coenzyme q-10

Complementary/Alternative Medicine: This monograph describes a natural or herbal product that is not subject to FDA guidelines for medicines. Patients and clinicians are advised to read package labels carefully to ensure safe and efficacious use.

REMS

HF.
Coenzyme Q-10 deficiency.
Mitochondrial disorders.
Muscular dystrophy.
HIV/AIDS.
Parkinson disease.

Action ⬆ ⬇

A cofactor in oxidative respiration for the Krebs cycle and the electron transport chain important for mitochondrial ATP generation. It also has antioxidant activity and membrane stabilizing ability.

Therapeutic effects:

Antioxidant effects.

Pharmacokinetics ⬆ ⬇

Absorption: Poor absorption in the GI tract; absorbed primarily in the small intestine.

Distribution: Unknown.

Metabolism/Excretion: Metabolized in all tissues; elimination via biliary and fecal excretion.

Half-Life: 34 hr.

Time/Action Profile ⬆ ⬇

	ONSET	PEAK	DURATION
PO	Unknown	5–10 hr	Unknown

Contraind./Precautions ⬆ ⬇

Contraindicated in:

Hypersensitivity.

Use Cautiously in:

Hypotension;
Surgery (discontinue ≥2 wk before procedure);
OB: Safety not established in pregnancy;
Lactation: Safety not established in breastfeeding;
Pedi: Safety and effectiveness not established in children.

Adv. Reactions/Side Effects ⬆ ⬇

CV: hypotension

Derm: rash

GI: ↓appetite, diarrhea, heartburn, nausea, vomiting

Neuro: dizziness

Interactions ⬆ ⬇

Natural-Drug Products:

HMG CoA reductase inhibitors (statins) can ↓ levels and effectiveness.
May ↓ effectiveness of anticoagulants.
May ↑ risk of hypotension with antihypertensives.
May protect againstanthracycline-associated cardiotoxicity.

Natural-Natural Products:

Red yeast rice can ↓ levels and effectiveness.
May ↑ risk of hypotension with fish oil and L-arginine.

Route/Dosage ⬆ ⬇

PO (Adults ): Coenzyme Q-10 deficiency: 150 mg once daily; Mitochondrial disorders: 150–160 mg (or 2 mg/kg) once daily; HF: 60–100 mg once daily; HIV/AIDS: 200 mg once daily; Parkinson disease: 300–2400 mg once daily; Muscular dystrophy: 100 mg once daily.

Availability ⬆ ⬇

Soft-gel capsules: ^OTC
Tablets: ^OTC

Assessment ⬆ ⬇

Monitor BP periodically during therapy.

Lab Test Considerations:

Monitor coagulation studies periodically during therapy.
- Monitor blood glucose during therapy; may cause hypoglycemia.
- Monitor lipid levels and serum lactate periodically during therapy.

Implementation ⬆ ⬇

Do not confuse coenzyme Q10 with Cometriq.
PO: Administer with a meal containing fat for optimal absorption.

Patient/Family Teaching ⬆ ⬇

Explain purpose and side effects of herb to patient.
Advise patient to consult with health care provider before using any herbal supplement, especially when taken concurrently with Rx or OTC medications or vitamins.
Advise patient to take with a meal containing fat.
May cause dizziness. Caution patient to avoid driving or other activities requiring alertness until response to medication is known.
Rep: Advise women of reproductive potential to notify health care provider if pregnancy is planned or suspected or breastfeeding before using this herb.

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Pronunciation ⬇

Classifications ⬆ ⬇

Indications ⬆ ⬇