Statin Myopathy & CoQ10

What is CoQ10

• Coenzyme Q10 is an important factor in mitochondrial ATP production.
• It is a potent lipid soluble antioxidant present in cell membranes and carried in the blood by LDL.
•  CoQ10 is biosynthesized in the body and available from dietary sources.
• Individual statins may have distinct effects on the synthesis of coenzyme Q10 (CoQ10).
• It has been speculated that a reduction in ubiquinone in skeletal muscle may contribute to statin-induced muscle injury.
• Different studies derived different conclusions about whether statin treatment decreases levels of ubiquinone in skeletal muscle.

Is CoQ10 Beneficial in Statin Myopathy?

• There’s a lack of evidence on the use of CoQ10 in prevention and improvent of statin accociated muscle event
• Two randomised controlled trials have investigated Co-enzyme Q10 for statin-associated myalgia, but they have conflicting results.
• One trial found that Co-enzyme Q10 (100mg daily for 30 days) improved pain scores for people with statin-associated myalgia more than vitamin E (400 IU daily).
• The other trial involving people who previously had statin-associated myalgia found no difference between Co-enzyme Q10 (200mg daily for 12 weeks) and placebo in myalgia scores or in the number of people who tolerated a higher dose of a statin.
• A 2015 meta-analysis of randomized trials concluded that existing trials do not suggest any significant benefit of CoQ10 for statin myopathy, but that larger trials are needed to confirm this lack of benefit.
• Patients may take coenzyme Q10 to lessen muscle symptoms, although published studies have not generally identified a benefit.

References:

1. Uptodate
2. http://www.fda.gov/ohrms/dockets/dailys/02/May02/052902/02p-0244-cp00001-02-Exhibit_A-vol1.pdf
3.  http://www.nps.org.au/medicines/nutrition/vitamins-and-minerals-oral/companion-products/q10-and-vitamin-d3-with-statins
4. https://www.pharmacist.com/coenzyme-q10-statin-induced-myopathy