Q10

Wetenschappelijke naam

Ubiquinol, Ubiquinone, Ubidecarenone, Mitoquinone

Q10

Co-enzym Q10, kortweg CoQ10 of Q10, is een vetoplosbare verbinding met een chemische structuur die vergelijkbaar is met vitamine K (7000). De "Q10" verwijst naar 10 isoprenoïde eenheden bevestigd aan een chinonring. Het is een vetoplosbare, vitamine-achtige stof die in alle cellen in het lichaam voorkomt. Bij mensen komt co-enzym Q10 het meest voor; in andere soorten domineren co-enzymen Q6, Q7, Q8 en Q9 (7000, 11892, 11894). De hoogste concentraties co-enzym Q10 worden gevonden in het hart, de lever, de nieren en de alvleesklier van mensen (7000). Er zijn twee fysiologische vormen van co-enzym Q10 die ook beschikbaar zijn als supplementen: de geoxideerde vorm (ubiquinone) en de gereduceerde vorm (ubiquinol) (95707).

Gebruik

Oraal wordt co-enzym Q10 gebruikt voor co-enzym Q10-tekort, hart- en vaatziekten, congestief hartfalen (CHF), angina, verwijde cardiomyopathie, hypertrofische cardiomyopathie, myocarditis, myocardinfarct (MI), diabetes, diabetische neuropathie, hypertensie, hyperlipidemie, anthracycline cardiotoxiciteit kanker en borstkanker. Het wordt ook oraal gebruikt voor bipolaire stoornis, ziekte van Huntington, ziekte van Parkinson, spierdystrofie, atletische prestaties, chronisch vermoeidheidssyndroom (CVS), ziekte van Lyme, pre-eclampsie, door warfarine veroorzaakt haarverlies, autismespectrumstoornis en aan chemotherapie gerelateerde vermoeidheid . Co-enzym Q10 wordt ook oraal gebruikt voor het stimuleren van het immuunsysteem bij mensen met HIV/AIDS, levensverlenging, mannelijke onvruchtbaarheid, migraine, mitochondriale myelopathieën, polycysteus ovarium syndroom (PCOS), niet-alcoholische leververvetting (NAFLD), gerimpelde huid en statine -geïnduceerde myopathie. Het wordt ook oraal gebruikt voor leeftijdsgebonden maculaire degeneratie (AMD), fibromyalgie, ischemie-reperfusieschade, multiple sclerose (MS), ziekte van Peyronie, ziekte van Alzheimer, amyotrofische laterale sclerose (ALS, ziekte van Lou Gehrig), cocaïneverslaving, post- poliosyndroom, astma, cerebellaire ataxie, chronische obstructieve longziekte (COPD), cyclisch braken syndroom (CVS), droge mond, staar, Friedreich ataxie, gehoorverlies, hepatitis C, door de moeder overgeërfde diabetes mellitus en doofheid (MIDD), Prader-Willi syndroom (PWS) en sepsis.

Plaatselijk wordt co-enzym Q10 gebruikt voor parodontitis. Als een oogdruppel wordt co-enzym Q10 gebruikt voor hoornvlieszweren en droge ogen.

Veiligheid

WAARSCHIJNLIJK VEILIG: indien oraal en op de juiste manier gebruikt. Co-enzym Q10 is veilig gebruikt in onderzoeken die maximaal 5 jaar duren, bij lokaal gebruik op het tandvlees (2107, 2108, 2134, 6037, 6038, 6407, 8163, 8916, 8917, 8918, 8938, 8939, 8940, 15395, 17413, 17716, 96538).

KINDEREN: WAARSCHIJNLIJK VEILIG: wanneer oraal en op de juiste manier gebruikt. Co-enzym Q10 in doses van 1-10 mg/kg/dag is tot 9 maanden veilig gebruikt onder medisch toezicht (12199, 13223, 15256, 44005).

ZWANGERSCHAP: MOGELIJK VEILIG: wanneer oraal en op de juiste manier gebruikt. Co-enzym Q10 100 mg tweemaal daags is met schijnbare veiligheid gebruikt tijdens de zwangerschap, beginnend bij een zwangerschapsduur van 20 weken tot het einde van de zwangerschap (17201).

LACTATIE: Onvoldoende betrouwbare informatie beschikbaar; vermijd te gebruiken.

Effectiviteit

WAARSCHIJNLIJK EFFECTIEF

Co-enzym Q10-tekort: zeldzame gevallen van gedocumenteerde co-enzym Q10-tekort met symptomen van zwakte, vermoeidheid en epileptische aanvallen zijn gemeld. Co-enzym Q10 oraal innemen lijkt de symptomen van een tekort te verbeteren (8160, 8161). Oraal co-enzym Q10 800 mg dagelijks driemaal, is aanbevolen voor de behandeling van co-enzym Q10-tekort bij volwassenen. Bij kinderen is 30 mg/kg per dag in drie verdeelde doses aanbevolen (89417).

