Comparative Study of Policosanol, Aspirin and the Combination Therapy Policosanol-Aspirin on Platelet Aggregation in Healthy Volunteers

Arruzazabala, M.L.; Valdés, S.; R, Más; Carbajal, Daisy; Fernández, Lilia

doi:10.1006/phrs.1997.0201

Cited by 42 publications

(17 citation statements)

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“…In the present study the possibility of a policosanol-warfarin interaction was investigated at a policosanol dose of 20 mg day -1 . Previous studies have reported that policosanol up to this dose inhibited platelet aggregation induced by ADP and collagen by more than 20% [27]. Interestingly, the present study showed no significant alteration in platelet aggregation after 2 weeks of treatment with 20 mg daily policosanol.…”

Section: Discussionsupporting

confidence: 47%

Pharmacokinetic and pharmacodynamic interactions of echinacea and policosanol with warfarin in healthy subjects

Abdul

Jiang

Williams

et al. 2010

Brit J Clinical Pharma

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WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT • Echinacea and policosanol are commonly used herbal medicines which may be ingested by patients receiving warfarin. Echinacea has been implicated in interacting with drug metabolizing enzymes and policosanol has been shown to decrease platelet aggregation. The potential interaction of echinacea and policosanol with warfarin has not previously been investigated. WHAT THIS STUDY ADDS • Concomitant treatments with echinacea increased the apparent clearance of S‐warfarin but did not have a clinically significant effect on warfarin pharmacodynamics in healthy subjects. Policosanol did not significantly affect warfarin pharmacokinetics or pharmacodynamics. AIMS This study investigated the pharmacokinetic and pharmacodynamic interactions of echinacea and policosanol with warfarin in healthy subjects. METHODS This was an open‐label, randomized, three‐treatment, cross‐over, clinical trial in healthy male subjects (n= 12) of known CYP2C9 and VKORC1 genotype who received a single oral dose of warfarin alone or after 2 weeks of pre‐treatment with each herbal medicine at recommended doses. Pharmacodynamic (INR, platelet activity) and pharmacokinetic (warfarin enantiomer concentrations) end points were evaluated. RESULTS The apparent clearance of (S)‐warfarin (90% CI of ratio; 1.01, 1.18) was significantly higher during concomitant treatment with echinacea but this did not lead to a clinically significant change in INR (90% CI of AUC of INR; 0.91, 1.31). Policosanol did not significantly affect warfarin enantiomer pharmacokinetics or warfarin response. Neither echinacea nor policosanol had a significant effect on platelet aggregation after 2 weeks of pre‐treatment with the respective herbal medicines. CONCLUSION Echinacea significantly reduced plasma concentrations of S‐warfarin. However, neither echinacea nor policosanol significantly affected warfarin pharmacodynamics, platelet aggregation or baseline clotting status in healthy subjects.

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Section: Discussionsupporting

confidence: 47%

Pharmacokinetic and pharmacodynamic interactions of echinacea and policosanol with warfarin in healthy subjects

Abdul

Jiang

Williams

et al. 2010

Brit J Clinical Pharma

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“…Aspirin (AS) remains the gold standard of antiplatelet therapy for stroke prevention, whereas extended release dypiridamole + AS has yielded the best results among combination therapy schemes [5][6][7][8]. Policosanol, a mixture of 8 high molecular weight sugarcane wax alcohols, has reduced platelet aggregation in experimental and clinical studies [9][10][11][12][13]. Also, policosanol has shown protective effects in experimental brain ischemia models, and to increase the antiplatelet/antithrombotic effects of AS [14,15], and long-term administered prevented the progression of carotid-vertebral atherosclerosis in humans [16].…”

Section: Introductionmentioning

confidence: 99%

Effects of policosanol on the recovery of ischemic stroke: a randomized controlled study

