Policosanol is an interesting chemical constituent, as it is derived from several different types of plants. It is primarily used for treating irregularities in blood lipids, such as cholesterol and elevated triglycerides. Moreover, because of its benefits for the cardiovascular system, policosanol is used by people with heart disease, intermittent claudication, elevated blood lipids, and for preventing atherosclerosis.
Policosanol is derived mainly from sugar cane and wheat germ oil. It is a mixture of the wax-like alcohol chemicals found in these plants. Biologically, these are typically long carbon chains, being comprised of such compounds as octacosanol, tetracosanol, hexacosanol, heptacosanol, nonacosanol, triacosanol, dotriacontanol, and tetratriacontanol. [1, 2] The main waxy alcohol ingredient, octacosanol, makes up roughly 60 to 70% of policosanol. Oftentimes, policosanol is incorrectly referred to as octacosanol. A proprietary form of policosanol has also been developed using beeswax as the source; it is purportedly more stable than other forms of policosanol.
Policosanol is used mainly for treating elevations in cholesterol. It works by slowing the synthesis of cholesterol in the liver and by hastening the breakdown of low-density lipoprotein (LDL, or “bad”) cholesterol. [3, 4] Policosanol is also useful for lowering platelet aggregation due to certain clotting stimuli. [5, 6] When compared to the abilty of aspirin to decrease platelet aggregation, policosanol was deemed as effective. 
In treating high blood levels of lipids (fats), policosanol is effective at lowering cholesterol and LDL as previously mentioned, and can increase the “good” cholesterol, or high-density lipoprotein (HDL) levels. In several studies, policosanol decreased LDL cholesterol by 11% to 31% and raised HDL cholesterol by 7% to 9%. [8-10] Also, policosanol’s cholesterol-lowering effect was compared to two pharmaceutical drugs and was shown to be just as effective as these prescription medications. [11, 12]
For treating intermittent claudication, policosanol was shown to improve the distance which those affected were able to walk (this is a common efficacy measurement in this condition) without experiencing pain. 
For treatment of hypercholesterolemia and intermittent claudication, the average dose is 10 to 20 milligrams per day. [13, 14]
There are no known states of deficiency; policosanol is not a substance that occurs normally in humans.
Policosanol is considered safe when used in accordance with proper dosing guidelines. [15, 16] Some reported side effects from taking policosanol include: insomnia, daytime sleepiness, irritability, dizziness, stomach upset, skin rash, nose bleeds, and increased appetite.  Because this substance harbors the ability to inhibit platelet aggregation, it may theoretically increase risk of bleeding in those already taking a pharmaceutical anticoagulant medication. Caution should be exercised when taking this and any other blood-thinning medications.
1. Merck Index, 12th ed. Whitehouse Station: Merck Research Laboratories, 1996.
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4. 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.
5. Arruzazabala ML, Mas R, Molina V, et al. Effect of policosanol on platelet aggregation in type II hypercholesterolemic patients. Int J Tissue React 1998;20:119-24.
6. Arruzazabala ML, Valdes S, Mas R, et al. Effect of policosanol successive dose increases on platelet aggregation in healthy volunteers. Pharmacol Res 1996;34:181-5.
7. Arruzazabala ML, Valdes S, Mas R, et al. Comparative study of policosanol, aspirin and the combination therapy policosanol-aspirin on platelet aggregation in healthy volunteers. Pharmacol Res 1997;36:293-7.
8. Canetti M, Moreira M, Mas R, et al. A two-year study on the efficacy and tolerability of policosanol in patients with type II hyperlipoproteinaemia. Int J Clin Pharmacol Res 1995;15:159-65.
9. Pons P, Rodriguez M, Robaina C, et al. Effects of successive dose increases of policosanol on the lipid profile of patients with type II hypercholesterolaemia and tolerability to treatment. Int J Clin Pharmacol Res 1994;14:27-33.
10. Torres O, Agramonte AJ, Illnait J, et al. Treatment of hypercholesterolemia in NIDDM with policosanol. Diabetes Care 1995;18:393-7.
11. Fernandez JC, Mas R, Castano G, et al. Comparison of the efficacy, safety and tolerability of policosanol versus fluvastatin in elderly hypercholesterolaemic women. Clin Drug Invest. 2001;21:103-113.
12. Ortensi G, Gladstein J, Valli H, Tesone PA. Comparative study of policosanol versus simvastatin in elderly patients with hypercholesterolemia. Cur Ther Res 1997;58:390-401.
13. 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;50:123-30.
14. Batista J, Stusser R, Saez F, Perez B. Effect of policosanol on hyperlipidemia and coronary heart disease in middle-aged patients. A 14-month pilot study. Int J Clin Pharmacol Ther 1996;34:134-7. 13 Ibid
15. Aleman CL, et al. Carcinogenicity of policosanol in mice: an 18-month study. Food Chem Toxicol. Jul1995;33(7):573-8.
16. Mesa AR, et al. Toxicity of policosanol in beagle dogs: one-year study. Toxicol Lett. Aug1994;73(2):81-90. 7 Ibid