Mitochondriale myopathieën: co-enzym Q10 oraal innemen lijkt de symptomen te verminderen bij sommige patiënten met genetische en verworven aandoeningen van mitochondriale dysfunctie (8159, 8162, 8163, 8912, 11050, 44240, 97905). Het effect begint langzaam, met een maximaal effect na 6 maanden (8163). Een specifieke co-enzym Q10-formulering (UbiQGel, Tishcon Corporation) heeft de Amerikaanse Food and Drug Administration (FDA) weesgeneesmiddelstatus bereikt voor mitochondriale myopathieën, waaronder MELAS (myoclonische epilepsie met lactaatacidose en beroerte-achtige afleveringen) syndroom, Kearns-Sayre-syndroom en MERRF (myoclonus epilepsie met rafelige rode vezels).

MOGELIJK EFFECTIEF

Congestief hartfalen (CHF): populatieonderzoek heeft aangetoond dat hartfalen geassocieerd is met lage co-enzym Q10-waarden (44220). Bovendien kunnen co-enzym Q10-waarden een voorspeller zijn van mortaliteit bij patiënten met hartfalen (44059). Sommige klinische onderzoeken tonen aan dat suppletie met co-enzym Q10 gunstig kan zijn voor patiënten met hartfalen. Een analyse van beschikbaar klinisch onderzoek uit 2017 bij patiënten met hartfalen toont aan dat dagelijks gebruik van co-enzym Q10 30-300 mg de inspanningscapaciteit verbetert en de mortaliteit met 31% vermindert in vergelijking met placebo. Co-enzym Q10 is echter niet geassocieerd met een verandering in de ejectiefractie of de classificatie van de New York Heart Association (NYHA) (97902). De grootste studie in deze analyse laat zien dat het dagelijks innemen van co-enzym Q10 300 mg gedurende maximaal 2 jaar de dood of ziekenhuisopname vermindert bij patiënten met NYHA klasse III-IV hartfalen die conventionele therapie krijgen. In deze specifieke populatie is het aantal patiënten dat moet worden behandeld om één groot cardiovasculair voorval te voorkomen 9 (96542). Ander klinisch onderzoek toont aan dat toevoeging van oraal co-enzym Q10 aan conventionele behandelingen de kwaliteit van leven lijkt te verbeteren en symptomen van hartfalen zoals dyspneu, perifeer oedeem, vergrote lever en slapeloosheid bij patiënten met milde tot ernstige (NYHA klasse II-IV) CHF lijkt te verminderen (6407, 6408, 6409, 8909, 12170, 44042, 44288, 44289, 44304, 44334, 44352). Aanvullend klinisch onderzoek toont aan dat het dagelijks innemen van co-enzym Q10 30 mg als adjuvans bij standaardzorg de incidentie van atriumfibrilleren met ongeveer 73% vermindert in vergelijking met standaardzorg (alleen bij patiënten met NYHA klasse II-IV CHF) (95609).

Diabetische neuropathie: klinisch onderzoek toont aan dat het dagelijks gebruiken van co-enzym Q10 400 mg gedurende 12 weken de parameters van zenuwgeleiding en symptomen van neuropathische pijn en stoornissen aanzienlijk verbetert in vergelijking met placebo bij diabetespatiënten met polyneuropathie (44217).

Fibromyalgie: klinisch onderzoek toont aan dat het dagelijks innemen van co-enzym Q10 400 mg gedurende 3 maanden de pijn verbetert met 24% tot 37%, vermoeidheid met 22% en slaapstoornissen met 33% in vergelijking met placebo bij vrouwen met fibromyalgie (97913). Voorlopig klinisch onderzoek toont ook aan dat het dagelijks gebruik van co-enzym Q10 300 mg gedurende 40 dagen de pijn met 52% tot 56% vermindert, vermoeidheid met 47%, ochtendmoeheid met 56% en gevoelige punten met 44% in vergelijking met placebo (89416). Deze patiënten ervoeren ook een verbetering van psychische symptomen, waaronder een vermindering van interpersoonlijke gevoeligheid, depressie, angst en vijandigheid (97912).

Co-enzym Q10 is ook geëvalueerd in combinatie met ginkgo (Bio-Biloba, Pharma Nord) voor de behandeling van fibromyalgie. Het dagelijks gebruiken van deze combinatie gedurende 12 weken verbetert de kwaliteit van leven, zoals fysieke fitheid, emotionele gevoelens, sociale activiteiten, algehele gezondheid en pijn in vergelijking met baseline (17716).

