Meta Information
ID:coenzyme-q10
Name:Coenzyme Q10
Schema Version:2.4_uniform_evidence_2026_06_18
Created
2026-05-21T22:30:00Z
Model
phase-a-upgrade-claude-sonnet-4.6
Interactions
Target id:
/dietary/high-fat-meal
Target name:
Meal Containing Fat
Severity:
major
Interaction type:
requirement
Nature:
temporal
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Coenzyme Q10 is a fat-soluble compound, and its absorption from the gut is significantly enhanced when consumed with dietary fats or oils.
Actionable advice:
CoQ10 should be taken with a meal that contains some fat or oil to ensure proper absorption.
Validation status:
validated_via_pubmed
Evidence tier:
tier_b
Evidence basis:
pubmed_abstract_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
While co-ingesting CoQ-10 with a fatty meal can enhance absorption, this approach is not always practical.
Label source:
PubMed: Frontiers in nutrition (2025)
Source url:
Exact phrase from label:
Coenzyme Q10 (CoQ10) exhibits important bioactive and health-promoting functions, yet its poor water solubility and low bioaccessibility restrict its wider application in food and nutraceutical formulations.
Label source:
PubMed: Food research international (Ottawa, Ont.) (2026)
Action type:
informational_none
Target id:
/class/statins
Target name:
Statins (HMG-CoA Reductase Inhibitors)
Severity:
major
Interaction type:
synergistic
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Statins inhibit the HMG-CoA reductase enzyme, which not only reduces cholesterol synthesis but also depletes the body's natural production of CoQ10.
Actionable advice:
Supplementing with CoQ10 can replenish levels depleted by statin therapy, which may help reduce muscle-related side effects.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
11 DESCRIPTION
LIPITOR (atorvastatin) is an inhibitor of 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA)
reductase.
Label source:
Action type:
informational_none
Target id:
/intervention/warfarin
Target name:
Warfarin
Severity:
major
Interaction type:
diminishing
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
CoQ10 is structurally similar to vitamin K2 and may have pro-coagulant effects, potentially reducing the anticoagulant efficacy of warfarin and increasing clotting risk.
Actionable advice:
CoQ10 supplementation should be avoided when taking warfarin, or used only under strict medical supervision with frequent INR monitoring.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Warfarin is thought to interfere with clotting factor synthesis by inhibition of the C1 subunit of vitamin K epoxide reductase (VKORC1) enzyme complex, thereby reducing the regeneration of vitamin K1 epoxide [see Clinical Pharmacology (12.5)].
Label source:
Action type:
avoid
Target id:
/procedure/surgery
Target name:
Scheduled Surgery
Severity:
major
Interaction type:
adverse
Nature:
temporal
Temporal spacing:
Hours before target:
336
Hours after target:
null
Description:
CoQ10 may affect blood pressure and blood clotting, which could interfere with blood pressure control during surgery and increase bleeding risk.
Actionable advice:
CoQ10 should be discontinued at least two weeks prior to any scheduled surgery.
Validation status:
validated_via_pubmed
Evidence tier:
tier_b
Evidence basis:
pubmed_abstract_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Other supplements, such as high doses of vitamin E (vitamin K antagonist activity), alfalfa (high-vitamin K content), and coenzyme Q10 (vitamin K-like activity), may affect blood clotting, which is dependent on vitamin K.
Label source:
PubMed: Methods in molecular biology (Clifton, N.J.) (2010)
Source url:
Exact phrase from label:
Haemorrhages were observed in five or six, six, one, one, one or one of six surviving rats given d-alpha, d-beta or d-gamma-tocopherols, ubiquinone Q-10, beta-carotene or retinol acetate, respectively (except for a retinol group in which four rats survived).
Label source:
PubMed: Food and chemical toxicology : an international journal published for the British Industrial Biological Research Association (1995)
Source url:
Exact phrase from label:
The secondary outcomes revealed that the ubiquinone group experienced reduced postoperative bleeding, with a median (IQR) drainage of 320 mL (230-415) compared to the drainage of 420 mL (242.5-747.5) in the placebo group (t(35.84) = 2.055, p = 0.047).
Label source:
PubMed: Antioxidants (Basel, Switzerland) (2025)
Action type:
avoid
Target id:
/class/chemotherapy-radiation
Target name:
Cytotoxic Cancer Therapies (Chemotherapy & Radiation)
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
As a potent antioxidant, CoQ10 could theoretically reduce the effectiveness of chemotherapy or radiation, which rely on generating oxidative stress to destroy cancer cells.
Actionable advice:
CoQ10 should not be taken during active cancer treatment without explicit approval and supervision from an oncologist.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
In the placebo group, one patient with FIGO Stage IB cancer received radiation therapy and the patient with FIGO Stage IVB cancer received chemotherapy and hormonal therapy.
Label source:
Action type:
avoid
Target id:
/intervention/red-yeast-rice
Target name:
Red Yeast Rice
Severity:
major
Interaction type:
synergistic
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Red yeast rice contains monacolin K, a naturally occurring statin compound, which depletes the body's CoQ10 levels in the same way as prescription statins.
