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

Heart failure
Coenzyme Q-10 deficiency
Mitochondrial disorders
Muscular dystrophy
Immune stimulant in HIV infection
Parkinson's 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:

OB: Pregnancy and lactation;
Allergy/hypersensitivity.

Use Cautiously in:

Hypotension;
Surgery (discontinue 2 wk prior to procedure).

Adv. Reactions/Side Effects ⬆ ⬇

CV: hypotension

Derm: rash

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

Neuro: dizziness

Interactions ⬆ ⬇

Natural-Drug Products:

HMG CoA reductase inhibitors (statins) can ↓ coenzyme Q-10 levels.
May ↑ risk of clotting with anticoagulants.
May have additive hypotensive effects with antihypertensives.
May protect againstanthracycline-associated cardiotoxicity.

Natural-Natural Products:

Red yeast can ↓ coenzyme Q-10 levels.
May have additive hypotensive effects with herbs that can lower BP including fish oil and L-arginine.

Route/Dosage ⬆ ⬇

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

Availability ⬆ ⬇

Soft-gel capsules:
Tablets:

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 ⬆ ⬇

Instruct patient to take with a meal containing fat, as directed.
May cause dizziness. Caution patient to avoid driving or other activities requiring alertness until response to medication is known.

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Pronunciation ⬇

Classifications ⬆ ⬇

Indications ⬆ ⬇