HIV/AIDS: co-enzym Q10 oraal innemen lijkt de immuunfunctie bij patiënten met HIV/AIDS te verbeteren (2123, 2124).

Ischemie-reperfusieletsel: klinisch onderzoek toont aan dat co-enzym Q10 oraal of intraveneus gedurende een week vóór cardiale bypass of vaatchirurgie hypoxische schade tijdens chirurgie vermindert (11902, 11903, 44031, 44294). Eén klinische studie toont aan dat het dagelijks innemen van co-enzym Q10 300 mg gedurende 2 weken voorafgaand aan cardiale bypass-chirurgie de subjectieve kwaliteit van leven verbetert in vergelijking met placebo na een follow-up van 37 maanden (43937). Sommige klinische onderzoeken wijzen er echter op dat co-enzym Q10 oraal, binnen 24 uur vóór de operatie, of in kleine doses van 100 mg per dag geen effect heeft op de hartfunctie of troponinespiegels in vergelijking met placebo na reperfusiechirurgie (11904, 44292). Co-enzym Q10 in combinatie met magnesium, selenium en omega-3-vetzuren gedurende 2 maanden voorafgaand aan en een maand na hartchirurgie lijkt de troponinespiegels en de duur van ziekenhuisopname aanzienlijk te verminderen (21651).

Migraine: sommige klinische onderzoeken tonen aan dat orale inname van co-enzym Q10 de frequentie van hoofdpijn met ongeveer 30% en het aantal dagen met hoofdpijngerelateerde misselijkheid met ongeveer 45% verlaagt bij volwassenen (8135, 11872). Een andere studie toont aan dat het dagelijks innemen van co-enzym Q10 (WN Pharmaceuticals, Ltd.) gedurende 3 maanden 100 mg de ernst van migraine, het aantal gemiste werkdagen als gevolg van migraine vermindert en de frequentie met de helft bij 60% van de patiënten (95608). Om de frequentie van migraine bij volwassenen met 50% te verminderen, is het aantal dat nodig is om (NNT) te behandelen met co-enzym Q10 100 mg TID gedurende 3 maanden (11872). Het kan tot 3 maanden duren voor een aanzienlijk voordeel (11872, 95608). In een meta-analyse van 5 onderzoeken verminderde co-enzym Q10 het aantal migraine-aanvallen per maand niet, maar verminderde het de duur van migraine en het aantal dagen met migraine in een maand (99430). Richtlijnen van de American Academy of Neurology beschouwen co-enzym Q10 mogelijk effectief voor de preventie van migraine (99430).

In één observationeel onderzoek is aangetoond dat het nemen van een specifiek combinatieproduct (Antemig, PiLeJe) met co-enzym Q10 100 mg, moederkruid 100 mg, magnesium 112,5 mg en vitamine B6 1,4 mg per dag gedurende 12 weken het aantal hoofdpijndagen per maand vermindert met 3,5 dagen en tegelijkertijd de kwaliteit van leven verbeteren in vergelijking met baseline (96531).

Bij kinderen en adolescenten suggereert klinisch onderzoek dat het gebruik van co-enzym Q10 100 mg gedurende 16 weken de frequentie, ernst of duur van de hoofdpijn niet significant verbetert in vergelijking met placebo (44197). Het gebruik van co-enzym Q10 lijkt echter de migraine-frequentie te verminderen bij kinderen met een laag co-enzym Q10 (15256).

Multiple sclerose (MS): klinisch onderzoek toont aan dat het dagelijks innemen van co-enzym Q10 500 mg gedurende 3 maanden vermoeidheid en depressie vermindert bij MS-patiënten (96539).

Spierdystrofie: co-enzym Q10 oraal innemen lijkt de fysieke prestaties te verbeteren bij sommige patiënten met spierdystrofieën (2127).

Myocardinfarct (MI): klinisch onderzoek suggereert dat oraal innemen van co-enzym Q10 het risico op cardiale gebeurtenissen lijkt te verminderen bij patiënten met recent MI die risico lopen op atherotrombose. Wanneer gestart bij patiënten binnen 72 uur na MI, lijkt co-enzym Q10 het risico op cardiale gebeurtenissen, waaronder niet-fatale MI en hartdood, aanzienlijk te verminderen met 52% bij toediening gedurende 28 dagen en met 45% bij toediening gedurende maximaal een jaar (10152, 44330). In één klinisch onderzoek verbeterde het toedienen van een enkele oplaaddosis van 250 mg co-enzym Q10 gevolgd door drie dagelijkse doses van 150 mg via een nasogastrische buis gedurende 5 dagen de overlevingskans van 3 maanden aanzienlijk met 134% vergeleken met placebo bij patiënten met recente MI die reanimatie kreeg (43935).

