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Supplement · Grade A

Coenzyme Q10 and medications.

Every documented pair, every citation. Below: 6 documented pairs grouped by mechanism.

Coenzyme Q10 is in the Distil supplement database, evidence Grade A. The page below lists every medication we have explicitly assessed it against.

Coenzyme Q10 fuels the mitochondria that power heart muscle, acts as an antioxidant in the cardiovascular system and may improve the lining of blood vessels. The evidence is Grade A for people on statins and in heart failure, anchored by the Q-SYMBIO trial (Mortensen 2014), and Grade B for the general population. The statin link is the clearest reason to consider it: statins lower CoQ10 as part of how they work, so depletion is built in. Form matters with age. Over 40, the body's conversion of ubiquinone to the active ubiquinol declines, so the reduced ubiquinol form at 100 to 200mg is the one to choose. Two interactions stand out. CoQ10 may blunt warfarin's effect, so anyone on it should have their INR monitored, while it pairs well with omega-3 for cardiovascular support. Take it in the morning, since a late dose can disturb sleep, and expect mild gut upset only at higher doses.

Below are the 6 documented pairs we have explicitly assessed for Coenzyme Q10: 2 amber and 4 green. The pairs cluster around 1 mechanism: Vitamin K pathway. Every call is cited to either a clinical reference (PMID) or the British National Formulary. Anything not listed here is either still to be assessed or beyond our database scope. The checker beneath surfaces assessments by medication, and the missing-item form at the bottom of the page routes any uncatalogued medication into our next curation pass.

Documented interactions

Vitamin K pathway

Coenzyme Q10 is structurally similar to vitamin K and may slightly reduce the effect of acenocoumarol, a vitamin-K-based blood thinner, which could lower your INR. The signal is weak and comes from reports with the related drug warfarin. If you take acenocoumarol, keep your CoQ10 intake steady and mention it to your anticoagulant clinic so your INR can be watched.

PMID 10902065 · BNF: Acenocoumarol

Reviewer-flagged: awaiting clinical-reviewer sign-off.

CoQ10 has a similar molecular shape to vitamin K and may reduce warfarin's effect for some people. If you start or stop CoQ10 on warfarin, check INR within two weeks.

Other

Green Atorvastatin

Statins do reduce plasma CoQ10 levels, but the best-quality randomised trials show that taking CoQ10 alongside a statin does not reliably reduce muscle pain or improve other statin side effects. We treat the pair as safe to combine. If you find it helps you personally that is fine, but the evidence for routine use is weak.

Statins do reduce plasma CoQ10 levels, but the best-quality randomised trials show that taking CoQ10 alongside a statin does not reliably reduce muscle pain or improve other statin side effects. We treat the pair as safe to combine. If you find it helps you personally that is fine, but the evidence for routine use is weak.

Statins do reduce plasma CoQ10 levels, but the best-quality randomised trials show that taking CoQ10 alongside a statin does not reliably reduce muscle pain or improve other statin side effects. We treat the pair as safe to combine. If you find it helps you personally that is fine, but the evidence for routine use is weak.

Green Simvastatin

Statins do reduce plasma CoQ10 levels, but the best-quality randomised trials show that taking CoQ10 alongside a statin does not reliably reduce muscle pain or improve other statin side effects. We treat the pair as safe to combine. If you find it helps you personally that is fine, but the evidence for routine use is weak.

What this list does not say. Pairs not flagged here are not implicitly safe. They are either not yet in our database, or fall outside our inclusion scope. Use the checker below to surface any medication, and submit a missing item if you take something we have not catalogued.

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For adults over 18. This tool gives evidence-graded information, not medical advice. Always discuss changes with your GP, especially if you take any medication, are pregnant, breastfeeding, or have a serious health condition.
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