DRUGS AND SUPPLEMENTS

Octacosanol

March 22, 2017

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Octacosanol

Natural Standard Bottom Line Monograph, Copyright © 2013 (www.naturalstandard.com). Commercial distribution prohibited. This monograph is intended for informational purposes only, and should not be interpreted as specific medical advice. You should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.

While some complementary and alternative techniques have been studied scientifically, high-quality data regarding safety, effectiveness, and mechanism of action are limited or controversial for most therapies. Whenever possible, it is recommended that practitioners be licensed by a recognized professional organization that adheres to clearly published standards. In addition, before starting a new technique or engaging a practitioner, it is recommended that patients speak with their primary healthcare provider(s). Potential benefits, risks (including financial costs), and alternatives should be carefully considered. The below monograph is designed to provide historical background and an overview of clinically-oriented research, and neither advocates for or against the use of a particular therapy.

Related Terms

  • 1-octacosanol, (3)H-octacosanol, cluytyl alcohol, montanyl alcohol, n-octacosanol, octacosanoic acid, policosanol, Suregada angustifolia (Baill. ex Muell. Arg.), very long chain fatty alcohols.

Background

  • Policosanol is a mixture of very long chain alcohols that is purified from sugar cane wax. Approximately 67% of policosanol is octacosanol. Although some research has been conducted using policosanol, little research is currently available that focuses on octacosanol alone. One preliminary clinical study in amyotrophic lateral sclerosis (ALS or Lou Gehrig's disease- a chronic, progressive, neurologic disease in which loss of nerve cells produces muscle paralysis) patients showed no measurable benefit from octacosanol. As octacosanol is the main component of policosanol, more research is needed to determine if octacosanol is the primary active component of policosanol.

Scientific Evidence

Uses

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Grade*

Amyotrophic lateral sclerosis (ALS)

ALS or Lou Gehrig's disease is a chronic, progressive, neurologic disease in which loss of nerve cells produces muscle paralysis. Preliminary study does not show any evidence of benefit in neurologic (brain) or pulmonary (lung) symptoms of amyotropic lateral sclerosis (ALS) patients. Additional study is needed in this area.

D

*Key to grades:A: Strong scientific evidence for this use; B: Good scientific evidence for this use; C: Unclear scientific evidence for this use; D: Fair scientific evidence against this use (it may not work); F: Strong scientific evidence against this use (it likely does not work).

Tradition/Theory

The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious and should be evaluated by a qualified health care professional.

  • Adrenoleukodystrophy (ALD, a rapidly progressive X-linked genetic degenerative disorder), antibacterial, antioxidant, atherosclerosis (hardening of the arteries), cardiovascular health, coronary heart disease, fatigue, granuloma annulare (chronic skin condition), hyperlipidemia (high cholesterol), hypertension (high blood pressure), intermittent claudication (muscle pain), ischemic heart disease, liver damage from drugs or toxins, neurologic disorders (Sjogren-Larsson syndrome), osteoporosis (postmenopausal), Parkinson's disease, platelet aggregation inhibition (blood disorder), reactivity/brain activity, seizure disorder, stroke prevention.

Dosing

The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.

Adults (over 18 years old)

  • There is no proven safe or effective dose for octacosanol in adults.

Children (under 18 years old)

  • There is no proven safe or effective dose for octacosanol in children.

Safety

The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Allergies

  • Avoid in individuals with a known allergy or hypersensitivity to octacosanol or policosanol.

Side Effects and Warnings

  • Octacosanol is the main component of policosanol. Little research is currently available on octacosanol alone. Therefore, the safety information is based on research conducted on policosanol.

  • Use octacosanol cautiously in patients taking nitrates.

  • Use cautiously in patients who are taking other lipid lowering drugs/herbs, such as acipimox, statins, bile acid sequestrants/resins, and cholesterol absorption inhibitors such as ezetimibe, fish oil, plant stanols/sterols, polyphenols, as well as nutraceuticals such as oat bran, psyllium, and soy proteins, due to potential additive blood-cholesterol lowering effects.

  • Use cautiously in patients taking aspirin due to potential additive platelet inhibition and risk of bleeding.

  • Use cautiously when using with drugs that lower blood pressure due to potential additive effects.

Pregnancy & Breastfeeding

  • Octacosanol is not recommended in pregnant or breastfeeding women due to a lack of available scientific evidence.

Interactions

Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy.

Interactions with Drugs

  • Although not well studied in humans, octacosanol (the main component of policosanol) may increase the risk of bleeding when taken with drugs that increase the risk of bleeding. Some examples include aspirin, anticoagulants ("blood thinners") such as warfarin (Coumadin®) or heparin, anti-platelet drugs such as clopidogrel (Plavix®), and non-steroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen (Motrin®, Advil®), or naproxen (Naprosyn®, Aleve®). Octacosanol may also interact with aspirin.

  • Octacosanol may alter blood sugar levels. Caution is advised when using medications that may also alter blood sugar. Patients taking drugs for diabetes by mouth or insulin should be monitored closely by a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.