Actionable advice:
CoQ10 should be supplemented when taking red yeast rice to replenish depleted levels.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
In conclusion, acute red yeast rice gavage suppressed hepatic and cardiac CoQ10 levels in rodents; furthermore, the inhibitory effect was responsive to the doses administered.
Label source:
PubMed: Acute administration of red yeast rice (Monascus purpureus) depletes tissue coenzyme Q(10) levels in ICR mice. (PMID 15705235)
Action type:
informational_none
Target id:
/class/antihypertensives
Target name:
Antihypertensive Medications
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
CoQ10 may have a mild blood pressure-lowering effect, which can add to the effects of antihypertensive medications, potentially causing blood pressure to drop too low (hypotension).
Actionable advice:
Blood pressure should be monitored closely when starting CoQ10 while on blood pressure medication.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Clinical trials have produced findings that suggest CoQ10 supplementation may lower both systolic and diastolic blood pressure in individuals diagnosed with essential hypertension, frequently as a component of adjunctive therapy.
Label source:
PubMed: The protective effects of coenzyme Q10 on blood pressure: a narrative review of anti-inflammatory and antioxidant mechanisms. (PMID 40820066)
Action type:
monitor
Target id:
/class/antidiabetic-medications
Target name:
Diabetes Medications
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
CoQ10 may improve insulin sensitivity and lower blood glucose levels, potentially enhancing the effect of diabetes medications and increasing the risk of hypoglycemia.
Actionable advice:
Blood glucose levels are best monitored closely when starting CoQ10 if medication for diabetes is taken.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Metformin decreases hepatic glucose production, decreases intestinal absorption of glucose, and improves insulin sensitivity by increasing peripheral glucose uptake and utilization.
Label source:
Action type:
monitor
Target id:
/condition/pregnancy
Target name:
Pregnancy
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
The safety of CoQ10 supplementation during pregnancy has not been definitively established, although some studies have explored its use in pre-eclampsia.
Actionable advice:
CoQ10 is best avoided during pregnancy unless specifically recommended and supervised by a physician.
Validation status:
anecdotal
Evidence tier:
tier_d
Evidence basis:
anecdotal_summary
Evidence anchors:
Exact phrase from label:
Healthcare professionals haven't decided if CoQ10 is safe to take during pregnancy or while breastfeeding.
Label source:
Anecdotal: Mayo Clinic
Action type:
avoid
Target id:
/condition/lactation
Target name:
Breastfeeding (Lactation)
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
It is unknown if CoQ10 is excreted in breast milk or what its effects on a nursing infant might be.
Actionable advice:
CoQ10 is best avoided while breastfeeding due to a lack of safety data.
Validation status:
anecdotal
Evidence tier:
tier_d
Evidence basis:
anecdotal_summary
Evidence anchors:
Exact phrase from label:
It is not known if coenzyme Q10 passes into breast milk.
Label source:
Anecdotal: WebMD
Action type:
avoid
Target id:
/intervention/pqq
Target name:
PQQ (Pyrroloquinoline quinone)
Severity:
moderate
Interaction type:
synergistic
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
PQQ supports mitochondrial biogenesis (creating new mitochondria) while CoQ10 enhances the efficiency of existing mitochondria, offering a dual-support mechanism for cellular energy.
Actionable advice:
Consider combining CoQ10 with PQQ for comprehensive mitochondrial support.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Exact phrase from label:
PQQ also promote mitochondrial biogenesis in order to increase the quantity and functional capability of mitochondria for enhanced metabolic activity to generate excessive energy rich ATPs
Label source:
Primary literature: https://pmc.ncbi.nlm.nih.gov/articles/PMC11541945/
Action type:
informational_none
Target id:
/circadian/sleep
Target name:
Going to Sleep
Severity:
minor
Interaction type:
adverse
Nature:
temporal
Temporal spacing:
Hours before target:
6
Hours after target:
null
Description:
As CoQ10 is crucial for cellular energy (ATP) production, some sensitive individuals may find it mildly stimulating if taken too close to bedtime.
Actionable advice:
CoQ10 is generally best taken in the morning or early afternoon to avoid potential sleep interference.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
CoQ10 functions as a key cofactor for adenosine triphosphate (ATP) production and exhibits antioxidant properties in vivo.
Label source:
PubMed: The role of CoQ10 in embryonic development. (PMID 38372883)
Action type:
avoid
Target id:
/class/anticoagulants-antiplatelets
Target name:
Anticoagulants and Antiplatelets
Severity:
minor
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Due to its structural similarity to Vitamin K, CoQ10 may theoretically interfere with the action of anticoagulant and antiplatelet drugs, although strong evidence is limited outside of warfarin.
