Concomitant use of policosanol and cardiac glycosides in older patients

Resumen

Policosanol is a cholesterol-lowering drug with documented efficacy and safety. The potential risk of adverse drug interaction (IDD) with policosanol appears to be low, but some interactions should still be explored. Cardiac glycosides are widely used in geriatric populations to treat congestive heart failure and atrial fibrillation but have a substantial risk of toxicity. As part of a large Prevention Study, we investigated whether concomitant administration of policosanol with cardiac glycosides induces any specific adverse event (AE) or alteration in any safety indicator in older patients. 1 470 elderly patients with high coronary risk were assigned by roasting to a group receiving policosanol 5 mg/d or to another group that would be treated with placebo treatment for three years. For the analysis, the records of all patients and 79 of them who took cardiac glycosides were included. Both groups were well matched at baseline. Effects on serum lipid profile of the policosanol group persisted during the test. At the end of the study, policosanol decreased low-density lipoprotein cholesterol (LDL-C) (33.9 %), total cholesterol (24.1 %), triglycerides (28.7 %) and HDL- C (16.7 %). Twenty-six patients (16 placebo, 10 policosanol, p < 0.05) were withdrawn from the study, 12 (9 placebo, 3 policosanol, p < 0.01) due to AE. The frequency of severe AE in the treatment with policosanol was lower (p < 0.05) than in patients treated with placebo, whereas that of other non-severe AEs was similar in both groups. We conclude that policosanol administered concomitantly with cardiac glycosides to elderly patients was effective and well tolerated, not increasing any AE. These results indicate, that policosanol can be consumed by these cardiac glycosides treated patients without significant risk of IDD.