Drug & supplement interaction

Policosanol + Nelarabine

Nelarabine brand name: Atriance.

No Known Interaction

Medically reviewed by Dr. Brian Staiger, PharmD, BCPS · Updated July 2026 · Pair last verified Sep 20, 2026

The bottom line No known interaction

We found no known interaction between Policosanol and Nelarabine in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the two are separately associated with some of the same side effects, which would make a new symptom harder to attribute to one or the other.

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Interaction report

Policosanol and Nelarabine

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Nelarabine and Policosanol in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Policosanol safety at a glance

Policosanol overall Use caution Generally well tolerated in studies, but its real-world benefit is uncertain and quality varies between products.

Pregnancy Avoid There is not enough safety information, so it is best to avoid use during pregnancy.

Breastfeeding Avoid There is not enough safety information, so it is best to avoid use while breastfeeding.

Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Nelarabine and Policosanol? Ask Dr. Brian Staiger, PharmD, BCPS directly ›

How we checked

Why No Interaction Is Listed for Nelarabine

Interactions in our licensed database are recorded against drug classes, not just single drug names. Nelarabine is filed under 3 classifications — immunosuppressants, cns depressants, seizure threshold lowering drugs. Policosanol has documented interactions with 6 drug classes — the most serious being anticoagulant/antiplatelet drugs (moderate), antidiabetes drugs (moderate) and beta-blockers (moderate) — and none of Nelarabine’s classifications are among them.

Classification data comes from our licensed Natural Medicines dataset. A medication can belong to classes beyond those recorded there, so this describes how the check was run — it is not a safety guarantee.

Keep it in perspective

Policosanol Does Interact With Other Medications

Policosanol has 242 moderate known drug interactions in our database — Nelarabine isn’t one of them. If you take anything else, check it against the full list below.

Moderate 242 No known interaction 2,588 (incl. Nelarabine)

Taking anything else?

Check Another of Your Medications Against Policosanol

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

What to actually watch for

No Interaction Found — But Data Suggests Policosanol and Nelarabine May Share Several of the Same Side Effects

This is not an interaction. Neither one changes how your body handles the other, and nothing here says they react together. What our sources do show is that each has separately been linked to the effects below — so taking both can make those effects more likely to turn up, and harder to pin on one or the other if they do. One of them is worth acting on rather than waiting out — marked below.

Bleeding or bruising Worth acting on Additional detail
Policosanol
“A case gum bleeding has been reported in a patient taking policosanol 20 mg and aspirin 100 mg daily for 7 days.”

Policosanol · Natural Medicines adverse-effect record, reported in myasthenia gravis.
1 source cited

2937. 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
Nelarabine

Listed in the ADVERSE REACTIONS section of the FDA label for Nelarabine. Read the label on DailyMed ›
Drowsiness / Trouble sleeping / Dizziness / Headache Additional detail
Policosanol
“Orally, policosanol may cause headache, mild vertigo, somnolence, irritability, or insomnia but these events are uncommon. In one clinical study, 1 out of 44 subjects receiving policosanol 20 mg daily 12 weeks experienced mild vertigo and 2 out of 44 experienced mild headache. In another study, 2 out of 70 patients taking policosanol 10 mg daily for 8 weeks experienced headache.”

Policosanol · Natural Medicines adverse-effect record, reported in cluster headache.
3 sources cited

14404. Greyling A, De Witt C, Oosthuizen W, Jerling JC. Effects of a policosanol supplement on serum lipid concentrations in hypercholesterolaemic and heterozygous familial hypercholesterolaemic subjects. Br J Nutr 2006;95:968-75. PubMed

69119. Francini-Pesenti F, Brocadello F, Beltramolli D, et al. Sugar cane policosanol failed to lower plasma cholesterol in primitive, diet-resistant hypercholesterolaemia: A double blind, controlled study. Complement Ther Med 2008;16:61-65. PubMed

95374. Castaño G, Fernández L, Mas R, Illnait J, Mesa M, Fernández JC. Comparison of the effects of policosanol and atorvastatin on lipid profile and platelet aggregation in patients with dyslipidaemia and type 2 diabetes mellitus. Clin Drug Investig. 2003;23(10 PubMed
Nelarabine

Listed in the ADVERSE REACTIONS section of the FDA label for Nelarabine. Read the label on DailyMed ›

Reported for Policosanol but not commonly for Nelarabine: stomach upset, mood changes or irritability, weight loss and a skin rash.

