The role of Coenzyme Q10 in statin-associated myopathy

Kalra, Dr Sanjay (2009) The role of Coenzyme Q10 in statin-associated myopathy. [Journal (Paginated)]

Full text available as:

PDF - Published Version


Statins, or 3-hydroxyl-3-methylglutaryl coenzyme HMG-CoA reductase inhibitors, are cholesterol-lowering drugs which are frequently used in the primary and secondary prevention of coronary artery disease. Current research and recommendations support and encourage more extensive use of these drugs. However, statin usage is limited by many factors, including a high incidence of statin-associated myalgia and myopathy. This review focuses on the use of Coenzyme Q in statin-associated myopathy.

Item Type:Journal (Paginated)
Keywords:statin, myalgia, myopathy, Coenzyme Q
ID Code:6668
Deposited By:Jalalian, Dr Mehrdad
Deposited On:14 Nov 2009 11:39
Last Modified:11 Mar 2011 08:57

References in Article

Select the SEEK icon to attempt to find the referenced article. If it does not appear to be in cogprints you will be forwarded to the paracite service. Poorly formated references will probably not work.

1. Jacobson TA. Toward ‘pain free’ statin prescribing Clinical algorithm for diagnosis and management of myalgia. Mayo Clinic Proceedings 2008;83 (6):87 -700.

2. Antons K, Wiliams C, Baker S, Philips P. Clinical perspectives of statin –induced rhabdomyolysis. Am Med 19;5: 400 -409.

3. Toth PP, Harper CR, Jacobson TA. Clinical characterization and molecular mechanisms of statin myopathy. Expert Review of Cardiovascular Therapy 2008; 6(7) :955 -969.

4. Marcoff L, Thompson PD. The role of coenzyme Q10 in statin-associated myopathy. J Am Coll Card 2007; 49(23): 2231-2237.

5. Molyneux SL, Young JM, Florkowski CM, Lever M, George PM. Coenzyme Q10: Is there a clinical role and a case for measurement? Clin Biochem Rev 2008; 29(2) :71-82.

6. James AM, Smith RA, Murphy MP. Antioxidant and prooxidant properties of mitochondrial coenzyme Q. Arch Biochem Biophys 2004; 423:47-56.

7. Arroyo A, Navarro F, Gomez-Diz C, et al. Interactions between ascorbyl free radical and coenzyme Q at the plasma membrane. J Bioenerg Biomembr 2000;32:199-200.

8. Constantinescu A, Maguite JJ, Packer L. Interactions between ubiquinones and vitamins in membranes and cells. Mol Aspects Med 1994; 423:47-56.

9. Quinzii CM, HiranoM, MauroS. CoQ10 deficiency diseases in adults. Mitochondrion 2007; 7(Suppl 1): S 122 –S126.

10. Tavintharan S, Ong CN, Jeyaseelan K, Sivakumar M, Sum CF. Reduced mitochondrial coenzyme Q10 levels in Hep G2 cells treated with high –dose simvastatin ; A possible role in statin induced hepatotoxicity ? Toxicology & Applied Pharmacology 2007; 223(2) :173 – 179.

11. Davidson M, Mckenny J, Stein E, et al. Comparision of one year efficacy and safety of atorvastatin versus lovastatin in primary hypercholesterolemia. Atorvastatin Study Group I. Am J Cardiol 1997; 79: 1475-1481.

12. Tomasetti M, Alleva R, Solenghi, MD, Littarru GP. Distribution of antioxidants among blood components and lipoproteins: significance of lipids/CoQ10 ratio as a possible marker of increased risk for atherosclerosis. Biofactors 1999;9:231-240.

13. Bargossi AM, Grossi G, Firrella Pl, Gaddi A, Di Giulio R, Battino M. Exogenous CoQ10 supplementation prevents plasma ubiquinone reduction induced by HMG-CoA reductase inhibitors. Mol Aspects Med 1994; 15 Suppl: 187-93.

14. Mortensen SA, Leth A, Anger E, Rohde M. Dose-related decreases of serum coenzyme Q10 during treatment with HMG-CoA reductase inhibitors. Mol Aspects Med 1997;18 Suppl:S137-44. Lorgeril M, Salen P, Bontemps L, Belichard P, Geyssant A, Itti R. Effects of lipid-lowering drugs on left ventricular function and exercise tolerance in dyslipidemic coronary patients. J Cardiovasc Pharmacol 1999;33:473-8.

16. Jula A, Marniemi J, Hupponen R, Virtanen A, Rastas M, Ronnemaa T. Effects of diet and simvastatin on serum lipids, insulin, and antioxidants in hyper-cholesterolerolemic men: a randomized controlled trial. JAMA 2002;287:598-605.

