Coenzyme Q10 and statins: Biochemical and clinical implications
Abstract
Statins are drugs of known and undisputed efficacy in the treatment of hypercholesterolemia, usually well tolerated by most patients. In some cases treatment with statins produces skeletal muscle complaints, and/or mild serum CK elevation; the incidence of rhabdomyolysis is very low. As a result of the common biosynthetic pathway Coenzyme Q (ubiquinone) and dolichol levels are also affected, to a certain degree, by the treatment with these HMG-CoA reductase inhibitors. Plasma levels of CoQ10 are lowered in the course of statin treatment. This could be related to the fact that statins lower plasma LDL levels, and CoQ10 is mainly transported by LDL, but a decrease is also found in platelets and in lymphocytes of statin treated patients, therefore it could truly depend on inhibition of CoQ10 synthesis. There are also some indications that statin treatment affects muscle ubiquinone levels, although it is not yet clear to which extent this depends on some effect on mitochondrial biogenesis. Some papers indicate that CoQ10 depletion during statin therapy might be associated with subclinical cardiomyopathy and this situation is reversed upon CoQ10 treatment. We can reasonably hypothesize that in some conditions where other CoQ10 depleting situations exist treatment with statins may seriously impair plasma and possible tissue levels of coenzyme Q10. While waiting for a large scale clinical trial where patients treated with statins are also monitored for their CoQ10 status, with a group also being given CoQ10, physicians should be aware of this drug-nutrient interaction and be vigilant to the possibility that statin drugs may, in some cases, impair skeletal muscle and myocardial bioenergetics.
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“(21) As selenium is involved in the regeneration of CoQ10 and supports antioxidant properties, a supplementation of selenium solely or in combination with CoQ10 in statin-treated patients has also been discussed in the literature.”
- Authors
- Littarru, G. P., & Langsjoen, P.
- Affiliations
- Marche Polytechnic University (IT)
- East Texas Medical Center (US)
- Corresponding author
- Littarru, Gian Paolo
- ORCID
- Langsjoen, Peter
- Venue
- Mitochondrion
- Publisher
- Elsevier BV
- Published
- 2007-06
- Volume
- 7
- Pages
- S168-S174
- ISSN
- 1567-7249 (ISSN-L)
- OpenAlex
- W2068699146
- Cited by
- 188
- References
- 60
- Citations by year
- 2026: 10 · 2025: 6 · 2024: 6 · 2023: 8 · 2022: 7 · 2021: 6 · 2020: 10 · 2019: 7 · 2018: 16 · 2017: 12 · 2016: 9 · 2015: 7 · 2014: 12 · 2013: 17 · 2012: 6
- FWCI
- 1.03
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Mitochondrion (publishedVersion)
- PubMed (publishedVersion)
- Università Politecnica delle Marche (Università Politecnica delle Marche) (submittedVersion)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Coenzyme Q10 studies and effects
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Health Sciences › Medicine › Biochemistry › Antioxidant Activity and Oxidative Stress
- Keywords
- coenzyme Q10, statins, drug-nutrient interactions, rhabdomyolysis, muscle toxicity, LDL cholesterol, mitochondrial biogenesis, subclinical cardiomyopathy, hypercholesterolemia, dolichol, skeletal muscle bioenergetics
- MeSH terms
- Animals, Biochemistry, Clinical Trials as Topic, Coenzymes, Dogs, Cricetinae, Heart Diseases, Humans, Hyperlipidemias, Models, Biological, Ubiquinone, Vitamins, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Rats, Biosynthetic Pathways
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