Effects for Nelarabine come from the ADVERSE REACTIONS section of its FDA label; effects for Policosanol come from the Natural Medicines adverse-effect record, quoted above. Where a percentage is shown, it is the share of 956 voluntary FDA FAERS reports for Nelarabine that mention that effect — a reporting proportion, not an incidence rate and not evidence the drug caused it. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

Everything else you take

See Every Supplement That Interacts With Nelarabine

This page covers Policosanol only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Nelarabine page lists 130 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: 1,4-butanediol (major), Beer (major), Gamma-hydroxybutyrate (ghb) (major), Kava (major) and L-tryptophan (major).

By severity: 6 major · 118 moderate · 6 minor.

From our pharmacist’s overview on the Nelarabine page

“Nelarabine (Atriance) is chemotherapy for a rare T-cell leukemia and lymphoma, and its most feared side effect is damage to the nervous system, from heavy drowsiness up to seizures. Most of the 130 supplement and herbal ingredients on this list press on exactly that weak point.”

Reviewed by 2 · Jul 18, 2026

Open the Nelarabine interaction page

One more smart check

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

We hold 479 real supplement products containing Policosanol, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Policosanol. Even though Policosanol itself has no known interaction with Nelarabine, another ingredient on your label might. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Policosanol and Nelarabine 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 Policosanol

Top 25%

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

29 days ago today

Medication Nelarabine

Steady interest

#2,261 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.

Where does our data come from?

Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Policosanol reference on this page ↓
Freshness: we automatically re-check this combination every week — this pair was last verified September 20, 2026. The Policosanol and Nelarabine records this page draws on were last updated July 10, 2026.
What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.

Data structure & sourcing designed and verified by Dr. Brian Staiger, PharmD, BCPS.

Supplement

About Policosanol

What is Policosanol?

High cholesterol
Heart and blood vessel health
Leg pain from poor circulation (intermittent claudication)
Physical stamina and energy

Policosanol is a mix of waxy alcohols (mostly octacosanol) made from sugar cane or other plant waxes, and it is often marketed as a natural way to lower cholesterol. Early studies from Cuba showed strong cholesterol-lowering effects, but independent studies in other countries have mostly failed to confirm these benefits. Talk with your pharmacist or doctor before using it, especially if you take cholesterol medicine.

Wax extracted from sugar cane, beeswax, rice bran, or wheat germ · Tablets, capsules

An interaction check asks whether these two react with each other — it does not ask whether Policosanol is a good idea for someone in your situation. Here is what our Policosanol record says about it on its own.

Policosanol: dosing

There is no official or universally agreed-upon dose for policosanol. The amounts used in studies have varied, and the source of the wax can change how a product behaves. They can help you decide if it is appropriate for you and whether your cholesterol or heart condition needs proven treatment instead.

From our Policosanol monograph — the full record covers uses, side effects and every documented interaction.

Read the full Policosanol monograph & all interactions

Medication

About Nelarabine Injection

What Is Nelarabine Injection Used For?

Brand name: Atriance

Nelarabine injection (brand name Arranon) is used to treat two aggressive blood cancers: T-cell acute lymphoblastic leukemia (T-ALL) and T-cell lymphoblastic lymphoma (T-LBL). It is approved for adult and pediatric patients age 1 year and older whose disease has not responded to — or has come back after — at least two prior chemotherapy regimens.

Nelarabine injection may also be given in combination with multi-agent chemotherapy as part of treatment for newly diagnosed T-ALL and T-LBL in certain settings, as studied in clinical trials.

Most-Reported Side Effects for Nelarabine

From FAERS, the FDA’s public side-effect reporting system (956 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Febrile neutropenia 75 reports

Neuropathy peripheral 60 reports

Neurotoxicity 60 reports

Sepsis 56 reports

Muscular weakness 55 reports

See full Nelarabine Injection drug information

Keep checking

Other Drugs & Policosanol

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

0Major

242Moderate

0Minor

2,587No known interaction

242 Moderate 2,587 No interaction

Moderate

242 interactions

Showing 60 of 242 moderate interactions — see all 242 on the Policosanol page.

No interaction 2,587 drugs checked — show the list

We also checked Policosanol against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,587 medications checked with no known interaction — see the full Policosanol list.

