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ubiquinone; coenzyme Q (CoQ, CoQ10, MitoQ, ubidecarenone)

Cofactor in mitochondrial electron transport. It is endogenously synthesized from isopentenyl pyrophosphate, an intermediate in the biosynthesis of cholesterol. Pharmacology: Coenzyme Q10 Indications: (uses) 1) congestive heart failure [8] 2) diabetes mellitus type 2 3) male infertility 4) muscular dystrophy 5) obesity, weight loss 6) hypertension (10% reduction in blood pressure) 7) replacement therapy with concurrent statin use [1-4] a) diminishes statin-induced myalgia [9] b) not useful for statin-induced myopathy [8] c) small trials suggest benefit, but larger trials needed [12] 8) migraine prophylaxis [5,8] 9) Parkinson's disease (investigational) [6] 10) mitochondrial disorders [8] Dosage: 1) 30-1200 mg PO QD 2) statin myopathy: 100 mg QD [10] 3) heart failure: 60-300 mg QD [10] 4) hypertension: 100-200 mg QD [10,11]* 5) type-2 diabetes: 100-20 mg QD [10] 6) migraine prophylaxis: 150 mg PO QD [5] 7) 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: 1) generally considered safe in doses up to 3 grams/day - increased serum transaminases with doses > 300 mg/day [11] 2) safety in children & pregnant women not determined 3) nausea, headache, diarrhea at high doses [10,11] 4) hypotension [11] Drug interactions: 1) Coenzyme Q10 may reduce effect of warfarin [7] 2) Coenzyme Q10 may increase effect of insulin [7] 3) Coenzyme Q10 may interact with cancer chemotherapeutic agents 4) statins diminish serum levels of ubiquinone [1-4]; coenzyme Q10 supplementation may restore serum CoQ levels 5) beta-blockers, phenothiazines, tricyclic antidepressants, methyldopa, hydrochlorothiazide, clonidine, hydralazine reported to have interaction, increasing need for or decreasing bioavailability of CoQ10 Laboratory: - ubiquinone 10 in serum/plasma - ubiquinone 10 in tissue 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

Interactions

molecular events

Related

cholesterol coenzyme Q deficiency (ubiquinone deficiency) electron transport isopentenyl pyrophosphate

Specific

semiquinone ubiquinol; reduced coenzyme Q ubisemiquinone or coenzyme Q radical

General

cofactor electron carrier quinone

Properties

COMPARTMENT: inner mitochondrial membrane

Database Correlations

Kegg map/map00130

References

  1. Ghirlanda et al, J Clin Pharmacol. 33:226, 1993
  2. Mortensen et al Mol Aspects Med 18(suppl):S137, 1997
  3. Folkers et al, Proc Natl Acad Sci USA 87:8931, 1990
  4. Bargossi et al, Int J Clin Lab Res 24:171, 1994
  5. Prescriber's Letter 9(6):33 2002
  6. Journal Watch 22(23):176, 2002 Shults CW et al, Arch Neurol 59:1541, 2002
  7. Use of Ubiquinone (Coenzyme Q10) in Patients Taking Statins Prescriber's Letter 11(4):22 2004 Detail-Document#: 200420 (subscription needed) http://www.prescribersletter.com
  8. Uses of Coenzyme Q10 Prescriber's Letter 11(7):41 2004 Detail-Document#: 200712 (subscription needed) http://www.prescribersletter.com
  9. 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: 17493470
  10. Prescriber's Letter 17(6): 2010 Uses of Coenzyme Q10 Detail-Document#: 260607 (subscription needed) http://www.prescribersletter.com
  11. 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. 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: 20601617
  13. 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: 29661838

Substructures

isoprene

Component-of

alpha tocopherol/carnitine/coenzyme/ubiquinone alpha tocopherol/lipoate/ubiquinone coenzyme/lipoate/ubiquinone coenzyme/ubiquinone/vitamin e docosahexaenoate/eicosapentaenoate/ubiquinone/vitamin e glycine/isoleucine/ubiquinone lipoate/ubiquinone red yeast rice/ubiquinone tocopherol/ubiquinone ubiquinone/vitamin e