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Curr Atheroscler Rep. 2010 Nov;12(6):407-13. doi: 10.1007/s11883-010-0134-3.

Coenzyme Q(10) and statin myalgia: what is the evidence?

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School of Medicine and Pharmacology, Royal Perth Hospital Unit, University of Western Australia, Medical Research Foundation Building Level 4, Rear 50, Murray Street, Perth, WA, 6847, Australia.


Statins lower cholesterol by inhibiting 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase, the rate-limiting enzyme in the biosynthesis of cholesterol. However, severe adverse events, including myalgias and rhabdomyolysis, have been reported with statin treatment. Different mechanisms have been proposed to explain statin-induced myopathy, including reduction of mevalonate pathway products, induction of apoptosis, mitochondrial dysfunction, and genetic predisposition. A decrease in coenzyme Q(10) (CoQ), a product of the mevalonate pathway, could contribute to statin induced myopathy. This article reviews the clinical and biochemical features of statin-induced myopathy, the inter-relationship between statins and the concentration of CoQ in plasma and tissues, and whether there is a role for supplementation with CoQ to attenuate statin-induced myopathy.

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