coenzyme Q10

Coenzyme Q10 is a fat-soluble compound found in virtually all the cell membranes in the body, and in the highest concentrations in the heart, liver, kidneys and pancreas. Coenzyme Q10 is a member of the ubiquinone family of compounds that is naturally synthesized in the body. It is also available from dietary sources such as fatty fish, organ meats, poultry, eggs, vegetable oils, whole grains, nuts, legumes, and certain fruits and vegetables.

Coenzyme Q10 is taken as a dietary supplement to reduce symptoms and improve outcomes in many cardiovascular conditions including congestive heart failure, heart attack (myocardial infarction), chest pain (angina), and high blood pressure (hypertension), and many other conditions such as mitochondrial diseases, muscular dystrophies, and statin-induced muscle pain (myalgia). Coenzyme Q10 may also be taken to supplement natural deficiency due to primary coenzyme Q10 deficiency, a rare genetic disorder, or secondary deficiency.

Coenzyme Q10 plays a vital role in the transfer of protons and electrons in mitochondria and lysosomes. Mitochondria are intracellular organelles which convert carbohydrates and fats into adenosine triphosphate (ATP), the form of energy cells can use. Lysosomes in the cells contain the digestive enzymes that break down cellular debris. Coenzyme Q10 is also an antioxidant that prevents cellular damage from oxidative stress caused by reactive oxygen species (ROS), also known as free radicals.

The suggested uses of coenzyme Q10 include:

• Cardiovascular conditions such as:
  • Congestive heart failure (CHF)
  • Myocardial infarction (MI)
  • Myocardial injury during procedures such as angioplasty
  • Reperfusion injury from free radicals after an MI
  • Prior to cardiac surgeries such as bypass or transplantation
  • Angina pectoris
  • Hypertension
  • Heart damage from chemotherapy drugs
• Chronic fatigue syndrome
• To boost the immune system in human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS)
• Diabetes mellitus
• Mitochondrial diseases
• Mitochondrial encephalomyopathy, an inherited disorder that affects multiple systems including the brain, nervous system and muscles
• Muscle wasting diseases (muscular dystrophies)
• Primary coenzyme Q10 deficiency
• Secondary coenzyme Q10 deficiency
• Muscle pain associated with statin use
• Gum (periodontal) disease
• To prevent plaque formation (atherosclerosis) in arteries
• To delay aging and improve age-related decline in vitality and energy

Clinical studies show some evidence that coenzyme Q10 use may be beneficial in some of the above conditions, particularly in the prevention of damage to the heart from heart disease or surgery and primary coenzyme Q10 insufficiency, however, there is inconclusive evidence for its efficacy in most of the conditions.

Research is ongoing (orphan designation) on the use of Coenzyme Q10, in conditions that include the following:

• Huntington’s disease
• Mitochondrial cytopathies
• Pediatric congestive heart failure
• Epidermolysis bullosa

Use coenzyme Q10 with caution in the following circumstances:

• Biliary obstruction
• Other concurrent antihypertensive therapies
• Concurrent cancer chemotherapy
• Concurrent radiation therapy
• Insufficiency in liver function
• Hypertension

Side effects of coenzyme Q10 include:

• Nausea
• Vomiting
• Diarrhea
• Heartburn
• Abdominal discomfort
• Reduced appetite
• Allergic skin rashes
• Elevated liver function test results
• Lowering of blood pressure

This is not a complete list of all side effects or adverse reactions that may occur from the use of this drug.

Call your doctor for medical advice about serious side effects or adverse reactions. You may also report side effects or health problems to the FDA at 1-800-FDA-1088.

There is no established standard dose of coenzyme Q10. Different supplement brands might have different ingredients and strengths. Follow directions on product labels and consult a healthcare professional before using.

Suggested dosage:

• 50-200 mg orally daily
• Congestive heart failure (CHF): 100 mg/day divided two to three times daily orally
• Myocardial preservation for heart surgery: 200 mg/day orally

• Published studies indicate that coenzyme Q10 has low toxicity and does not induce serious adverse effects.
• In case of overdose, any adverse effects may be treated with symptomatic and supportive care.

Inform your doctor of all medications you are currently taking, who can advise you on any possible drug interactions. Never begin taking, suddenly discontinue, or change the dosage of any medication without your doctor’s recommendation.

• Coenzyme Q10 has no known severe or serious interactions with other drugs.
• Moderate interaction of coenzyme Q10 include:
  • warfarin
• Mild interactions of coenzyme Q10 include:
  • atorvastatin
  • fluvastatin
  • glyburide
  • insulin aspart
  • insulin detemir
  • insulin glargine
  • insulin glulisine
  • insulin lispro
  • insulin NPH
  • insulin regular human
  • lovastatin
  • pitavastatin
  • pravastatin
  • rosuvastatin
  • simvastatin
  • tolazamide

The drug interactions listed above are not all of the possible interactions or adverse effects. For more information on drug interactions, visit the RxList Drug Interaction Checker.

It is important to always tell your doctor, pharmacist, or health care provider of all prescription and over-the-counter medications you use, as well as the dosage for each, and keep a list of the information. Check with your doctor or health care provider if you have any questions about the medication.

• During pregnancy, the use of coenzyme Q10 supplements (100 mg twice daily) from 20 weeks gestation was found to be safe
• There are no studies on safety of coenzyme Q10 use in breastfeeding women; avoid use

• In general, coenzyme Q10 appears safe and well tolerated by most people
• Consult with your healthcare provide before taking coenzyme Q10 because of its potential side effects and interactions with certain medications
• Coenzyme Q10 is marketed as an herbal supplement and is not stringently regulated by the FDA like prescription drugs; products may differ in formulations and strengths; exercise caution in choosing your product