Sánchez¹

2012

iosrphr

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Background. Antiplatelet therapy lowers the risk of recurrent stroke. Policosanol, a mixture of 8 high molecular weight sugar cane wax alcohols, has shown to reduce platelet aggregation. Objectives. To investigate whether the therapy with policosanol plus aspirin (AS) could improve the neurological outcome as compared to placebo + AS in patients with a recent ischemic stroke. Methods. Ninety-two (92) patients with a modified Rankin Scale score (mRSs) ≥2 -≤4 after suffering an ischemic stroke within 30 days before enrollment were randomized to placebo or policosanol (20 mg/day) + AS (125 mg/day) (pla + AS or poli + AS) for 24 weeks. The primary efficacy variable was to obtain a better stroke outcome (mRSs ≤1) as compared to pla +AS. Reduction of platelet aggregation was a secondary variable. Results. After 12 and 24 weeks on therapy, the rates of patients treated with poli + AS (10/46, 21.7% and 32/46, 69.6%, respectively) who achieved mRSs ≤1 were significantly (p0.01 and p0.0001, respectively) greater than those treated with pla + AS (0/46, 0.0% and 7/46, 15.2%, respectively). Poli + AS treatment given for 6 weeks reduced significantly (p0.00001 vs baseline, p0.01 vs pla + AS) the mean mRSs value (24.1%), and this effect improved thereafter, so that it was reduced by 31.0% and 55.2% after 12 and 24 weeks on therapy, respectively. Poli + AS treatment also reduced significantly arachidonic acid-and adenosine diphosphateinduced platelet aggregation by 41.0% and 24.8%, respectively. Treatments were well tolerated. There were not withdrawals due to adverse experiences. Conclusions. In patients with recent ischemic stroke, poli + AS treatment improved the neurological recovery and decreased platelet aggregation as compared to pla + AS.

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“…Some studies do demonstrate that Policosanol may have effects beyond choles- terol reduction similar to statins, such as decreasing smooth muscle cell proliferation, LDL oxidation, and platelet aggregation [12][13][14][15][16][17][18][19][20]. Further human studies are needed to clarify these effects.…”

Section: Resultsmentioning

confidence: 99%

Policosanol, an aliphatic alcohol sugarcane derivative: use in patients intolerant of or inadequately responsive to statin therapy

2011

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Policosanol is a compound derived from sugarcane wax with low-density-lipoprotein (LDL) cholesterol-lowering properties. The aim of this study is to evaluate the effect of Policosanol on LDL cholesterol reduction in patients intolerant of statin therapy or on concomitant statin therapy but not at target LDL cholesterol levels. Twenty-one patients treated with policosanol 10 mg twice a day for 156 ± 63 days were analyzed retrospectively. Pre-and posttreatment fasting lipid profiles were collected and statistical analysis was performed as paired t-tests. Data were further analyzed into subgroups based on the presence or absence of statin therapy. In the 21 patients, LDL cholesterol decreased by 17% (p < 0.001) and total cholesterol decreased by 9.4% (p < 0.001). No significant changes were seen in high-density-lipoprotein (HDL) cholesterol or triglyceride levels. In the 6 patients treated with a statin and Policosanol, there was also a 17% LDL cholesterol reduction (p = 0.005). In the 15 patients treated only with Policosanol, LDL cholesterol was also decreased by 17% (p = 0.003). Policosanol use was observed to be associated with a mild-to-moderate (17%) decrease in LDL cholesterol. This association was observed in patients intolerant of statin therapy and in those receiving adjunctive Policosanol with statin therapy.

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Comparative Study of Policosanol, Aspirin and the Combination Therapy Policosanol-Aspirin on Platelet Aggregation in Healthy Volunteers

Cited by 42 publications

References 0 publications

Pharmacokinetic and pharmacodynamic interactions of echinacea and policosanol with warfarin in healthy subjects

Pharmacokinetic and pharmacodynamic interactions of echinacea and policosanol with warfarin in healthy subjects

Effects of policosanol on the recovery of ischemic stroke: a randomized controlled study

Policosanol, an aliphatic alcohol sugarcane derivative: use in patients intolerant of or inadequately responsive to statin therapy

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