CoQ10 and Statins: A Pharmacist Explains

Megan Nunn, PharmD
·6 min read
4
  • Oops!
    Something went wrong.
    Please try again later.

Find out if coQ10 counteracts muscle pain caused by statins and more.

Medically reviewed by Alex Yampolsky, PharmD

Statins are a class of medicines commonly prescribed to lower cholesterol and help prevent heart attacks and strokes.

While they have lots of benefits, statins are also associated with muscular side effects, ranging from muscle pain to breakdown.

Statins deplete your muscles' coenzyme Q10 (coQ10), which may lead to muscle damage. Some people who take statins also supplement with coQ10 to minimize muscular side effects.

Here's what you need to know about coQ10 supplementation for people on statin therapy, including possible benefits and precautions.

Statins

Statins (HMG-CoA reductase inhibitors) are first-line medicines used to lower low-density lipoprotein cholesterol ("bad" or LDL cholesterol).

In general, statin medicines can lower LDL cholesterol levels by 20%-50%. They also reduce triglycerides (fats) by 10%-20%. This carries over into benefits for the heart. Taking a statin for five years has been shown to decrease the risk of major heart events by about 10%.

About 25% of Americans over 39 take a statin medication. This class of drugs includes commonly-prescribed medications like:

The most important side effects of statins have to do with the muscles. These side effects can include:

Research shows that 10% to 25% of people who take statins report muscular side effects, which may lead to discontinuing treatment.  It is important to notify your healthcare provider of any adverse effects and decide how adverse effects should be addressed.

Other side effects of statin therapy include:

<p>Courtney Hale / Getty Images</p> Mature female opening a vitamin bottle

Courtney Hale / Getty Images

Mature female opening a vitamin bottle

Uses of CoQ10



Explainer

Supplement use should be individualized and vetted by a healthcare professional, such as a registered dietitian nutritionist (RD or RDN), pharmacist, or healthcare provider. No supplement is intended to treat, cure, or prevent disease.



CoQ10, also known as ubiquinone, is an important energy source for every cell in the body. It has antioxidant and anti-inflammatory properties.

Many disease states are associated with low levels of coQ10. Some of these include:

CoQ10 is one of the most commonly used dietary supplements in the U.S. It's been studied for conditions such as:

Keep in mind that so far, there's not enough evidence to routinely recommend coQ10 for all of these uses.

CoQ10 is made in the body by the same pathway blocked by statins. CoQ10 levels can be depleted in people who take these medicines. It's theorized that lower levels of coQ10 are responsible for the muscular side effects of statin medications.

But overall, the data is mixed and doesn't fully support taking coQ10 to counter all statin side effects.

A small study compared the effects of 400 milligrams (mg) of coQ10 daily to a placebo (sugar pill) in 37 adults who also took simvastatin. Researchers concluded that eight weeks of coQ10 supplementation had no significant effect on levels of coQ10 in the muscles. CoQ10 supplements did not improve symptoms of muscle pain, even in those who did see an increase in coQ10 levels in the muscles.

However, another clinical trial showed a coenzyme Q10 supplementation (50 mg twice daily) reduced statin-related muscle symptoms.

Researchers completed an analysis of eight clinical trials that examined coQ10's role in people taking statins. The effects of coQ10 supplementation were mixed or didn't support use in muscle pain any more than a placebo. It also didn't significantly increase creatine kinase activity, which may be a marker for muscle pain.

Nutrition

CoQ10 is made in the body. It can also be obtained through some foods or in supplement form.

In general, the body needs about 500 milligrams (mg) of coQ10 daily, but only about 5 mg of this comes from food sources. Standard doses of coQ10 supplements are 300 mg.

Foods rich in coQ10 include the following:

Special Considerations

Precautions

Discuss the use of coQ10 with your healthcare provider prior to using it if you are in one of these categories to optimize safety:

  • Avoid coQ10 if you're allergic to it or its components (parts).

  • Seek immediate medical attention if you have a severe allergic reaction (itching, hives, shortness of breath).

  • Some people should take extra precautions while taking this supplement. These include children and those who are pregnant or nursing.

Side Effects

As with all supplements, coQ10 may cause side effects. These side effects may be common or severe.

Mild side effects of coQ10 include:

Interactions

CoQ10 may interact with the following prescription medications:

  • Statins. As detailed above, statins reduce levels of coQ10 in the body.

  • Jantoven (warfarin). CoQ10 is structurally similar to vitamin K and may decrease levels of Jantoven in the body.

  • Theophylline. Animal studies show an interaction between theophylline, an asthma medication, and coQ10.

  • Insulin and other diabetes medications. CoQ10 decreases fasting blood sugar levels slightly, so it could cause low blood sugar (hypoglycemia) if taken with other diabetes medicines. Signs of hypoglycemia include fast heart rate, shakiness, or headache.

Carefully reading a supplement's ingredients list and nutrition facts panel to know which ingredients and how much of each ingredient is included is essential. Please review the supplement label with your healthcare provider to discuss potential interactions with foods, other supplements, and medications.



Explainer

In the United States, the Food and Drug Administration (FDA) does not regulate supplements the way it regulates prescription drugs. That means some supplement products may not contain what the label says.

When choosing a supplement, look for third-party tested products and consult a healthcare provider, registered dietitian nutritionist (RD or RDN), or pharmacist.



Summary

CoQ10 is found in every cell of your body and is an important energy source.

Statins, a class of cholesterol-lowering medications, can lower the amount of coQ10 in your body.

Some people who take statins also supplement with coQ10 to minimize the side effects of statins on the muscles. These side effects can include muscle weakness, cramps, and even dissolution.

The bottom line, though, is that while anecdotal reports abound, there's minimal scientific basis for adding coQ10 to statin therapy. Research shows mixed benefits from coQ10 regarding muscle pain or symptoms.

If you are taking a statin medication, discuss any side effects you may have with your healthcare provider before stopping your medicine. They can help you lower your dose or change to a more appropriate medication if warranted.

Frequently Asked Questions

Should a statin and coQ10 be taken together?

Though this is sometimes recommended, there's not enough evidence to recommend taking coQ10 with a statin. While it may not hurt, more robust research is needed to prove there's any benefit.

What are statins?

Statins (HMG-CoA reductase inhibitors) are a frequently prescribed class of cholesterol-lowering medications.

What is CoQ10?

CoQ10 is a coenzyme that is made in the body and can also be obtained through foods and dietary supplements. It acts as an antioxidant and provides energy to cells in the body.

What can I do if I have muscular side effects while taking a statin?

Always discuss with your healthcare provider prior to making any changes to your medication regimen.

Some options your provider may recommend to help with muscle pain while on a statin include:

  • Lowering the dose of your medicine

  • Changing to a different statin—Lescol (fluvastatin) and Crestor (rosuvastatin) are less likely to cause muscle damage

  • Changing to a different class of drug, such as Zetia (ezetimibe)

Read the original article on Verywell Health.