This updated Medicines Q&A evaluates the available evidence on the use of coenzyme Q10 supplementation to reduce the risk of statin-induced myopathy.
There is some limited evidence which suggests that CoQ10 supplementation with statin treatment may improve statin-associated muscle symptoms. However, CoQ10 supplementation does not appear to have any effect on CK levels though data on this are also limited. More information is needed about the cause of statin-induced myopathy including about how exogenous CoQ10 affects endogenous tissue levels and whether restoring these levels results in a clinical reduction of muscle symptoms. Most importantly, studies which evaluate the effect of CoQ10 in improving adherence to statins are currently lacking which is why NICE do not recommend its use. As the benefits of statins are well researched and they are in widespread use, it is important that measures are taken to reduce the risk of rare but potentially serious side effects. Such measures include:
- Using the minimum effective dose of statins.
- Adhering to the recommendations in the summaries of product characteristics of statins such as measuring baseline CK levels before starting treatment in patients with predisposing factors
- Avoiding medicines which interact with statins where feasible.
- Educating patients to recognise and act on the early signs of myopathy.