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Coenzyme Q10
A compound the body makes, found in almost every cell. It has been put forward for heart failure, statin muscle aches, high blood pressure and migraine.
Explained simply · Last reviewed
What it is
Coenzyme Q10, often shortened to CoQ10 and also called ubiquinone, is a substance the body makes on its own. LiverTox, the US government's liver-injury database, says it is found in virtually all cells of the body. NCCIH, the US agency that studies complementary medicine, says the highest levels are in the heart, liver, kidneys and pancreas. It says researchers became interested in supplements because coenzyme Q10 has important functions in the body, and because people with some diseases have lower levels of it.
More about Coenzyme Q10
LiverTox, the US government's liver-injury database, says it is found in virtually all cells of the body. NCCIH, the US agency that studies complementary medicine, says the highest levels are in the heart, liver, kidneys and pancreas. It says researchers became interested in supplements because coenzyme Q10 has important functions in the body, and because people with some diseases have lower levels of it.
LiverTox says it is an essential part of the energy-producing chain in the mitochondria, the part of the cell that turns food into usable energy. It also calls coenzyme Q10 an essential antioxidant, and says the body normally makes it in adequate amounts.
According to LiverTox, coenzyme Q10 has been put forward for many conditions, among them migraine, Parkinson's disease, heart failure, high blood pressure, and muscle pain and muscle disease caused by statins. LiverTox says it is widely used and sold over the counter as tablets, capsules, gelcaps, wafers and liquids, and that it is not approved by the FDA for any disease or medical condition. NCCIH says it is sold in the United States as a dietary supplement. Lower levels in some diseases are a different question from whether taking more helps, and that second question is what the ratings below are about.
Also known as: CoQ10, ubiquinone, ubiquinol
At a glance
Safety: known risks, 1 group who should avoid it or take extra care and 3 documented interactions. See Safety ↓Claims made about Coenzyme Q10, and how strong the evidence is for each:
- Helps people with heart failureEvidence rating: Limited
- Relieves muscle pain caused by statinsEvidence rating: Limited
- Lowers blood pressure in people with primary high blood pressure (primary hypertension)Evidence rating: Evidence against
- Prevents migraineEvidence rating: Limited
- Helps Parkinson's disease symptomsEvidence rating: Evidence against
Longevity and aging claims
Claims made about Coenzyme Q10 and aging, and how strong the evidence is for each. A change in a marker is not the same as a longer life.
Each rating follows our published rules and the sources cited for it. We don’t add our own medical judgment. How we rate
Safety
Read this before the ratings below.
Risks
- NCCIH reports that no serious side effects of coenzyme Q10 have been reported. Mild side effects such as insomnia or digestive upset may occur.
- LiverTox describes coenzyme Q10 as well tolerated, with side-effect rates no higher than with placebo. The side effects that do occur are mostly stomach upset, nausea, headache, dizziness, and tiredness, and are usually mild and short-lived. Serious adverse events are rare and usually considered unrelated.
- Despite decades of wide use, LiverTox reports no convincing cases of liver injury caused by coenzyme Q10, and rates it an unlikely cause of clinically apparent liver injury.
Who should avoid it or take extra care
- NCCIH says coenzyme Q10 may interact with warfarin and insulin and may not be compatible with some types of cancer treatment (listed below). Anyone thinking of taking coenzyme Q10, and anyone on these treatments, should talk to their doctor or pharmacist first.
Documented interactions
- Warfarin (a blood thinner): NCCIH states that coenzyme Q10 may interact with the anticoagulant warfarin. NCCIH does not describe the nature of the interaction. Source [1]
- Insulin: NCCIH states that coenzyme Q10 may interact with the diabetes drug insulin. NCCIH does not describe the nature of the interaction. Source [1]
- Some types of cancer treatment: NCCIH states that coenzyme Q10 may not be compatible with some types of cancer treatment. NCCIH does not say which. Source [1]
Safety sources: Source [1]Source [2]
What the evidence says
Each claim is rated on its own evidence. Ratings follow the scale on our methodology page.
