ubiquinone; coenzyme Q (CoQ, CoQ10, MitoQ, ubidecarenone)
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Introduction
Cofactor in mitochondrial electron transport. It is endogenously synthesized from isopentenyl pyrophosphate, an intermediate in the biosynthesis of cholesterol.
Pharmacology
Coenzyme Q10
Indications
(uses)
- congestive heart failure[8]
- diabetes mellitus type 2
- male infertility
- muscular dystrophy
- obesity, weight loss
- hypertension (10% reduction in blood pressure)
- replacement therapy with concurrent statin use [1-4]
- diminishes statin-induced myalgia[9]
- not useful for statin-induced myopathy[8]
- small trials suggest benefit, but larger trials needed[12]
- migraine prophylaxis[5][8]
- Parkinson's disease (investigational)[6]
- mitochondrial disorders[8]
Dosage
- 30-1200 mg PO QD
- statin myopathy: 100 mg QD[10]
- heart failure: 60-300 mg QD[10]
- hypertension: 100-200 mg QD[10][11]*
- type-2 diabetes: 100-20 mg QD[10]
- migraine prophylaxis: 150 mg PO QD[5]
- Parkinson's disease: 1200 mg QD-TID[6]
* may lower systolic BP up to 21 mm Hg & diastolic BP up to 16 mm Hg in patients with hypertension[11]
* GRS11 claims that in combination with 25 lb weight loss, may lower systolic blood pressure >140 - 85 = >55 mm Hg (no supporting data provided)
Adverse effects
- generally considered safe in doses up to 3 grams/day
- increased serum transaminases with doses > 300 mg/day[11]
- safety in children & pregnant women not determined
- nausea, headache, diarrhea at high doses[10][11]
- hypotension[11]
Drug interactions
- Coenzyme Q10 may reduce effect of warfarin[7]
- Coenzyme Q10 may increase effect of insulin[7]
- Coenzyme Q10 may interact with cancer chemotherapeutic agents
- statins diminish serum levels of ubiquinone [1-4]; coenzyme Q10 supplementation may restore serum CoQ levels
- beta-blockers, phenothiazines, tricyclic antidepressants, methyldopa, hydrochlorothiazide, clonidine, hydralazine reported to have interaction, increasing need for or decreasing bioavailability of CoQ10
Laboratory
Mechanism of action
- ubiquinone serves as a cofactor in electron transport
- putative vasodilator via reduction of reactive oxygen[13]
- preservation of nitric oxide in the endothelium
More general terms
More specific terms
Additional terms
- cholesterol
- coenzyme Q deficiency (ubiquinone deficiency)
- electron transport
- isopentenyl pyrophosphate
Component of
- tocopherol/ubiquinone
- red yeast rice/ubiquinone
- glycine/isoleucine/ubiquinone
- alpha tocopherol/lipoate/ubiquinone
- ubiquinone/vitamin e
- lipoate/ubiquinone
- docosahexaenoate/eicosapentaenoate/ubiquinone/vitamin e
- coenzyme/ubiquinone/vitamin e
- coenzyme/lipoate/ubiquinone
- alpha tocopherol/carnitine/coenzyme/ubiquinone
References
- ↑ Ghirlanda et al, J Clin Pharmacol. 33:226, 1993
- ↑ Mortensen et al Mol Aspects Med 18(suppl):S137, 1997
- ↑ Folkers et al, Proc Natl Acad Sci USA 87:8931, 1990
- ↑ Bargossi et al, Int J Clin Lab Res 24:171, 1994
- ↑ 5.0 5.1 5.2 Prescriber's Letter 9(6):33 2002
- ↑ 6.0 6.1 6.2 Journal Watch 22(23):176, 2002 Shults CW et al, Arch Neurol 59:1541, 2002
- ↑ 7.0 7.1 7.2 Use of Ubiquinone (Coenzyme Q10) in Patients Taking Statins Prescriber's Letter 11(4):22 2004 Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=200420&pb=PRL (subscription needed) http://www.prescribersletter.com
- ↑ 8.0 8.1 8.2 8.3 8.4 Uses of Coenzyme Q10 Prescriber's Letter 11(7):41 2004 Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=200712&pb=PRL (subscription needed) http://www.prescribersletter.com
- ↑ 9.0 9.1 Caso G, Kelly P, McNurlan MA, Lawson WE. Effect of coenzyme q10 on myopathic symptoms in patients treated with statins. Am J Cardiol. 2007 May 15;99(10):1409-12. Epub 2007 Apr 3. PMID: https://www.ncbi.nlm.nih.gov/pubmed/17493470
- ↑ 10.0 10.1 10.2 10.3 10.4 10.5 Prescriber's Letter 17(6): 2010 Uses of Coenzyme Q10 Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=260607&pb=PRL (subscription needed) http://www.prescribersletter.com
- ↑ 11.0 11.1 11.2 11.3 11.4 11.5 Geriatric Review Syllabus, 8th edition (GRS8) Durso SC and Sullivan GN (eds) American Geriatrics Society, 2013
Geriatric Review Syllabus, 11th edition (GRS11) Harper GM, Lyons WL, Potter JF (eds) American Geriatrics Society, 2022 - ↑ 12.0 12.1 Wyman M1, Leonard M, Morledge T. Coenzyme Q10: a therapy for hypertension and statin-induced myalgia? Cleve Clin J Med. 2010 Jul;77(7):435-42. PMID: https://www.ncbi.nlm.nih.gov/pubmed/20601617
- ↑ 13.0 13.1 Rossman MJ, Santos-Parker JR, Steward CAC et al Chronic Supplementation With a Mitochondrial Antioxidant (MitoQ) Improves Vascular Function in Healthy Older Adults. Hypertension. 2018 Apr 16. PMID: https://www.ncbi.nlm.nih.gov/pubmed/29661838