17. Littarru GP, Langsjoen P. Coenzyme Q and statins: Biochemical and clinical implications .Mitochondrion, 2007 ; 7(Suppl 1) : S168 –S174.

18. Berthold HK, Naini A, D: Mauro S, et al. Effect of ezetimibe and /or coenzyme Q10 levels in plasma : a randomized trial. Drug safety 2006; 29(8) :703 -712.

19. Morand OH, Aebi JD, Dehmlow H, et al. Ro 48-8.071, a new 2,3- oxidosqualene: lanosterol cylase inhibitor lowering plasma cholesterol in hamsters, squirrel monkeys, and minipigs: comparison to simvastatin. J Lipid Rees 1997;38: 373-90.

20. Low P, Andersson M, Edlund C, Dallner G. Effects of mevinolin treatment on tissue dolichol and ubiquinone levels in the rat. Biochim Biophys Acta 1992; 1165:102-9.

21. Nakahara K, Kuriyama M, Sonnoda Y, et al. Myopathy induced by HMG-CoA reductase inhibitors in rabbits: a pathological, electro-physiological, and biochemical study. Toxicol Appl Pharmacol 1998; 152:99-106.

22. Schaefer WH, Lowrence JW, Loughlin AF,et al. Evaluation of ubiquinone concentration and mitochondrial function relative to cerivastatin-induced skeletal myopathy in rats. Toxicol Appl Pharmacol 2004;194: 10-23.

23. Laaksonen R, Jokelainen K, Lasskso J, et al. The effect of simvastatin treatment on natural antioxidants in low-density lipoproteins and high-energy phosphates and ubiquinone in skeletal muscle. Am J Cardiol 1996; 77: 851-854.

24. Fukami M, Maeda N, Fukushige J, et al. Effects of HMG-CoA reductase inhibitors on skeletal muscles of rabbits. Res Exp Med (Berl) 1993; 193: 263-73.

25. Pavia H, Thelen KM,Vancoster R, et al. High- dose statins and skeletal muscle metabolism in humans: a randomized, controlled trial. Clin Pharmacol Ther 2005;78: 60-8.

26. Lamperti C,Naini AB,Lucchini V, et al. Muscle coenzyme Q10 level in statin-related myopathy. Arch Neurol 2005; 62: 109-12.

27. Phillips PS, Clerkson P, Karas RH. Statin-associated myopathy. JAMA 2003; 289:1681-1690.

28. Diebold BA, Bhagavan NV, Guillory RJ. Influences of lovastatin administration on the respiratory burst of leukocytes and the phosphorylation potential of mitochondria in guinea pigs. Biochim Biophys Acta 1994;1200: 100-108.

29. Satoh K, Yamato A, Nakai T, Hoshi K, Ichihara K. Effects of 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors on mitochondrial respiration in ischaemic dog hearts Br J Pharmacol 1995;116:1894-1898.

30. Sugiyama S. HMG CoA reductase inhibitor accelerates aging effect on diaphragm mitochondrial respiratory function in rats Biochem Mol Biol Int 1998; 46: 923-931.

31. Duncan AJ, Hargreaves IP, Damicin MS, Land JM, Heales SJR. Decreased ubiquinone availability and impaired mitochondrial cytochrome oxidase activity associated with statin treatment. Toxicology Mechanisms and Methods 2009; 19 (1) :44-50.

32. Thibault A, Samid D, Tompkins AC, et al. Phase I study of lovastatin, an inhibitor of the mevalonate pathway, in patients with cancer. Clin Cancer Res 1996;2: 483-491.

33. Kim WS, Kim MM, Choi HJ, et al. Phase II study of high-dose lovastatin in patients with advanced gastric adenocarcinoma. Invest New Drugs 2001;19:81-83.

34. Langsjoen PH, Langsjoen AM, Lucas LA. Treatment of statin adverse effects with supplementation of Coenzyme Q 10 and statin drug discontinuation. BioFactors 2005; 25 (1-4):147 -152.

35. Schaars CF, Stalenhoef AF. Effects of ubiquinone (Coenzyme Q10) in myopathy in statin users. Curr Opin Lipidol 2008; 19(6): 553-7.

36. Kelly P, Vasu S, Getato M, McNurlan M, Lawson WE. Coenzyme Q10 improves myopathic pain in statin treated patients J Am Coll Cardiol 2005;45: 3A.

37. Young JM, Florkowski CM, Molyneux SL, McEwan RG, Frampton CM, George PM. Coenzyme Q10 does not improve simvastatin tolerability in dyslipidemic patients with prior statin-induced myalgia AHA 2006. Circulation 2007; 114: II41.

38. Levy HB, Kohlhaas HK. Considerations for supplementing with Coenzyme Q10 during statin therapy. The Annals of Pharmacotherapy 2006; 40(2):290-294.


Repository Staff Only: item control page