Coenzyme Q10 (CoQ10): Ubiquinone vs Ubiquinol, Statins and Evidence
Coenzyme Q10 (CoQ10): what it is, what Cochrane and trials show for heart failure and statin muscle pain, ubiquinone versus ubiquinol, interactions and safety.
Content last updated . This page has not been medically reviewed.
Overview
Coenzyme Q10 (CoQ10) is a substance naturally present in the human body, with the highest levels in the heart, liver, kidneys and pancreas. It is sold in the United States as a dietary supplement. [1] It is not a vitamin and has no recommended daily intake or deficiency syndrome in the sources read for this page. People with some diseases have lower levels, which is why researchers have tested supplements. [1]Evidence labels are explained on Antioxidants Explained.
Evidence by use
| Use | What the sources found | Label |
|---|---|---|
| Chronic heart failure | A 2021 Cochrane review (11 studies, 1,573 people) found CoQ10 probably reduces all-cause mortality (risk ratio 0.58, from one study of 420 people) and hospitalization for heart failure, but all studies had unclear or high risk of bias. [2] The NCCIH (page updated 2019) called heart-failure research inconclusive. [1] | Mixed to promising but limited |
| The main heart-failure trial | Q-SYMBIO (420 people, CoQ10 100 mg three times daily plus standard care): no change in short-term endpoints, but fewer major cardiovascular events over 2 years (15% vs 26%). [3] Doses here are study amounts. | Single trial |
| Statin muscle pain | A 2018 meta-analysis of 12 trials (575 people) found less muscle pain with CoQ10. [4] A 2020 meta-analysis of 7 trials (321 people) found no benefit for myalgia or for staying on the statin. [5] The NCCIH says the overall evidence does not support it. [1] | Mixed |
| Cancer | Not shown to treat cancer; may reduce heart damage from one type of chemotherapy drug. [1] | Insufficient evidence |
| Parkinson's disease | A major NIH-funded study found no symptom improvement in early disease, even at higher-than-usual doses. [1] | Negative |
| Blood pressure | Probably no meaningful effect, from a small amount of evidence. [1] | Insufficient evidence |
Ubiquinone versus ubiquinol
Ubiquinone is the standard supplement form; ubiquinol is the form that appears mostly in the blood. In one crossover study of 21 healthy adults aged 65 to 74, CoQ10 appeared in blood mostly as ubiquinol even when taken as ubiquinone. A ubiquinol capsule did not significantly raise absorption compared with standard ubiquinone, while a water-soluble syrup absorbed 2.4 times better after a single 100 mg dose. [6] That is one small single-dose study and says nothing about health outcomes. A fuller side-by-side comparison belongs on the Compare Supplements pages.Interactions and side effects
No serious side effects have been reported; mild effects such as insomnia or digestive upset may occur. [1] CoQ10 may interact with the blood thinner warfarin and with insulin, and may not be compatible with some cancer treatments. [1] The National Cancer Institute adds that drugs for cholesterol, blood pressure or blood sugar may decrease CoQ10's effects, and that an observational study of breast cancer patients linked antioxidant supplements, including CoQ10, to higher recurrence. [7] Do not stop a statin or any prescribed medicine to use CoQ10; see medication interactions and interactions by drug class.Labels and quality
The FDA does not regularly review how supplements are made, so batches and brands may differ. [7] See reading supplement labels and quality testing and certifications. I did not find a verified daily intake reference or upper limit for CoQ10; proper evidence not found for those.Related
Antioxidant evidence by use · Antioxidant safety and marketing claimsFrequently asked questions
Does CoQ10 prevent statin muscle pain?
Results conflict: a 2018 meta-analysis reported less muscle pain, a 2020 one did not. [4][5]
Is ubiquinol better than ubiquinone?
One small crossover study did not find a significant absorption gain for a ubiquinol capsule over ubiquinone, and the blood form was mostly ubiquinol either way. [6]
Is CoQ10 safe with warfarin?
It may change how the body uses warfarin, so ask the prescriber or pharmacist first. [1]
Can CoQ10 help in cancer treatment?
It has not been shown to treat cancer, and it may not be compatible with some treatments. [1]
References
- NCCIH, Coenzyme Q10. Read 2026-10-22.
- Coenzyme Q10 for heart failure (Cochrane Database Syst Rev 2021). Read 2026-10-22.
- Mortensen et al., The effect of coenzyme Q10 on morbidity and mortality in chronic heart failure: Q-SYMBIO (JACC Heart Fail 2014). Read 2026-10-22.
- Qu et al., Effects of coenzyme Q10 on statin-induced myopathy: an updated meta-analysis (J Am Heart Assoc 2018). Read 2026-10-22.
- Effect of coenzyme Q10 on statin-associated myalgia and adherence to statin therapy: systematic review and meta-analysis (Atherosclerosis 2020). Read 2026-10-22.
- Pravst et al., Comparative bioavailability of different coenzyme Q10 formulations in healthy elderly individuals (Nutrients 2020). Read 2026-10-22.
- National Cancer Institute, Coenzyme Q10 (PDQ) patient version. Read 2026-10-22.
Education, not medical advice. This page is for general information. It does not diagnose or treat any condition and is not a substitute for care from a qualified health professional. Natural does not automatically mean safe. Ask a clinician or pharmacist before changing your care, especially if you take medication, are pregnant or breastfeeding, or have a health condition.