Sommige klinische onderzoeken tonen aan dat het dagelijks gebruiken van een combinatie van 100 mg co-enzym Q10 en 100 mcg selenium gedurende een jaar, het risico op verlenging van het QT-interval met 60% verlaagt in vergelijking met placebo bij post-MI-patiënten (44275).

Peyronie-ziekte: klinisch onderzoek toont aan dat bij patiënten met vroege chronische Peyronie-ziekte, het gebruik van co-enzym Q10 (Kaneka Nutrients, Osaka) gedurende 24 weken 300 mg per dag gedurende 24 weken nieuwe plaquevormingen aanzienlijk vermindert en de erectiele functie en plaquegrootte verbetert in vergelijking met placebo. Bovendien hebben patiënten die deze dosis co-enzym Q10 gebruiken een kans van 75,6% om de ziekteprogressie te vertragen in vergelijking met placebo (44180).

Dosering & gebruik

Volwassen

Oraal:

  • Algemeen: Er zijn verschillende doses co-enzym Q10 gebruikt. Om bijwerkingen te minimaliseren, worden verdeelde dagelijkse doses co-enzym Q10 over het algemeen aanbevolen wanneer doses hoger zijn dan 100 mg per dag (3370).
  • Leeftijdsgebonden maculaire degeneratie: twee capsules van een specifiek combinatieproduct (Phototrop, Sigma-tau Health Science Ltd.) met acetyl-L-carnitine 100 mg, omega-3-vetzuren 530 mg en co-enzym Q10 10 mg dagelijks gedurende 12 maanden zijn gebruikt (43946).
  • Angina: Co-enzym Q10 60 mg eenmaal daags of 50 mg driemaal daags gedurende 4 weken is gebruikt (2121, 44336).
  • Astma: Co-enzym Q10 (Q-Gel, Tishcon Corporation) 120 mg, vitamine E 400 mg en vitamine C 250 mg per dag in aanvulling op conventionele anti-astmatische therapie gedurende 16 weken is gebruikt (43969).
  • Bipolaire stoornis: Co-enzym Q10 800 mg per dag gedurende 4 weken is gebruikt (95606).
  • Borstkanker: Co-enzym Q10 (Bio-Quinone, Pharma Nord), dagelijks 390 mg (3995).
  • Kanker: co-enzym Q10 300 mg, samen met vitamine C 5,7 mg, vitamine E 1,625 mg, selenomethionine 487 mcg, foliumzuur 5 mg, vitamine A 25.000 IE en bètacaroteen 76 mg, allemaal dagelijks in twee verdeelde doses gebruikt (44159).
  • Hart- en vaatziekten (CVD): een combinatie van co-enzym Q10 (Bio-Quinon, Pharma Nord, Denemarken) 100 mg tweemaal daags plus organische seleniumgisttabletten (SelenoPrecise, Pharma Nord) 200 mcg dagelijks gedurende maximaal 5 jaar is gebruikt (92904).
  • Cerebellaire ataxie: Co-enzym Q10 30 mg/kg dagelijks gedurende 2 jaar is gebruikt (44177).
  • Chronische obstructieve longziekte (COPD): Co-enzym Q10 90 mg per dag gedurende 8 weken is gebruikt (44293).
  • Co-enzym Q10-tekort: 150-2400 mg per dag in maximaal drie verdeelde doses is gebruikt (8160, 89417).
  • Congestief hartfalen (CHF): Co-enzym Q10 100 mg per dag verdeeld in twee of drie doses gedurende maximaal 2 jaar of 2 mg/kg dagelijks gedurende maximaal één jaar is in de meeste onderzoeken gebruikt (6037, 6038, 6407, 6408, 6409, 8909, 44288). Er zijn ook voordelen gevonden met lagere doses van 30 mg per dag gedurende 1 jaar of 50-60 mg per dag gedurende maximaal 3 maanden, evenals hogere doses (50-100 mg driemaal daags voor maximaal 2 jaar) (12170, 43967, 43971, 44277, 44289, 44304, 44334, 95610, 96542).
  • Cyclisch braken syndroom (CVS): Co-enzym Q10 10 mg/kg tweemaal daags is gebruikt (17703).
  • Diabetische neuropathie: co-enzym Q10 400 mg per dag gedurende 12 weken is gebruikt (44217).
  • Droge mond: er is gedurende één maand dagelijks 100 mg co-enzym Q10 (ubiquinol) of geoxideerd co-enzym Q10 (ubiquinon) 100 mg gebruikt (44191).
  • Fibromyalgie: Co-enzym Q10 300 mg per dag gedurende 40 dagen is gebruikt (89416, 97912). Co-enzym Q10 200 mg tweemaal daags gedurende 3 maanden is gebruikt (97913). Co-enzym Q10 (Bio-Quinon Q10, Pharma Nord) 200 mg in combinatie met ginkgo (Bio-Biloba, Pharma Nord) 200 mg dagelijks gedurende 84 dagen is gebruikt (17716).
  • Friedreich ataxia: Co-enzym Q10 (Bio-Quinon Q10, Pharma Nord) 200 mg tweemaal daags plus vitamine E (Bio-E-Vitamine, Pharma Nord) 1050 IE tweemaal daags gedurende 2 jaar is gebruikt (43943, 44064).
  • Gehoorverlies: Co-enzym Q10 terclatrate (Qter) 160 mg per dag gedurende 30 dagen is gebruikt (44171, 44184).
  • HIV/AIDS: Co-enzym Q10 100-200 mg per dag is tot 4 jaar en 10 maanden gebruikt (2123, 2124).
