo. After 12 weeks, the researchers found no statistically or clinically significant effect on LDL-C, HDL-C, total cholesterol, triglycerides, or lipoproteins.  In other words they found policosanol to be of no clinical value.<ref name="negative" />
| accessdate =
 
  }}</ref><ref name="pmid15767233">{{cite journal |author=Chen JT, Wesley R, Shamburek RD, Pucino F, Csako G |title=Meta-analysis of natural therapies for hyperlipidemia: plant sterols and stanols versus policosanol |journal=Pharmacotherapy |volume=25 |issue=2 |pages=171–83 |year=2005 |pmid=15767233 |doi=10.1592/phco.25.2.171.56942 |url= }}</ref> despite a number of studies funded by the Cuban government, which produces and markets the drug.<ref>{{cite journal | journal = Nature Biotechnology | volume = 22 | issue = 12s | pages = DC19–DC24 | year = 2004 | doi = 10.1038/nbt1204supp-DC19 | title = Cuba—innovation through synergy | url = http://www.nature.com/nbt/journal/v22/n12s/fig_tab/nbt1204supp-DC19_T1.html | author = Thorsteinsdóttir, Halla | pmid = 15583679 | last2 = Sáenz | first2 = TW | last3 = Quach | first3 = U | last4 = Daar | first4 = AS | last5 = Singer | first5 = PA}}</ref> Older independent clinical trials found no evidence of the efficacy of policosanol,<ref name="negative"/> while more recent studies have found effect.<ref>{{Cite pmid|23302671}}</ref><ref>{{Cite pmid|23018482 }}</ref>
As this is sometimes a Cuban product, there is controversy from the USA. (Please note that Nature's Life sells Policosanol 23 mg that is manufactured by NutraPure, Inc. in California, and states "Made with Pride in the USA".) Resistance to the acceptance of Policosanol has been driven by two factors (i) heavy investment in the marketing of competitor drugs (Lipitor and Zocor) and (ii) the US economic embargo/blockade of Cuba, which backs a general prejudice against Cuban technology. However, Policosanol is now widely marketed and used around the world. For example, it is sold in most pharmacies in Australia by Herron and Blackmores.
 
The above mentioned study by Berthold conflicts with more than 50 previous studies of 4596 patients over the past 20 years. Policosanol is one of the most widely studied natural supplements in the world. Many of the supportive studies were first conducted in Cuba but others in various countries including the U.S. have shown the benefits of policosanol.
 
For example:
 
Chen JT, Wesley R, Shamburek RD, Pucino F, Csako G. (2005) Meta-analysis of natural therapies for hyperlipidemia: plant sterols and stanols versus policosanol. Pharmacotherapy. 2005 Feb;25(2):171-83. [School of Pharmacy and Pharmacal Sciences, Purdue University, West Lafayette, Indiana]
 
Long- term effects of policosanol on older patients with Type 2 diabetes. Asia Pac J Clin Nutr. 2004;13(Suppl):S101.
 
Effects of policosanol and ticlopidine in patients with intermittent claudication: a double-blinded pilot comparative study. Angiology. 2004 Jul-Aug;55(4):361-71.
 
Concomitant use of policosanol and beta-blockers in older patients. Int J Clin Pharmacol Res. 2004;24(2-3):65-77.
 
Pub Med Nutr Rev. 2003 Nov;61(11):376-83. Role of policosanols in the prevention and treatment of cardiovascular disease. Varady KA, Wang Y, Jones PJ. School of Dietetics and Human Nutrition, McGill University, Ste-Anne-de-Bellevue, Quebec, Canada
 
Roberto Menéndez, Rosa Más, Ana MA. Amor, Rosa MA. González, Julio C. Fernández, Idania Rodeiro, Mirta Zayas & Sonia Jiménez. (2000) Effects of policosanol treatment on the susceptibility of low density lipoprotein (LDL) isolated from healthy volunteers to oxidative modification in vitro, Br J Clin Pharmacol, 50, 255-262. [Center of Natural Products, National Center for Scientific Research, PO Box 6880, Havana, Cuba]
 
Davalos J.M., Mederos H., Rodriguez J., et al. (1996): Effect of policosanol in hypercholesterolemia due to nephrotic syndrome. X Latinciamerican Congress of Nephrology and Hypertension, 14 September, Santiago de Chile, Chile.  
 
Arruzazabala M. L., Carbajal D., Mas R. and Valdes S. (1997): Comparative study of policosanol, aspirin and the combination therapy policosanol-aspirin on platelet aggregation in healthy volunteers. Pharmacol Res 36(4):293-7.
 
Stusser R., Batista J., Padron R. et al. (1998): Long-term therapy with policosanol improves treadmill exercise-ECG testing performance of coronary heart disease patients. Int J Clin Pharmacol Ther 36(9):469-73.
 
== 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 (medicine)|panacea]] by some Cubans.


