Drug & supplement interaction

Octacosanol + Naproxen, Pseudoephedrine

Naproxen, Pseudoephedrine brand name: Aleve Cold and Sinus.

Moderate Interaction
The bottom line Moderate

Octacosanol has a moderate interaction with Naproxen, Pseudoephedrine. Theoretically, octacosanol might inhibit platelet aggregation; however, clinical research suggests that this effect may not be clinically significant.

Read the full interaction report
SeverityModerate
LikelihoodPossible
EvidenceB
What do Severity, Likelihood & Evidence mean?
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Interaction report

Octacosanol and Naproxen, Pseudoephedrine

Here is the interaction we found between these two, with the evidence behind it.

Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

Why this applies to Naproxen, Pseudoephedrine

Naproxen, Pseudoephedrine falls under ANTICOAGULANT/ANTIPLATELET DRUGS — the group Octacosanol interacts with.

Theoretically, octacosanol might inhibit platelet aggregation; however, clinical research suggests that this effect may not be clinically significant.
Octacosanol is the main component of policosanol. Some clinical research shows that taking policosanol 10-50 mg daily for 7-15 days can inhibit platelet aggregation in healthy patients. However, one clinical trial shows that taking policosanol 10 mg twice daily for 2 weeks prior to initiating warfarin does not affect warfarin pharmacokinetics or warfarin response. Furthermore, a study in patients undergoing percutaneous coronary intervention with a drug-eluting stent found that taking policosanol 40 mg plus clopidogrel and aspirin daily for 30 days modestly reduced the risk for minor bleeding events when compared with taking clopidogrel and aspirin alone.
Severity Moderate Likelihood Possible Evidence B

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the gist for Aleve Cold and Sinus, which pairs naproxen (an NSAID) with pseudoephedrine (a decongestant). The thing to watch is the naproxen half. Naproxen on its own already makes platelets a bit slippery and can irritate the stomach lining. Octacosanol has been studied for a mild blood-thinning effect of its own, so in theory stacking the two could nudge your bleeding risk up a little. Think easier bruising, nosebleeds, or stomach upset.

That said, the human evidence here is fairly weak, and one study actually showed only a small change in bleeding. So this is more a 'keep an eye out' than a red alert. If you take blood thinners, have ulcers, or notice unusual bruising, check with your pharmacist or doctor first.

References
  1. Carbajal D, Arruzazabala ML, Valdes S, Mas R. Effect of policosanol on platelet aggregation and serum levels of arachidonic acid metabolites in healthy volunteers. Prostaglandins Leukot Essent Fatty Acids 1998;58:61-4.
  2. Arruzazabala ML, Valdes S, Mas R, et al. Comparative study of policosanol, aspirin and the combination therapy policosanol-aspirin on platelet aggregation in healthy volunteers. Pharmacol Res 1997;36:293-7. PubMed
  3. Valdes S, Arruzazabala ML, Fernandez L. Effect of policosanol on platelet aggregation in healthy volunteers. Int J Clin Pharmacol Res 1996;16:67-72.
  4. Abdul MI, Jiang X, Williams KM, et al. Pharmacokinetic and pharmacodynamic interactions of echinacea and policosanol with warfarin in healthy subjects. Br J Clin.Pharmacol. 2010;69:508-15. PubMed
  5. Xu K, Liu X, Li Y, Wang Y, Zang H, Guo L, et al. Safety and efficacy of policosanol in patients with high on-treatment platelet reactivity after drug-eluting stent implantation: two-year follow-up results. Cardiovasc Ther. 2016 Oct;34(5):337-42. doi: 10.1 PubMed
  6. Li C, Ding Y, Si Q, Li K, Xu K. Multiple functions of policosanol in elderly patients with dyslipidemia. J Int Med Res. 2020;48(7):300060520936082. PubMed

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Octacosanol Also Interacts With Other Medications

Octacosanol has 247 moderate known drug interactions in our database — the Naproxen, Pseudoephedrine one above is one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Octacosanol

Covers the 2,830 medications we’ve checked against Octacosanol. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Naproxen, Pseudoephedrine

This page covers Octacosanol only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Naproxen, Pseudoephedrine page lists 334 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Asarabacca (major), Beer (major), Danshen (major) and Ephedra (major).

By severity: 11 major · 279 moderate · 44 minor.

From our pharmacist’s overview on the Naproxen, Pseudoephedrine page

“Aleve Cold and Sinus pairs naproxen, an anti-inflammatory painkiller, with pseudoephedrine, a decongestant that acts as a mild stimulant, and that combination is why its supplement list runs to 334 entries and deserves real vigilance. The two biggest themes mirror the two drugs.”

Reviewed by 2 · Jul 18, 2026

Open the Naproxen, Pseudoephedrine interaction page

One more smart check

Taking Octacosanol as Part of a Dietary Supplement Product? Check It for Interactions

We hold 435 real supplement products containing Octacosanol, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Octacosanol. Your product may carry other ingredients that interact with Naproxen, Pseudoephedrine too, on top of Octacosanol — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Octacosanol and Naproxen, Pseudoephedrine Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Octacosanol
Steady interest

#1,058 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Naproxen, Pseudoephedrine
Steady interest

#1,421 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Octacosanol

What is Octacosanol?

Octacosanol
  • Physical performance and endurance
  • Cholesterol support
  • Parkinson's and movement concerns
  • Antioxidant support
  • General energy and stamina

Octacosanol is a waxy long-chain alcohol from plant sources that is most often promoted for exercise endurance and cholesterol support, but solid human evidence is limited and results are mixed. It appears generally well tolerated in supplement amounts, but it is not a proven treatment for any condition, so talk with your pharmacist or doctor before using it.

Read the full Octacosanol monograph & all interactions
Keep checking

Other Drugs & Octacosanol

Browse every other medication we’ve checked against Octacosanol — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
247Moderate
0Minor
2,582No known interaction
Moderate

247 interactions

Showing 60 of 247 moderate interactions — see all 247 on the Octacosanol page.

No interaction 2,582 drugs checked — show the list
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

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Pharmacist Counseling Corner

Taking Octacosanol and Naproxen, Pseudoephedrine Together: Common Questions

Can you take Octacosanol with Naproxen, Pseudoephedrine?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Octacosanol and Naproxen, Pseudoephedrine interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.