Helps people with heart failure Evidence rating: Limited
People with heart failure take it hoping it will help their heart and keep them out of hospital.
A 2021 Cochrane review found, at moderate certainty, fewer deaths (one trial) and heart-failure admissions (two trials), but no convincing evidence to support or refute its use.
A 2021 Cochrane review looked at 11 trials in 1,573 people with heart failure. It found moderate-certainty evidence that coenzyme Q10 probably reduces death from any cause and hospital admission for heart failure. Both findings rest on very few trials. The death result comes from a single trial of 420 people, which the reviewers say applies only to the kind of patients and regimen that trial used. The hospital-admission result comes from two trials.
The reviewers report that two of the included trials, one of them that single mortality trial, were partially funded by pharmaceutical companies that manufacture and distribute coenzyme Q10 supplements.
For heart attack and stroke, the results were inconclusive (low certainty). For the heart's pumping function (ejection fraction) and for exercise capacity, the evidence was very low certainty, so the reviewers were very uncertain of any effect. Results for adverse events were inconclusive, at low certainty. The reviewers concluded that there is currently no convincing evidence to support or refute the use of coenzyme Q10 for heart failure, and called for further trials.
NCCIH likewise describes research on coenzyme Q10 in heart failure as inconclusive. This rating follows the lowest certainty among the outcomes the claim covers, which is very low.
Sources: Source [1]Source [2]
Relieves muscle pain caused by statins Evidence rating: Limited
People on statins take it hoping it will ease the muscle aches the medicine can cause.
Two of three reviews found less statin muscle pain and one did not; NCCIH says the overall evidence does not support the idea that coenzyme Q10 can reduce it.
The reviews disagree. A 2018 meta-analysis of 12 randomized trials in 575 patients found that coenzyme Q10 reduced statin-associated muscle pain, weakness, cramps and tiredness compared with placebo. It did not lower creatine kinase, a blood marker of muscle damage. Its authors note that the eligible trials were few and mostly small, and that results varied widely between them.
A 2020 meta-analysis of 7 trials in 321 patients with statin-associated muscle pain did not show a benefit on muscle pain. Only two of the eight studies it reviewed had found one. It found no difference in how many patients stayed on their statin. One of its three authors lists an affiliation with Roche Diagnostics; the paper's conflict-of-interest statement declares nothing to disclose.
A 2025 meta-analysis of 7 trials in 389 patients found a significant reduction in muscle pain intensity. Results again varied widely between trials, and the overall effect changed depending on which trials were included. Its authors say more research is needed before evidence-based recommendations can be made. That analysis was funded by the Society for Applied Vitamin Research (GVF, Jena, Germany).
NCCIH states that although individual studies have varied, the overall scientific evidence does not support the idea that coenzyme Q10 can reduce muscle pain caused by statins. LiverTox states that larger, more rigorously controlled trials have failed to show definite evidence of benefit for conditions including statin-induced muscle pain and muscle disease (myalgia and myopathy). Where sources disagree, this page takes the lower rating.
Lowers blood pressure in people with primary high blood pressure (primary hypertension) Evidence rating: Evidence against
People with high blood pressure take it hoping it will bring their blood pressure down.
A 2016 Cochrane review of two trials in 50 people with primary hypertension found no clinically significant effect on blood pressure, and rated that moderate certainty.
This rating covers only people with primary hypertension, the group a 2016 Cochrane review studied. That review concluded, with moderate-certainty evidence, that coenzyme Q10 does not have a clinically significant effect on blood pressure. Pooling two placebo-controlled trials in 50 people, it found no significant change in systolic or diastolic blood pressure.
A third trial was left out of the pooled result because the reviewers judged its risk of bias unacceptably high. They note that including it would have shown a small but statistically significant lowering. They downgraded their certainty to moderate because the result comes from so few people, and said more well-conducted trials are needed.
NCCIH states that the small amount of evidence currently available suggests coenzyme Q10 probably does not have a meaningful effect on blood pressure. Reviews in other groups, such as people with cardiometabolic disorders, were not assessed for this page.
