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Muhammad Aiyaz Sharif 
Product Manager 
PharmEvo Pvt. Ltd
What is Co-enzyme Q10? 
Coenzyme Q10, also known as ubiquinone, coenzyme Q, and 
abbreviated at times to CoQ10 . 
This oil-soluble, vitamin-like substance is present in most 
eukaryotic cells, primarily in the mitochondria. 
It is a component of the electron transport chain and 
participates in aerobic cellular respiration, generating 
energy in the form of ATP. 
Ninety-five percent of the human body’s energy is 
generated this way.1,2 
1.Ernster, L; Dallner, G (1995). "Biochemical, physiological and medical aspects of ubiquinone function". Biochimica et 
Biophysica Acta 1271 (1): 195–204. 
2.Dutton, PL; Ohnishi, T; Darrouzet, E; Leonard, MA; Sharp, RE; Cibney, BR; Daldal, F; Moser, CC (2000). "4 Coenzyme Q 
oxidation reduction reactions in mitochondrial electron transport". In Kagan, VE; Quinn, PJ. Coenzyme Q: Molecular 
mechanisms in health and disease. Boca Raton: CRC Press. pp. 65–82
Who discovered it? 
CoQ10 was first discovered by Professor Fredrick L. Crane 
and colleagues at the University of Wisconsin–Madison 
Enzyme Institute in 1957.3,4 
In 1958, its chemical structure was reported by Dr. Karl 
Folkers and coworkers at Merck. 
In 1961 Peter Mitchell proposed the electron transport 
chain (which includes the vital proton motive role of CoQ10) 
and he received a Nobel Prize for the same in 1978. 
3.Crane, F; Hatefi, Y; Lester, R; Widmer, C (1957). "Isolation of a quinone from beef heart mitochondria". 
Biochimica et Biophysica Acta 25 (1): 220–1 
4.Peter H. Langsjoen,"Introduction of Coezyme Q10“
WWhhaatt iiss tthhee rroollee ooff NNeeooQQ1100
How is it synthesized? 
Starting from acetyl-CoA, a 
multistep process of mevalonate 
pathway produces farnesyl-PP 
(FPP), the precursor for 
cholesterol and CoQ10.
CCaauusseess ooff CCooQQ1100 ddeeccrreeaassee 
1. Age Dependent Decrease. 
2. Use Of Statin.
WWhhyy uussee aalloonngg wwiitthh ssttaattiinn?? 
So reduction in cholesterol 
leads to reduction in CoQ10 
which results in myalgia and 
reduced cardio protection 
Statin Use 
Add What to do?
PPhhaarrmmaaccookkiinneettiiccss 
Absorption: 
Following ingestion of 100 mg of CoQ, peak 
plasma levels occur between 5 and 10 hours. 
T max is approximately 6.5 hours
PPhhaarrmmaaccookkiinneettiiccss 
Distribution: 
The plasma half-life of CoQ in different tissues 
varies between 49-125 hours. 
Following absorption from the GI tract, CoQ is 
taken up by chylomicrons. The major portion of 
an exogenous dose of CoQ is deposited in the 
liver and packaged into VLDL lipoprotein.
PPhhaarrmmaaccooddyynnaammiiccss 
Metabolism/Excretion: 
It is assumed that metabolism and excretion of 
exogenous CoQ is analogous to endogenously 
produced CoQ. The excretion of CoQ is 
predominantly via the biliary tract.
PPhhaarrmmaaccooddyynnaammiiccss 
Drug interaction: 
Warfarin: CoQ may antagonize the effects of 
warfarin. CoQ is structurally similar to vitamin K. 
Chemotherapy: Theoretically, CoQ may 
decrease the efficacy of chemotherapy due to 
antioxidant activity.
DDoossaaggee aanndd IInnddiiccaattiioonn 
DDoossaaggee:: 
• One capsule twice daily. 
IInnddiiccaattiioonn:: 
• Statin Induced Myalgia. 
• Age dependent depletion of CO-Q10. 
• In Patients with major cardiovascular events. 
• Chronic Fatigue syndrome
Clinical Studies
Am J Clin Nutr 2013;97:233–4
CCeellll NNuummbbeerr:: 00333333--22229922223311
CCoonncclluussiioonn 
These patients, steadily worsening and expected to die 
within 2 years under conventional therapy, generally 
showed an extraordinary clinical improvement, indicating 
that CoQ10 therapy might extend the lives of such patients. 
This improvement could be due to correction of a 
myocardial deficiency of CoQ10 and to enhanced synthesis 
of CoQ10-requiring enzymes.
Response of patients in classes III and IV of cardiomyopathy to 
therapy in a blind and crossover trial with coenzyme Q10 
Proc. Nati. Acad. Sci. USA 
Vol. 82, pp. 4240-4244, June 1985 
Medical Sciences 
A double-blind and double-crossover trial has been 
conducted by administering CoQ10 and a matching placebo 
orally to two groups of patients having class I or IV 
cardiomyopathy (classification according to criteria of the 
New York Heart Association). 
Group A received CoQ10 and then placebo; group B 
received placebo and then CoQ10. Blood levels of CoQ1o 
and cardiac function were determined at 0 and 4 weeks 
(control stabilization period) and at 16 and 28 weeks (after 
the 12-week CoQ/placebo-treatment periods).
RReessuullttss 
• For group A, significant increases in CoQ10 blood levels 
and cardiac function (SV and EF) occurred during CoQ10 
treatment and then decreased during crossover to 
placebo. 