  • Hypertensie: Co-enzym Q10 100-200 mg in één tot drie verdeelde doses per dag gedurende maximaal 12 weken is gebruikt (2122, 9890, 17702, 17650, 17651, 44343, 95607). Ook is een specifiek co-enzym Q10-product (Q-Gel, Tishcon Corporation) 60 mg tweemaal daags gedurende 8 weken gebruikt (3365). Voor geïsoleerde systolische hypertensie is co-enzym Q10 60 mg tweemaal daags gedurende 12 weken gebruikt (8907).
  • Hyperlipidemie: Co-enzym Q10 200 mg per dag in combinatie met een omega-3-vetzuursupplement (ZENNIX, Pharma Nord) met docosahexaeenzuur 520 mg en eicosapentaeenzuur 155 mg driemaal daags gedurende 12 weken is gebruikt in combinatie met statine-therapie (97910).
  • Hypertrofische cardiomyopathie: een specifiek co-enzym Q10-product (co-enzym Q10, Vitaline) 120-240 mg per dag totdat de co-enzym Q10-waarden hoger waren dan 2 mcg/ml (11031).
  • Ischemie-reperfusieschade: co-enzym Q10 150-300 mg per dag in maximaal drie verdeelde doses gedurende 1-2 weken voor een operatie is gebruikt om ischemie-reperfusieschade te voorkomen (11902, 11903, 44294). Ook co-enzym Q10 100 mg driemaal daags, magnesiumorotaat 400 mg driemaal daags, liponzuur 100 mg driemaal daags, omega-3 vetzuren 300 mg driemaal daags, en selenium 200 mcg eenmaal daags gedurende ongeveer 2 maanden vóór de operatie en één maand na de operatie (21651).
  • Mannelijke onvruchtbaarheid: co-enzym Q10 200-300 mg per dag gedurende 26 maanden is gebruikt (12169, 17413).
  • Maternaal overgeërfde diabetes mellitus en doofheid (MIDD): co-enzym Q10 150 mg dagelijks gedurende 3 jaar is gebruikt (2125).
  • Migraine hoofdpijn: co-enzym Q10 100 mg één of drie keer per dag of 150 mg eenmaal daags gedurende 3 maanden (8135, 11872, 95608). Vloeibare gelformuleringen van co-enzym Q10 1-3 mg/kg per dag gedurende ongeveer 3 maanden zijn gebruikt bij jonge volwassenen van 22 jaar of jonger (15256).
  • Mitochondriale myopathieën: co-enzym Q10 150-160 mg of 2 mg/kg per dag is gebruikt (8159, 8162, 8163, 44240). In sommige gevallen zijn de doses geleidelijk verhoogd tot 3000 mg per dag (8912).
  • Spierdystrofie: co-enzym Q10 100 mg per dag gedurende 3 maanden is gebruikt (2127).
  • Multiple sclerose (MS): Co-enzym Q10 500 mg tweemaal daags gedurende 3 maanden is gebruikt (96539).
  • Myocardinfarct (MI): Co-enzym Q10 60 mg tweemaal daags gedurende maximaal één jaar is gebruikt (10152, 44330). Ook is vloeibaar co-enzym Q10 (Sanomit, MSE Pharma) 250 mg toegediend als oplaaddosis, gevolgd door vloeibaar co-enzym Q10 (Sanomit, MSE Pharma) 150 mg driemaal daags 150 mg via een nasogastrische buis gedurende 5 dagen (43935). Bovendien is een combinatie van co-enzym Q10 (Bio-Quinon, Pharma Nord), 100 mg plus selenium (Bio-Selenium, Pharma Nord), 100 mcg dagelijks gedurende één jaar gebruikt (44275).
  • Myocarditis: gedurende 2 weken is een niet-gespecificeerde dosis co-enzym Q10 met trimetazidine gebruikt, een anti-angina medicijn dat in China wordt gebruikt (97916).
  • Niet-alcoholische leververvetting (NAFLD): Co-enzym Q10 100 mg per dag gedurende 12 weken is gebruikt (97907).
  • Ziekte van Parkinson: 300 mg, 600 mg, 1200 mg en 2400 mg per dag in 3-4 verdeelde doses per dag gedurende maximaal 24 maanden (8938, 15255, 44212, 95610).
  • Parodontitis: Co-enzym Q10 50 mg per dag gedurende 3 weken is gebruikt (8917,8918).
  • Ziekte van Peyronie: Co-enzym Q10 (Kaneka Nutrients) 300 mg per dag gedurende 24 weken is gebruikt (44180).
  • Polycysteus ovarium syndroom (PCOS): Co-enzym Q10 (Nature Made) 100 mg per dag gedurende 12 weken is gebruikt (97914).
  • Pre-eclampsie: een specifiek co-enzym Q10-product (Q-absorberen, Jarrow Formulas) 100 mg tweemaal daags beginnend bij 20 weken zwangerschap en doorlopend tot het einde van de termijn is gebruikt (17201).
  • Nierfalen: Co-enzym Q10 180 mg dagelijks gedurende 28 dagen is gebruikt (44347).
  • Door statines geïnduceerde myopathie: co-enzym Q10 100 mg per dag gedurende 30 dagen is gebruikt (16008, 44345, 95602). Een hogere dosis co-enzym Q10 100 mg tweemaal daags is gebruikt voor door vlekken geïnduceerde rabdomyolyse (95605).
  • Door Warfarine geïnduceerd haarverlies: Co-enzym Q10 30 mg per dag gedurende maximaal 2 maanden is gebruikt (455).

