Policosanol is a sugarcane-wax alcohol capsule. Cuban and East Asian programs report lower artery-plaque cholesterol, modest blood-pressure drops, and longer pain-free walking in people with poor leg circulation; independent trials of the original Cuban product found no blood-fat change. That split is the central fact. Serious side effects are uncommon; cautions are a disputed extra anti-clotting effect and product quality. (Full Review)

Protocol

Cuban / Dalmer clinic pattern

5–20 mg daily

5 mg once daily with the evening meal, titrated to 10–20 mg if lipids are the target; some claudication protocols used 10 mg twice daily

Time of day

Evening with food

Originator convention; no human timing study shows a morning advantage

Baseline biomarkers

apoB and LDL-C at 8–12 weeks

A null lipid change is an informative negative, not a reason to keep escalating past 20–40 mg

Time to effect

LDL Cholesterol Reduction

8–12 weeks

Fair decision point; Cuban papers often claimed 6–12 weeks

Blood Pressure Reduction

12 weeks

Korean 10–20 mg daily window

Walking Distance in Intermittent Claudication

24 months

Cuban claudication trial; independent replications essentially absent

Benefits

Medium: LDL Cholesterol Reduction; Blood Pressure Reduction

Low: Walking Distance in Intermittent Claudication; HDL Cholesterol Increase; Reduced Platelet Aggregation

Speculative: Exercise Endurance and Recovery; Cardiovascular Events and Lifespan

Contraindications

Known hypersensitivity to sugarcane wax alcohols or capsule excipients

Pregnancy and lactation

Active pathological bleeding or a planned invasive procedure within about 7–14 days, if the antiplatelet claim is treated as real

Children and adolescents

Key Interactions

Warfarin and other vitamin K antagonists

Aspirin, clopidogrel, prasugrel, ticagrelor

NSAIDs (ibuprofen, naproxen)

Antihypertensives (propranolol, other beta-blockers, ACE inhibitors such as lisinopril)

Statins (atorvastatin, simvastatin, rosuvastatin)

Other lipid nutraceuticals (red yeast rice, berberine, plant sterols, high-dose niacin)

Antiplatelet supplements (garlic, ginkgo, high-dose fish oil, high-dose vitamin E)

Glucose-lowering drugs (insulin, sulfonylureas such as glipizide)

Risk & Side Effects

Medium: Additive Antiplatelet Effect and Bleeding Tendency

Low: Gastrointestinal Discomfort; Headache, Insomnia, Dizziness, and Weight Change; Liver Enzyme Change; Glycemic Drift

Speculative: Additive Blood-Pressure Lowering

Monitoring

Marker	Target	Why
LDL-C	<70 mg/dL (<1.8 mmol/L); many longevity clinics use 50–70	Claimed primary lipid effect
apoB	<80 mg/dL; some clinics <60	Particle number; better atherosclerotic-risk marker than LDL-C
HDL-C	>60 mg/dL	Claimed Cuban/Korean rise
Triglycerides	<100 mg/dL	Little expected policosanol effect; contextual
hs-CRP	<0.5–1.0 mg/L	Residual inflammatory risk
ALT / AST	ALT roughly <25 U/L (women) / <33 U/L (men)	Liver-safety analog to statin labs
Sitting SBP / DBP	<120 / <80 mmHg	Meta-analysis blood-pressure signal
INR (if on warfarin)	Stay in the prescribed therapeutic band	Theoretical antiplatelet overlap

Cadence: Baseline fasting lipid panel with apoB, resting blood pressure, and INR if on warfarin, before the first capsule. Claudication goals add timed walking distance and ankle–brachial index; bleed-risk histories add a platelet count and bruising diary. Repeat lipids and blood pressure at 8–12 weeks; then every 6–12 months if continued. INR stays on the warfarin clinic’s usual cadence.

Qualitative Assessment

Walking distance and calf pain on a familiar route (claudication goal)
Easy bruising, gum bleeding, or prolonged bleeding from small cuts
Sleep quality and morning energy
Home blood-pressure scatter and lightheadedness on standing

Policosanol for Health & Longevity

Protocol

Benefits

Risk & Side Effects

Monitoring

Qualitative Assessment