• For group B, there was no change in CoQ10 blood levels 
and cardiac function (SV and EF) during placebo 
treatment, but increases in both parameters occurred in 
crossover to CoQ10

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Coenzyme Q10

  • 1. Muhammad Aiyaz Sharif Product Manager PharmEvo Pvt. Ltd
  • 2. What is Co-enzyme Q10? Coenzyme Q10, also known as ubiquinone, coenzyme Q, and abbreviated at times to CoQ10 . This oil-soluble, vitamin-like substance is present in most eukaryotic cells, primarily in the mitochondria. It is a component of the electron transport chain and participates in aerobic cellular respiration, generating energy in the form of ATP. Ninety-five percent of the human body’s energy is generated this way.1,2 1.Ernster, L; Dallner, G (1995). "Biochemical, physiological and medical aspects of ubiquinone function". Biochimica et Biophysica Acta 1271 (1): 195–204. 2.Dutton, PL; Ohnishi, T; Darrouzet, E; Leonard, MA; Sharp, RE; Cibney, BR; Daldal, F; Moser, CC (2000). "4 Coenzyme Q oxidation reduction reactions in mitochondrial electron transport". In Kagan, VE; Quinn, PJ. Coenzyme Q: Molecular mechanisms in health and disease. Boca Raton: CRC Press. pp. 65–82
  • 3. Who discovered it? CoQ10 was first discovered by Professor Fredrick L. Crane and colleagues at the University of Wisconsin–Madison Enzyme Institute in 1957.3,4 In 1958, its chemical structure was reported by Dr. Karl Folkers and coworkers at Merck. In 1961 Peter Mitchell proposed the electron transport chain (which includes the vital proton motive role of CoQ10) and he received a Nobel Prize for the same in 1978. 3.Crane, F; Hatefi, Y; Lester, R; Widmer, C (1957). "Isolation of a quinone from beef heart mitochondria". Biochimica et Biophysica Acta 25 (1): 220–1 4.Peter H. Langsjoen,"Introduction of Coezyme Q10“
  • 4. WWhhaatt iiss tthhee rroollee ooff NNeeooQQ1100
  • 5. How is it synthesized? Starting from acetyl-CoA, a multistep process of mevalonate pathway produces farnesyl-PP (FPP), the precursor for cholesterol and CoQ10.
  • 6. CCaauusseess ooff CCooQQ1100 ddeeccrreeaassee 1. Age Dependent Decrease. 2. Use Of Statin.
  • 7.
  • 8. WWhhyy uussee aalloonngg wwiitthh ssttaattiinn?? So reduction in cholesterol leads to reduction in CoQ10 which results in myalgia and reduced cardio protection Statin Use Add What to do?
  • 9. PPhhaarrmmaaccookkiinneettiiccss Absorption: Following ingestion of 100 mg of CoQ, peak plasma levels occur between 5 and 10 hours. T max is approximately 6.5 hours
  • 10. PPhhaarrmmaaccookkiinneettiiccss Distribution: The plasma half-life of CoQ in different tissues varies between 49-125 hours. Following absorption from the GI tract, CoQ is taken up by chylomicrons. The major portion of an exogenous dose of CoQ is deposited in the liver and packaged into VLDL lipoprotein.
  • 11. PPhhaarrmmaaccooddyynnaammiiccss Metabolism/Excretion: It is assumed that metabolism and excretion of exogenous CoQ is analogous to endogenously produced CoQ. The excretion of CoQ is predominantly via the biliary tract.
  • 12. PPhhaarrmmaaccooddyynnaammiiccss Drug interaction: Warfarin: CoQ may antagonize the effects of warfarin. CoQ is structurally similar to vitamin K. Chemotherapy: Theoretically, CoQ may decrease the efficacy of chemotherapy due to antioxidant activity.
  • 13. DDoossaaggee aanndd IInnddiiccaattiioonn DDoossaaggee:: • One capsule twice daily. IInnddiiccaattiioonn:: • Statin Induced Myalgia. • Age dependent depletion of CO-Q10. • In Patients with major cardiovascular events. • Chronic Fatigue syndrome
  • 15.
  • 16.
  • 17. Am J Clin Nutr 2013;97:233–4
  • 18.
  • 20.
  • 21. CCoonncclluussiioonn These patients, steadily worsening and expected to die within 2 years under conventional therapy, generally showed an extraordinary clinical improvement, indicating that CoQ10 therapy might extend the lives of such patients. This improvement could be due to correction of a myocardial deficiency of CoQ10 and to enhanced synthesis of CoQ10-requiring enzymes.
  • 22. Response of patients in classes III and IV of cardiomyopathy to therapy in a blind and crossover trial with coenzyme Q10 Proc. Nati. Acad. Sci. USA Vol. 82, pp. 4240-4244, June 1985 Medical Sciences A double-blind and double-crossover trial has been conducted by administering CoQ10 and a matching placebo orally to two groups of patients having class I or IV cardiomyopathy (classification according to criteria of the New York Heart Association). Group A received CoQ10 and then placebo; group B received placebo and then CoQ10. Blood levels of CoQ1o and cardiac function were determined at 0 and 4 weeks (control stabilization period) and at 16 and 28 weeks (after the 12-week CoQ/placebo-treatment periods).
  • 23. RReessuullttss • For group A, significant increases in CoQ10 blood levels and cardiac function (SV and EF) occurred during CoQ10 treatment and then decreased during crossover to placebo. • For group B, there was no change in CoQ10 blood levels and cardiac function (SV and EF) during placebo treatment, but increases in both parameters occurred in crossover to CoQ10