Topisch:

  • Corneale ulceratie: een specifieke oogdruppel (Visudrop, Liba Laboratories) met co-enzym Q10, vitamine E en hypromellose, 2-4 keer per dag toegediend als 1 druppel in het aangedane oog (97904).
  • Droge ogen: een specifieke oogdruppel (VisuXL, Visufarma) met co-enzym Q10 en verknoopt hyaluronzuur in een 1: 1-concentratie, gegeven als 1 druppel in elk oog gedurende 12 weken gedurende 12 weken, is gebruikt (97909).
  • Cataract: een oogdruppeloplossing met co-enzym Q10 plus vitamine E D-alfa-tocoferylpolyethyleenglycol 1000 succinaat, tweemaal daags gedurende 9 maanden is gebruikt (44228).
  • Gerimpelde huid: Crème met 1% co-enzym Q10, tweemaal daags aangebracht gedurende 5 maanden, is gebruikt (44082).
  • Ischemie-reperfusieschade: Intraveneus co-enzym Q10 5 mg/kg twee uur voorafgaand aan cardiale bypass of vasculaire chirurgie is gebruikt (44031).

Kinderen

Oraal:

  • Anthracycline-cardiotoxiciteit: co-enzym Q10 100 mg tweemaal daags is gebruikt bij kinderen van 3-12 jaar (44279).
  • Autismespectrumstoornis: een gereduceerde vorm van co-enzym Q10 genaamd ubiquinol (Li-QH, Tishcon Corporation) 50 mg per dag gedurende één week gevolgd door 50 mg tweemaal daags gedurende 11 extra weken is gebruikt (89419).
  • Co-enzym Q10-tekort: co-enzym Q10 60-250 mg per dag in maximaal drie verdeelde doses is gebruikt (8161, 89417).
  • Cyclisch braken syndroom (CVS): co-enzym Q10 10 mg/kg tweemaal daags is gebruikt (17703).
  • Gedilateerde cardiomyopathie: co-enzym Q10 3 mg/kg/dag en 10 mg/kg/dag in 2-3 verdeelde doses gedurende maximaal 9 maanden zijn gebruikt (12199, 13223). Een specifiek vloeibaar preparaat (QuinoMit Q10 Fluid, MSE Pharmazeutika GmbH, Duitsland) 10 mg/kg/dag gedurende 24 weken is ook gebruikt (99427).
  • Migraine-hoofdpijn: vloeibare gelformuleringen van co-enzym Q10 1-3 mg/kg per dag gedurende ongeveer 3 maanden is gebruikt bij pediatrische en adolescente patiënten van 3-22 jaar (15256).
  • Spierdystrofie: co-enzym Q10 100 mg per dag gedurende 3 maanden is gebruikt bij pediatrische en adolescente patiënten in de leeftijd van 8-15 jaar (2127).
  • Prader-Willi-syndroom (PWS): Co-enzym Q10 2,5 mg/kg per dag gedurende één jaar is gebruikt (44005).