== References ==
== References ==
<references/>
{{reflist|2}}


== External links ==
== External links ==
*[http://www.pdrhealth.com/drug_info/nmdrugprofiles/nutsupdrugs/pol_0207.shtml Policosanol] at PDRHealth.com
*[http://www.pdrhealth.com/drug_info/nmdrugprofiles/nutsupdrugs/pol_0207.shtml Policosanol] at PDRHealth.com
*[http://www.policosanol.com/monograph.htm Monograph] at www.policosanol.com
*{{US patent|6225354}}


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Revision as of 17:39, 27 July 2014

Policosanol
Clinical data
AHFS/Drugs.comInternational Drug Names
ATC code
Identifiers
CAS Number
E number{{#property:P628}}
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Chemical and physical data
FormulaCH3-(CH2)n-CH2OH n=24-34
Molar mass(variable)
  (verify)

PolicosanolTemplate:Pronunciation-needed (or polycosanol) is the generic term for a natural mixture of long chain alcohols extracted from plant waxes. It is used as a nutritional supplement intended to lower LDL cholesterol ("bad" cholesterol) and increase HDL cholesterol ("good" or "healthy" cholesterol) and to help prevent atherosclerosis, though some studies have raised questions about the effectiveness of policosanol.

Physical properties

Policosanol is a mixture of a few fatty alcohols derived from the waxes of such plants as sugar cane[1] and yams, as well as beeswax.[citation needed][clarification needed] The most prevalent alcohol in policosanol is octacosanol,[2] followed by triacontanol.

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.

Modulation of HMG-CoA reductase[3] and bile acid absorption inhibition[4] have been proposed as mechanisms.

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").,[5][6][7] despite a number of studies funded by the Cuban government, which produces and markets the drug.[8] Older independent clinical trials found no evidence of the efficacy of policosanol,[5] while more recent studies have found effect.[9][10]

References

  1. ↑ Marinangeli CP, Kassis AN, Jain D, Ebine N, Cunnane SC, Jones PJ (2007). "Comparison of composition and absorption of sugarcane policosanols" (abstract). Br. J. Nutr. 97 (2): 381–8. doi:10.1017/S0007114507336763. PMID 17298709.
  2. ↑ Ohta Y, Ohashi K, Matsura T, Tokunaga K, Kitagawa A, Yamada K (2008). "Octacosanol attenuates disrupted hepatic reactive oxygen species metabolism associated with acute liver injury progression in rats intoxicated with carbon tetrachloride". J Clin Biochem Nutr. 42 (2): 118–25. doi:10.3164/jcbn.2008017. PMC 2266062. PMID 18385828.
  3. ↑ Singh DK, Li L, Porter TD (2006). "Policosanol inhibits cholesterol synthesis in hepatoma cells by activation of AMP-kinase". J. Pharmacol. Exp. Ther. 318 (3): 1020–6. doi:10.1124/jpet.106.107144. PMID 16714400.
  4. ↑ Ng CH, Leung KY, Huang Y, Chen ZY (2005). "Policosanol has no antioxidant activity in human low-density lipoprotein but increases excretion of bile acids in hamsters". J. Agric. Food Chem. 53 (16): 6289–93. doi:10.1021/jf051269a. PMID 16076108.
  5. ↑ 5.0 5.1 Heiner K. Berthold, MD, PhD; Susanne Unverdorben, MD; Ralf Degenhardt, PhD; Michael Bulitta, Dipl-Stat; Ioanna Gouni-Berthold, MD (May 17, 2006). "Effect of Policosanol on Lipid Levels Among Patients With Hypercholesterolemia or Combined Hyperlipidemia". Journal of the American Medical Association. 295 (19): 2262–2269. doi:10.1001/jama.295.19.2262. PMID 16705107. Retrieved 2006-10-03.
  6. ↑ Pons P, Rodriguez M, Robaina C, Illnait J, Mas R, Fernandez L, Fernandez JC. (1994). "Effects of successive dose increases of policosanol on the lipid profile of patients with type II hypercholesterolaemia and tolerability to treatment". International Journal of Clinical Pharmacology Research. 14 (1): 27–33. PMID 7927958.
  7. ↑ Chen JT, Wesley R, Shamburek RD, Pucino F, Csako G (2005). "Meta-analysis of natural therapies for hyperlipidemia: plant sterols and stanols versus policosanol". Pharmacotherapy. 25 (2): 171–83. doi:10.1592/phco.25.2.171.56942. PMID 15767233.
  8. ↑ Thorsteinsdóttir, Halla; Sáenz, TW; Quach, U; Daar, AS; Singer, PA (2004). "Cuba—innovation through synergy". Nature Biotechnology. 22 (12s): DC19–DC24. doi:10.1038/nbt1204supp-DC19. PMID 15583679.
  9. ↑ PMID 23302671 (PMID 23302671)
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  10. ↑ PMID 23018482 (PMID 23018482)
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External links

Template:Lipid modifying agents Template:Alcohols

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