From the Guidelines
Patients taking statins should not consider CoQ10 supplementation for routine use, as evidence does not support its effectiveness in mitigating potential side effects, according to the 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA guideline on the management of blood cholesterol 1.
The use of CoQ10 supplementation in patients taking statins is not recommended due to the lack of evidence supporting its effectiveness in treating statin-associated muscle symptoms (SAMS) or other side effects. The 2018 guideline states that CoQ10 is not recommended for routine use in patients treated with statins or for the treatment of SAMS (S5-20, S5-21) 1.
While some studies suggest that CoQ10 supplementation may have beneficial effects on blood pressure in patients with cardiometabolic disorders, the evidence is not strong enough to support its use in patients taking statins specifically for this purpose 1.
It is essential for patients to discuss any concerns about statin side effects with their healthcare provider, as they can help determine the best course of action and ensure that the benefits of statin therapy are not compromised. The healthcare provider may recommend alternative strategies to manage side effects, such as adjusting the statin dose or switching to a different statin.
In summary, the current evidence does not support the routine use of CoQ10 supplementation in patients taking statins, and patients should consult their healthcare provider for guidance on managing potential side effects.
From the Research
CoQ10 and Statins: Mitigating Potential Side Effects
- Statins, or HMG-CoA reductase inhibitors, are commonly prescribed to reduce cardiovascular morbidity and mortality, but they can cause myopathy, a condition characterized by muscle weakness and pain 2, 3.
- Coenzyme Q10 (CoQ10) supplementation has been proposed as a potential mitigation strategy for statin-induced myopathy, as statins can decrease plasma levels of CoQ10 3, 4.
- Some studies suggest that CoQ10 supplementation can ameliorate statin-associated muscle symptoms, such as muscle pain and weakness, and increase plasma levels of CoQ10 2, 4.
- However, other studies have found no significant benefit of CoQ10 supplementation in improving statin-induced myopathy, including no reduction in plasma creatine kinase levels or improvement in muscle pain 5, 6.
- A meta-analysis of randomized controlled trials found that CoQ10 supplementation did not have a significant benefit in improving statin-induced myopathy, including no significant reduction in muscle pain or improvement in creatine kinase activity 5.
- Another study found that CoQ10 supplementation did not reduce muscle pain in patients with statin myalgia, and marginally more subjects reported pain with CoQ10 than with placebo 6.
Key Findings
- CoQ10 supplementation may increase plasma levels of CoQ10, but its effect on statin-induced myopathy is unclear 3, 4.
- Some studies suggest that CoQ10 supplementation can ameliorate statin-associated muscle symptoms, but others have found no significant benefit 2, 4, 5, 6.
- The optimal dose and duration of CoQ10 supplementation for mitigating statin-induced myopathy are unknown 3, 4.
- Further research is needed to determine the efficacy and safety of CoQ10 supplementation in patients taking statins 3, 4, 5.