Bijwerkingen

Algemeen: oraal, co-enzym Q10 wordt over het algemeen goed verdragen. In klinische onderzoeken zijn geen significante bijwerkingen gemeld waaronder één onderzoek met een hoge dosis co-enzym Q10 (dagelijks 2,4 gram) gedurende maximaal 5 jaar  (2134 ,6037, 6038, 6047, 8135, 8938, 8939, 8940, 17201, 17413, 43955, 44131, 44233, 44334, 95606, 95607, 95608, 95610, 96538). Co-enzym Q10 kan echter gastro-intestinale bijwerkingen veroorzaken zoals misselijkheid, braken, diarree, onderdrukking van de eetlust, brandend maagzuur en epigastrisch ongemak, hoewel dit voorkomt bij minder dan 1% van de patiënten (2134, 3370, 6409, 8135, 8938, 8939, 8940, 10152). Sommige van deze bijwerkingen kunnen worden geminimaliseerd als de totale dagelijkse doses van meer dan 100 mg worden verdeeld en twee tot drie keer per dag worden toegediend (3370).

Interactie

Medicijnen

ALKYLERENDE AGENTEN

Theoretisch kunnen antioxidanten zoals co-enzym Q10 tumorcellen beschermen tegen chemotherapeutische middelen die werken door oxidatieve stress te induceren, zoals de alkylerende middelen (bijv. Cyclofosfamide, Cytoxan) en radiotherapie (5158, 5159). Het klinische belang van deze interactie is onbekend en vereist verder onderzoek.

ANTIHYPERTENSIEVE DRUGS

Co-enzym Q10 kan de bloeddruk verlagen en kan additieve bloeddrukverlagende effecten hebben bij gebruik met antihypertensiva; voorzichtig gebruiken. Sommige antihypertensiva omvatten captopril (Capoten), enalapril (Vasotec), losartan (Cozaar), valsartan (Diovan), diltiazem (Cardizem), amlodipine (Norvasc), hydrochloorthiazide (HydroDiuril), furosemide (Lasix) en vele anderen (2122, 9890, 17702, 43932, 43982).

DOXORUBICIN (Adriamycin, anderen)

Voorlopig bewijs suggereert dat de niveaus van co-enzym Q10 zijn verhoogd bij kinderen en adolescenten van 2,5-19 jaar oud met kanker die doxorubicine (Adriamycin) krijgen in vergelijking met andere chemotherapeutica (14412). Dit kan een gevolg zijn van de afgifte van co-enzym Q10 uit apoptotisch hartweefsel. Co-enzym Q10 lijkt de farmacokinetiek van doxorubicine niet significant te veranderen (14413). De invloed van co-enzym Q10 op de effectiviteit van doxorubicine is onbekend.

WARFARIN (Coumadin)

Gelijktijdig gebruik kan de antistollingseffecten van warfarine verminderen (2128, 6048, 6199). Co-enzym Q10 is chemisch vergelijkbaar met menaquinon en kan vitamine K-achtige procoagulerende effecten hebben. Vier gevallen van verminderde werkzaamheid van warfarine waarvan wordt gedacht dat deze te wijten zijn aan co-enzym Q10 zijn gemeld (2128, 6048, 11048). Er is echter voorlopig klinisch onderzoek dat suggereert dat co-enzym Q10 de effecten van warfarine mogelijk niet significant vermindert bij patiënten met een stabiele INR (11905). Houd patiënten die warfarine en co-enzym Q10 gebruiken nauwlettend in de gaten. Een dosisaanpassing kan nodig zijn.

Kruiden en supplementen

ACACIA: het combineren van co-enzym Q10 met acaciagom lijkt de absorptie van co-enzym Q10 te beïnvloeden. In farmacokinetisch onderzoek bij dieren en mensen verhoogt emulgerend co-enzym Q10 in acaciagom de absorptie van co-enzym Q10 vergeleken met alleen co-enzym Q10 poeder (44168). Theoretisch kan dit het risico op bijwerkingen verhogen.

BETA-CAROTENE: co-enzym Q10 kan de serumspiegels van beta-caroteen beïnvloeden. In klinisch onderzoek verhoogde suppletie met co-enzym Q10 de bètacaroteenwaarden (44330). Theoretisch kan dit het risico op bijwerkingen verhogen

KRUIDEN EN SUPPLEMENTEN MET HYPOTENSIEVE EFFECTEN: co-enzym Q10 kan de bloeddruk verlagen (2122, 9890, 17702, 43932, 43982). Theoretisch kan het combineren van co-enzym Q10 met andere kruiden of supplementen met hypotensieve effecten het risico op hypotensie verhogen. Sommige van deze kruiden en supplementen zijn andrographis, caseïnepeptiden, kattenklauw, co-enzym Q10, visolie, L-arginine, lycium, brandnetel, theanine en anderen.

