Positives

• Patients with intermittent claudication describe reduced leg pain during exercise on policosanol, attributed to improved peripheral circulation Examine.com.
  
  
• In Cuban-funded type II hyperlipidemia trials, patients on 25 mg per day of sugar-cane policosanol described meaningful LDL reductions with excellent tolerability Redalyc.
  
  

Negatives

• A 2006 JAMA randomized trial in North American patients found no LDL, HDL, triglyceride, or lipoprotein(a) benefit from policosanol after 12 weeks JAMA.
  
  
• An independent German review found that outside of Cuban-funded studies the success rate for cholesterol lowering drops to roughly 14 percent Examine.com.
  
  

Hurdles & Side Effects

• Patients have no reliable way to verify whether their policosanol is genuine sugar-cane derived material from Cuba versus cheaper beeswax substitutes Examine.com.
  
  
• Patients on warfarin or antiplatelet drugs are cautioned about additive bleeding risk despite policosanol's overall safe profile WebMD.