See the full Policosanol interactions page

See every supplement checked against Nelarabine, ranked by severity

Evidence & sources

Policosanol References

The 15 references that drive our Policosanol monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

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.
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
Valdes S, Arruzazabala ML, Fernandez L. Effect of policosanol on platelet aggregation in healthy volunteers. Int J Clin Pharmacol Res 1996;16:67-72.
Greyling A, De Witt C, Oosthuizen W, Jerling JC. Effects of a policosanol supplement on serum lipid concentrations in hypercholesterolaemic and heterozygous familial hypercholesterolaemic subjects. Br J Nutr 2006;95:968-75. PubMed
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
Molina, Cuevas, V, Arruzazabala, M. L., Carbajal, Quintana D., Mas, Ferreiro R., and Valdes, Garcia S. Effect of policosanol on arterial blood pressure in rats. Study of the pharmacological interaction with nifedipine and propranolol. Arch Med Res 1998;29
Castano G, Fernandez L, Mas R, et al. Comparison of the efficacy, safety and tolerability of original policosanol versus other mixtures of higher aliphatic primary alcohols in patients with type II hypercholesterolemia. Int.J.Clin.Pharmacol.Res. 2002;22:5
Arruzazabala, M. L., Carbajal, D., Mas, R., Valdes, S., and Molina, V. Pharmacological Interaction Between Policosanol and Nitroprusside in Rats. J Med Food 2001;4(2):67-70. PubMed
Castano G, Mas R, Gamez R, et al. Concomitant use of policosanol and beta-blockers in older patients. Int J Clin Pharmacol.Res 2004;24:65-77.
Francini-Pesenti F, Brocadello F, Beltramolli D, et al. Sugar cane policosanol failed to lower plasma cholesterol in primitive, diet-resistant hypercholesterolaemia: A double blind, controlled study. Complement Ther Med 2008;16:61-65. PubMed
Castaño G, Fernández L, Mas R, Illnait J, Mesa M, Fernández JC. Comparison of the effects of policosanol and atorvastatin on lipid profile and platelet aggregation in patients with dyslipidaemia and type 2 diabetes mellitus. Clin Drug Investig. 2003;23(10 PubMed
Fernandez L, Mas R, Illnait J, Fernandez JC. Policosanol: results of a postmarketing surveillance study of 27,879 patients. Curr Ther Res 1998;59(10):717-22. DOI
Wang HY, Jiao QP, Chen SY, et al. Efficacy and safety of policosanol plus fenofibrate combination therapy in elderly patients with mixed dyslipidemia: A randomized, controlled clinical study. Am J Med Sci. 2018;356(3):254-261. PubMed
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
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

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking Policosanol and Nelarabine Together: Common Questions

Is it safe to take Policosanol with Nelarabine?

We do not list a known interaction between Policosanol and Nelarabine. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.

Do Policosanol and Nelarabine have any of the same side effects?

Yes — our sources link each of them separately to 5 of the same effects. That is not an interaction: neither changes how your body handles the other. It does mean that if one of those effects turns up, it can be harder to tell which one is behind it. They are listed on this page with the source behind each.

How was the Policosanol and Nelarabine combination checked?

Interactions in our licensed database are recorded against drug classes. Nelarabine is filed under 3 classifications, and Policosanol has documented interactions with 6 drug classes — none of Nelarabine's classifications are among them. A medication can belong to classes beyond those recorded in our dataset, so this describes how the check was run rather than guaranteeing safety.

Does Policosanol interact with any other medications?

Yes. Policosanol has 242 documented drug interactions in our database — Nelarabine is simply not one of them. If you take anything else, it is worth checking each one; they are all listed on this page.

Does Nelarabine interact with any supplements?

Yes. Nelarabine has documented interactions with 130 supplements in our database — Policosanol is not one of them. The Nelarabine interaction page linked on this page lists every one, ranked by severity.

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

Where next

Keep Exploring

Policosanol monograph Uses, safety profile, and every drug interaction in one place Nelarabine Injection drug information The full plain-English guide to this medication Nelarabine supplement interactions Every supplement checked against Nelarabine, ranked by severity Supplement interaction checker Check any supplement or product against your medications Browse medications A–Z Every drug we’ve checked against herbs & supplements References The 15 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Nelarabine and Policosanol?

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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.