  • In theory, octacosanol (the main component of policosanol) may lower blood pressure. Caution is advised in patients taking blood pressure medications due to possible additive effects.

  • Although not well studied in humans, octacosanol (the main component of policosanol) may lower cholesterol. Caution is advised in patients taking cholesterol medications due to possible additive effects.

  • Octacosanol (the main component of policosanol) may decrease blood pressure and may interact with beta-blockers. It may also interact with nitrates, but the effects in humans are unclear.

  • Octacosanol may also have liver damaging effects. Caution is advised in patients with liver disorders or taking liver medications.

Interactions with Herbs & Dietary Supplements

  • Although not well studied in humans, octacosanol (the main component of policosanol) may increase the risk of bleeding when taken with herbs and supplements that are believed to increase the risk of bleeding. Multiple cases of bleeding have been reported with the use of Ginkgo biloba, and fewer cases with garlic and saw palmetto. Numerous other agents may theoretically increase the risk of bleeding, although this has not been proven in most cases.

  • Octacosanol may alter blood sugar levels. Caution is advised when using herbs or supplements that may also alter blood sugar. Blood glucose levels may require monitoring, and doses may need adjustment.

  • In theory, octacosanol may lower cholesterol. Caution is advised in patients taking cholesterol-altering herbs and supplements due to possible additive effects.

  • Octacosanol may be liver damaging. Caution is advised in patients taking herbs and supplements that may also damage the liver and in patients with liver disorders.

  • Octacosanol may also lower blood pressure. Caution is advised in patients taking other blood pressure-altering herbs or supplements due to possible additive effects.

  • Taking policosanol (which includes octacosanol) and omega-3 fatty acids or willow bark may have additive cholesterol-lowering effects and may also alter blood clotting.

Author Information

  • This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

References

Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.

  1. Bays H, Stein EA. Pharmacotherapy for dyslipidaemia--current therapies and future agents. Expert.Opin.Pharmacother. 2003;4(11):1901-1938. View Abstract

  2. Castano G, Mas R, Fernandez L, et al. Effects of policosanol and lovastatin in patients with intermittent claudication: a double-blind comparative pilot study. Angiology 2003;54(1):25-38. View Abstract

  3. Castano G, Mas R, Fernandez L, et al. Effects of policosanol 20 versus 40 mg/day in the treatment of patients with type II hypercholesterolemia: a 6-month double-blind study. Int.J.Clin.Pharmacol.Res. 2001;21(1):43-57. View Abstract

  4. Castano G, Mas R, Gamez R, et al. Effects of policosanol and ticlopidine in patients with intermittent claudication: a double-blinded pilot comparative study. Angiology 2004;55(4):361-371. View Abstract

  5. Castano G, Mas R, Roca J, et al. A double-blind, placebo-controlled study of the effects of policosanol in patients with intermittent claudication. Angiology 1999;50(2):123-130. View Abstract

  6. Chen JT, Wesley R, Shamburek RD, et al. Meta-analysis of natural therapies for hyperlipidemia: plant sterols and stanols versus policosanol. Pharmacotherapy 2005;25(2):171-183. View Abstract

  7. Gamez R, Maz R, Arruzazabala ML, et al. Effects of concurrent therapy with policosanol and omega-3 fatty acids on lipid profile and platelet aggregation in rabbits. Drugs R.D. 2005;6(1):11-19. View Abstract

  8. Hargrove JL, Greenspan P, Hartle DK. Nutritional significance and metabolism of very long chain fatty alcohols and acids from dietary waxes. Exp Biol Med (Maywood.) 2004;229(3):215-226. View Abstract

  9. Lin Y, Rudrum M, van der Wielen RP, et al. Wheat germ policosanol failed to lower plasma cholesterol in subjects with normal to mildly elevated cholesterol concentrations. Metabolism 2004;53(10):1309-1314. View Abstract

  10. McCarty MF. An ezetimibe-policosanol combination has the potential to be an OTC agent that could dramatically lower LDL cholesterol without side effects. Med Hypotheses 2005;64(3):636-645. View Abstract

  11. Menendez R, Marrero D, Mas R, et al. In vitro and in vivo study of octacosanol metabolism. Arch Med Res 2005;36(2):113-119. View Abstract

  12. Musa R, Yunoki K, Kinoshita M, et al. Increased levels of policosanol and very long-chain fatty acids in potato pulp fermented with Rhizopus oryzae. Biosci.Biotechnol.Biochem. 2004;68(11):2401-2404. View Abstract

  13. Noa M, Mas R, Mendoza S, et al. Policosanol prevents bone loss in ovariectomized rats. Drugs Exp.Clin Res 2004;30(3):117-123. View Abstract

  14. Taylor JC, Rapport L, Lockwood GB. Octacosanol in human health. Nutrition 2003;19(2):192-195. View Abstract

  15. Venkatesan M, Viswanathan MB, Ramesh N, et al. Antibacterial potential from Indian Suregada angustifolia. J Ethnopharmacol 7-14-2005;99(3):349-352. View Abstract

Copyright © 2013 Natural Standard (www.naturalstandard.com)

The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.

Updated:  

March 22, 2017