Coenzyme Q10 and Statins

[tubonkulous]

Since statins inhibit HMG-CoA reductase, mevalonate production is decreased, so mevalonate cannot go on to make ubiquinone, the oxidized form of coenzyme Q10. Should patients taking statins also be taking coenzyme Q10 supplements, since they're not producing as much?

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[beautifulrobot]

Sounds like a homework question...

 

[Rouelle]

Agreed with @giga

But yeah, some statin users also take CoQ10

 

[RxPreceptor]

Homework for sure...
But how does one measure ubiquinone or determine there is a deficiency or need to spend (or likely waste) a solid 40$/month on some OTC CoQ10?
Are food sources of CoQ10 enough, does one blindly assume anyone taking a "statin" is deficient? Is this even an evidence based recommendation or just anecdotal? Go practice your researching skills/resource management

 

[bacillus1]

Agreed with @giga

But yeah, some statin users also take CoQ10

Data is not strong enough for us to cover it. If the patients want to buy it OTC, that's on them...may or may not work.

 

[owlegrad]

When I worked for an MTM company this was a TIP we frequently targeted. To be honest I was never really on board for it though. Maybe there is a benefit, maybe not but there (OP - learn the difference between there, their, and they're) is just not nearly enough evidence of benefit for me to personally take it or recommend it to anyone. Not to mention when you buy a supplement OTC you can't even be sure that you are getting what you pay for. It's a hard no for me.

 

[spacecowgirl]

Does raising serum CoQ10 result in increased CoQ10 in the myocyte?

 

[tubonkulous]

Homework for sure...
But how does one measure ubiquinone or determine there is a deficiency or need to spend (or likely waste) a solid 40$/month on some OTC CoQ10?
Are food sources of CoQ10 enough, does one blindly assume anyone taking a "statin" is deficient? Is this even an evidence based recommendation or just anecdotal? Go practice your researching skills/resource management

I'm actually a friendly physician, reaching out to ask pharmacy colleagues a question they might know the answer to so I can best care for my patients and answer their questions.

 

[owlegrad]

If it was a TIP, does that mean the insurance company actually covered it? Or just "here, spend your own money to buy this thing to increase store sales"?. No clue anymore how the private sector works.

Well I worked for an MTM company not a retail company so there were no “store sales” to increase. But to answer the question, it wasn’t covered by insurance. Although they did pay us for the TIP to recommend it.

 

[RxPreceptor]

See full article/attachment (PL resource)
"What is the role of coenzyme Q10 (ubiquinol)?

• In patients with a history of statin muscle symptoms, confirmed by placebo-controlled crossover rechallenge, CoQ10 600 mg daily did not affect pain, muscle strength, or aerobic performance vs placebo in patients taking simvastatin 20 mg daily [Evidence level B; lower-quality RCT].2
  
• Canadian and European consensus panels advise against use of dietary supplements (including vitamin D) for statin muscle symptoms.3,10
  
• Coenzyme Q10 is well-tolerated if patients insist on trying it.7 However, it can be expensive. The suggested dose for statin muscle pain is 100 to 200 mg daily (in divided doses if >100 mg/day)."

 

[Thoughtfulsinner]

Dr. Oz recommends it

 

[tubonkulous]

Thank you! I am wondering about the potential cardiovascular benefits in patients who are on statins.