OMEGA-3 VETZUREN: co-enzym Q10-niveaus en omega-3-vetzuren kunnen elkaars positieve werking op lipide en non-lipide parameters bij plaquevorming in de slagaders bevorderen. In klinisch onderzoek verbeterde de combinatie van omega-3-vetzuren met co-enzym Q10 de leverenzym-activiteit, bloeddruk en ontstekingsmarkers (44128)

RODE GIST RIJST: theoretisch, aangezien rode gist HMG-CoA-reductaseremmer ("statine") bestanddelen bevat, kan het de co-enzym Q10-waarden verlagen (512).

VITAMINE A: co-enzym Q10 kan de serumspiegels van vitamine A beïnvloeden. In klinisch onderzoek verhoogde suppletie met co-enzym Q10 de vitamine A-waarden (44330). Theoretisch kan dit het risico op bijwerkingen verhogen die verband houden met vitamine A.

VITAMINE C: Co-enzym Q10 kan de serumspiegels van vitamine C beïnvloeden. In klinisch onderzoek verhoogde suppletie met co-enzym Q10 de vitamine C-waarden (44330). Theoretisch kan dit het risico op bijwerkingen verhogen die verband houden met vitamine C.

VITAMINE E: Co-enzym Q10 kan de serumspiegels van vitamine E beïnvloeden. In klinisch onderzoek verhoogde suppletie met co-enzym Q10 de vitamine E-waarden (44330). Theoretisch kan dit het risico op bijwerkingen geassocieerd met vitamine E verhogen.

VITAMINE K: Co-enzym Q10 is chemisch vergelijkbaar met vitamine K2 (menaquinon) en kan vitamine K-achtige effecten hebben, waaronder antagonisme van warfarine (2128, 6048). Gelijktijdig gebruik van co-enzym Q10 en vitamine K kan additieve effecten veroorzaken en het risico op stolling verhogen bij mensen die anticoagulantia gebruiken.

Voedsel

Geen bijwerkingen bekend.

Lab testen

Prostaatspecifiek antigeen (PSA): klinisch bewijs toont aan dat het dagelijks innemen van co-enzym Q10 100 mg gedurende 12 weken PSA-waarden tot 33% verlaagt bij gezonde mannen (89423). Theoretisch kan co-enzym Q10 PSA-niveaus en testresultaten beïnvloeden bij mannen die worden gescreend op prostaatkanker.

Ziektes

HYPOTENSIE, HYPERTENSIE: co-enzym Q10 kan de bloeddruk verlagen. Het kan additieve effecten hebben met medicijnen die worden gebruikt voor hypertensie; voorzichtig gebruiken (2122, 3365, 9890).

ROKEN: Het roken van sigaretten put het lichaam van co-enzym Q10 uit (7722).

CHIRURGIE: Co-enzym Q10 kan de bloeddruk beïnvloeden. Theoretisch kan co-enzym Q10 de bloeddrukcontrole tijdens en na chirurgische ingrepen verstoren. Vertel patiënten om co-enzym Q10 ten minste 2 weken voor electieve chirurgische procedures te stoppen.

Werkingsmechanisme

Algemeen: co-enzym Q10 is een vitamine-achtige verbinding die aanwezig is in vrijwel alle cellen en in bijzonder hoge concentraties in het hart, de lever, de nieren en de alvleesklier. In de cel wordt 25% tot 30% van het totale co-enzym Q10 in de kern gevonden, 40% tot 50% in de mitochondriën, 15% tot 20% in de microsomen en 5% tot 10% in de cytosol. Co-enzym Q10 is in vet oplosbaar en werkt vergelijkbaar met een vitamine (2134, 11892). Zijn primaire functies omvatten activiteit als een antioxidant, een membraanstabilisator en als een cofactor in veel metabole routes, met name bij de productie van adenosinetrifosfaat (ATP) bij oxidatieve ademhaling (2134, 6037, 6048, 6410, 11892).

Het lichaam produceert voldoende hoeveelheden co-enzym Q10, dus het wordt niet beschouwd als een vitamine (11893). Het wordt ook ingenomen in kleine hoeveelheden uit voedingsbronnen, waaronder vlees en zeevruchten. De hoeveelheden ingenomen in voedingsmiddelen benaderen echter niet de therapeutische doses. Co-enzym Q10 in sojaolie lijkt een superieure biologische beschikbaarheid te hebben in vergelijking met andere formuleringen (457).

De biosynthese van co-enzym Q10 is een 17-stappenproces dat riboflavine, niacinamide, pantotheenzuur (B5), pyridoxine, cobalamine (B12), foliumzuur, vitamine C en andere sporenelementen vereist (89413). Tekorten aan serumco-enzym Q10 kunnen worden veroorzaakt door onvoldoende inname van deze voedingsstoffen.

Bovenstaande monografie is geschreven aan de hand van de onderstaande referenties.

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