Sources: Source [1]Source [2]
Prevents migraine Evidence rating: Limited
People who get migraines take it hoping the attacks will come less often.
A 2021 review of six trials found fewer and slightly shorter migraines, at moderate certainty; a 2019 review of two trials found no significant reduction.
A 2021 meta-analysis of six trials in 371 adults found that coenzyme Q10 reduced how often migraines occurred and how long attacks lasted, with moderate-certainty evidence for each. The reduction in attack length was small, about a fifth of an hour (0.19 hours). It found no significant reduction in how severe the headaches were, and rated that evidence low certainty.
Three of the six trials gave coenzyme Q10 together with something else: a multi-ingredient supplement, L-carnitine, or preventive medication. The review's certainty ratings pool those combination trials with the trials of coenzyme Q10 alone. Two trials declared funding from drug manufacturers. The authors say coenzyme Q10 might have a beneficial effect, but that because of the small number of trials and small effect sizes, the results should be considered with caution.
An earlier 2019 meta-analysis of vitamins and minerals could pool only two coenzyme Q10 trials, with 97 participants, in its analysis of adults. It found no significant reduction in migraine frequency, duration or severity, and rated the strength of the evidence for each of those three results moderate. It concluded that, based on insufficient evidence, it is unknown whether coenzyme Q10 is effective for preventing migraine. Its authors add, of the evidence on coenzyme Q10 and magnesium together, that "the available evidence is of low to moderate strength and from trials with substantial risk of bias". It lists one of its two coenzyme Q10 trials as industry funded.
The sources disagree, and the lowest certainty among the outcomes is low.
Sources: Source [1]Source [2]
Helps Parkinson's disease symptoms Evidence rating: Evidence against
People with Parkinson's disease take it hoping it will ease their symptoms.
NCCIH reports that a major NIH-funded study found no improvement in early Parkinson's symptoms, and that a 2017 evaluation concluded coenzyme Q10 is not helpful.
NCCIH reports that a major NIH-funded study found coenzyme Q10, even in higher-than-usual doses, did not improve symptoms in people with early Parkinson's disease. It adds that a 2017 evaluation of that study and several smaller ones concluded coenzyme Q10 is not helpful for Parkinson's symptoms.
This rating rests on that authority statement; the underlying study and evaluation are not cited here directly.
Sources: Source [1]
Longevity and aging
What the cited sources report about lifespan, death from any cause, and markers studied in connection with aging. A change in a marker is not the same as a longer life. Each outcome is rated on its own evidence, on the same scale as the claims above.
Helps people live longer Evidence rating: Insufficient
People take it hoping it will help them live longer.
A 2014 Cochrane review of adults without cardiovascular disease found no trial of coenzyme Q10 alone reporting deaths; one with selenium reported fewer, which its authors call hypothesis-generating.
This entry is about death from any cause in people generally, including older adults. People with heart failure are covered by the heart failure claim above. A 2014 Cochrane review looked for randomized trials, lasting at least three months, of coenzyme Q10 taken on its own by adults without cardiovascular disease, with death from any cause as one of its main outcomes. It found six small trials, with 218 people at high risk of cardiovascular disease, and none of them reported deaths. Its searches ran to December 2013.
The reviewers discuss one trial in older Swedish people that reported fewer deaths from cardiovascular disease over five years. That trial gave coenzyme Q10 together with selenium, and the Cochrane reviewers note of its result that the effects could be due to either coenzyme Q10, selenium or a combination of the two.
A 10-year follow-up of the same trial covers 443 older people the authors describe as healthy, who took the combination or a placebo for four years. It reports that 98 of 221 people in the supplement group and 120 of 222 in the placebo group died from any cause, which the authors report as reduced death from any cause in the supplement group.
Not all of them were free of heart disease: at the start, about a fifth were in New York Heart Association class III (a marked limitation of physical activity) and about a fifth had ischemic heart disease. Death from cardiovascular disease was the outcome the follow-up set out to study. Its authors describe it as a small study whose observations should be regarded as hypothesis-generating.