Actionable advice:
This is best used with caution, and it is worth talking to a physician before combining CoQ10 with blood-thinning medications.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
6 Aluminum Lake
10 mg: Dye-free
12 CLINICAL PHARMACOLOGY
12.1 Mechanism of Action
Warfarin acts by inhibiting the synthesis of vitamin K-dependent clotting factors, which include
Factors II, VII, IX, and X, and the anticoagulant proteins C and S.
Label source:
Action type:
informational_none
Target id:
/class/beta-blockers
Target name:
Beta-Blockers
Severity:
minor
Interaction type:
diminishing
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Certain beta-blocker medications (e.g., propranolol, metoprolol) may interfere with CoQ10-dependent enzymes, potentially reducing endogenous CoQ10 levels over time.
Actionable advice:
If you are on long-term beta-blocker therapy, consider discussing CoQ10 supplementation with your doctor.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
(2) In asthmatic patients, metoprolol reduces FEV1 and FVC significantly less than a nonselective beta-blocker, propranolol, at equivalent beta1-receptor blocking doses.
Label source:
Action type:
informational_none
Target id:
/class/tricyclic-antidepressants
Target name:
Tricyclic Antidepressants
Severity:
minor
Interaction type:
diminishing
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Some tricyclic antidepressants (e.g., amitriptyline) may interfere with enzymes involved in CoQ10 synthesis, potentially leading to lower levels with long-term use.
Actionable advice:
Consider discussing CoQ10 supplementation with your doctor if on long-term tricyclic antidepressant therapy.
Validation status:
validated_via_pubmed
Evidence tier:
tier_b
Evidence basis:
pubmed_abstract_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Amitriptyline treatment induced a dose-dependent decrease in CoQ levels in tumor cells. CoQ decreased levels were associated with down-regulation of the expression of COQ4 gene, as well as decreased Coq4 and Coq6 protein levels.
Label source:
PubMed: European journal of pharmacology (2017)
Source url:
Exact phrase from label:
In order to evaluate the putative mitochondrial toxicity of amitriptyline, we have analyzed CoQ(10) and ATP levels, oxidative damage and mitochondrial mass in peripheral blood cells from control healthy volunteers and psychiatric patients with depressive episodes treated or non-treated with amitriptyline.
Label source:
PubMed: Journal of psychiatric research (2012)
Source url:
Exact phrase from label:
Lastly, coenzyme Q10 levels can be reduced by TCA use.
Label source:
PubMed: American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists (2026)
Action type:
informational_none
Target id:
/intervention/vitamin-e
Target name:
Vitamin E
Severity:
minor
Interaction type:
synergistic
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Vitamin E and CoQ10 work together as fat-soluble antioxidants to protect cell membranes, and Vitamin E helps regenerate the active (reduced) form of CoQ10.
Actionable advice:
Taking CoQ10 and Vitamin E together can provide complementary antioxidant support.
Validation status:
validated_via_pubmed
Evidence tier:
tier_b
Evidence basis:
pubmed_abstract_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
In addition, ubiquinol can efficiently sustain the effect of vitamin E by regenerating the vitamin from the tocopheroxyl radical, which otherwise must rely on water-soluble agents such as ascorbate (vitamin C).
Label source:
PubMed: The Clinical investigator (1993)
Source url:
Exact phrase from label:
In quinone form (oxidized form), it serves as an electron transporter that transfers the electrons in the electron transport chain between various complexes, and in ubiquinol form (reduced form), it serves as potent antioxidants by scavenging free radicals or by tocopherol regeneration in the living organism.
Label source:
PubMed: Drug research (2022)
Action type:
informational_none
Target id:
/intervention/omega-3-fatty-acids
Target name:
Omega-3 Fatty Acids
Severity:
minor
Interaction type:
synergistic
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
The fatty acids in omega-3 supplements can improve the absorption of fat-soluble CoQ10, and both substances provide complementary support for cardiovascular health.
Actionable advice:
Taking CoQ10 with an omega-3 supplement can enhance its absorption and provide combined benefits.
Validation status:
unvalidatable
Evidence tier:
tier_e
Evidence basis:
unvalidatable
Evidence anchors:
Source url:
Scientific literature support not found
Exact phrase from label:
Label source:
Expert review: CoQ10 is a fat-soluble compound whose absorption is enhanced by co-administration with dietary fats. Omega-3 fatty acid supplements provide a lipid matrix that facilitates CoQ10 solubilization and lymphatic absorption. Both agents have complementary cardiovascular protective effects.
Action type:
informational_none
Target id:
/class/thyroid-hormones
Target name:
Thyroid Hormones
Severity:
minor
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
There is limited and theoretical evidence that CoQ10 could alter thyroid hormone levels or metabolism, potentially affecting therapy, though this is not well-established.
Actionable advice:
This is best used with caution, and it is worth monitoring thyroid function for those on thyroid replacement therapy who notice changes.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
The major pathway of thyroid hormone metabolism is through sequential deiodination.
Label source:
Action type:
monitor
Derived From
coq10
Provenance Note
Interactions duplicated from 'coq10'. Synonym of CoQ10.