Concomitant use of policosanol and benzodiazepines in older patients.

Policosanol is a cholesterol-lowering drug well tolerated in different populations, including those with high consumption of concomitant drugs, and the frequency of adverse events (AE) has been very low, suggesting a low risk of adverse drug interactions. Benzodiazepines (BZPs) are widely consumed to manage anxiety and sleep disorders in the elderly. Drug to drug interactions (DDI) with BZP are frequent since they are metabolised mainly through the cytochrome P450 (CYP 450) hepatic system, subsystem CYP3A4, which oxidises many drugs, representing a risk for potentially serious AE. Despite policosanol is not metabolized through CYP 450 system, it can be frequently consumed with BZP, and there are increasing reports of DDI with BZPs. Then, we researched whether policosanol administered together with BZP induced AE different from placebo based on the records of all older patients taking BZP (118 receiving placebo + BZPs, 121 policosanol + BZPs) included in a long-term prevention study. Analysis was by intention-to-treat. Both groups were well matched at baseline. After 1 year, policosanol reduced (p < 0.0001) low-density lipoprotein-cholesterol (LDL-C) (21.3 %), total cholesterol (TC) (15.8 %) and triglycerides (TG) (p < 0.01) (21.2 %), and raised high-density lipoprotein-cholesterol (HDL-C) (10.2 %), effects persisted during the trial. At study completion, policosanol lowered (p < 0.000 1) LDL-C (31.0 %), TC (21.6 %), TG (23.0 %) and raised HDL-C (17.8 %). There were 43 (18.0 %) withdrawals (27 placebo, 16 policosanol), 17 (10 placebo, 7 policosanol) due to AE. Treatment did not impair safety indicators, policosanol reduced diastolic and systolic pressure, individual values being normal. The rate of AE was similar in both groups. Then, policosanol showed a persistent efficacy and was well tolerated in older patients taking BZP, not increasing AE or impairing safety indicators. Then, policosanol can be indicated in older hypercholesterolemic patients taking BZP. [ABSTRACT FROM AUTHOR]