Part of its analysis costs were funded by Pharma Nord, the company whose supplements were used in the trial, alongside public funders; the paper states the funders had no role in its design, analysis or interpretation. No cited trial of coenzyme Q10 on its own reports death from any cause. That is too little evidence to show an effect, not evidence of no effect.
Sources: Source [1]Source [2]
How and when to take it
What the cited sources say about taking it. Ask your doctor or pharmacist what applies to you.
It is fat-soluble
LiverTox notes that because coenzyme Q10 is fat-soluble, it is frequently given with lipids or vitamin E to improve absorption. Source [1]
Sources
- Coenzyme Q10 for heart failureCochrane Database of Systematic Reviews, 2021 · Systematic review · Primary source · Certainty: very low
- Coenzyme Q10National Center for Complementary and Integrative Health, NIH, 2019 · Health authority summary · Primary source
- Coenzyme Q10LiverTox: Clinical and Research Information on Drug-Induced Liver Injury, National Institute of Diabetes and Digestive and Kidney Diseases, 2024 · Health authority summary · Primary source
- Effects of Coenzyme Q10 on Statin-Induced Myopathy: An Updated Meta-Analysis of Randomized Controlled TrialsJournal of the American Heart Association, 2018 · Meta-analysis · Primary source
- Effect of Coenzyme Q10 on statin-associated myalgia and adherence to statin therapy: A systematic review and meta-analysisAtherosclerosis, 2020 · Meta-analysis · Primary source
- Effects of coenzyme Q10 supplementation on myopathy in statin-treated patients: a systematic review and meta-analysisJournal of Nutritional Science, 2025 · Meta-analysis · Primary source
- Blood pressure lowering efficacy of coenzyme Q10 for primary hypertensionCochrane Database of Systematic Reviews, 2016 · Systematic review · Primary source · Certainty: moderate
- Coenzyme Q10 supplementation for prophylaxis in adult patients with migraine—a meta-analysisBMJ Open, 2021 · Meta-analysis · Primary source · Certainty: low
- Vitamins and Minerals for Migraine Prophylaxis: A Systematic Review and Meta-analysisCanadian Journal of Neurological Sciences, 2019 · Meta-analysis · Primary source · Certainty: moderate
- Co-enzyme Q10 supplementation for the primary prevention of cardiovascular diseaseCochrane Database of Systematic Reviews, 2014 · Systematic review · Primary source
- Reduced Cardiovascular Mortality 10 Years after Supplementation with Selenium and Coenzyme Q10 for Four Years: Follow-Up Results of a Prospective Randomized Double-Blind Placebo-Controlled Trial in Elderly CitizensPLOS ONE, 2015 · Randomized controlled trial · Supporting source
Page history
Show all 6 changes to this page
- — Rewritten to the content style guideline; ratings and sources unchanged.
- — Revised in the source audit. The 2019 vitamins and minerals meta-analysis has now been read in full. The migraine summary now says that it rated the strength of the evidence for its coenzyme Q10 results moderate, and its source entry now records that certainty, that the review had no funding, and that one author disclosed previous research funding from Allergan Canada Ltd. No rating changed.
- — Added a "Longevity and ageing" section with one entry: helping people live longer, rated insufficient. It cites a 2014 Cochrane review that found no trials of coenzyme Q10 alone reporting death from any cause in people without cardiovascular disease, and a 10-year follow-up of a trial of selenium and coenzyme Q10 combined in older Swedish people. No existing claim, rating or source changed.
- — Published. All five claims, the safety section and every source passed the site's source and wording reviews. The Kovacic 2025 funder classification, the Okoli 2019 funding statement and the male-fertility candidate claim stay logged in docs/08-open-decisions.md.
- — Revised after source review. Removed the male fertility claim: newer coenzyme Q10 meta-analyses exist, so "insufficient" no longer described the research, and they have not yet been read in full. Blood pressure now covers only people with primary hypertension, the group the cited review studied. Added industry funding disclosures to the heart failure and statin summaries, and the authors' own caution to the migraine summary.
- — First drafted. Heart failure, statin muscle symptoms, and migraine rated limited; blood pressure and Parkinson's disease rated evidence-against; male fertility rated insufficient.