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CoQ10 (ubiquinol vs ubiquinone)

Also called coenzyme Q10, ubiquinone, ubiquinol, ubidecarenone, CoQ-10

By Kymata Health editorial teamLast reviewed October 8, 2026 · What changed

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Summary

CoQ10 is sold as ubiquinone (oxidized) or ubiquinol (reduced). In a 12-person comparison, ubiquinol raised blood CoQ10 more (grade D). Statins lower blood CoQ10, but trials of CoQ10 for statin muscle symptoms disagree (grade C), and it had no clear effect on blood pressure. NCCIH reports only mild side effects.

Top graded outcomes:C evidence grade Muscle symptoms in statin usersC evidence grade Blood pressureC evidence grade Long-term clinical events (heart-failure trial)

Key facts

Forms covered
Ubiquinone (oxidized CoQ10) and ubiquinol (reduced CoQ10)[2][8]
Ubiquinol vs ubiquinone
Higher plasma CoQ10 with ubiquinol at 200 mg/day in one 12-person study ↑ (D)[2]
Top studied outcomes
Muscle symptoms in statin users ? mixed (C); blood pressure ↔ (C); long-term clinical events in one heart-failure trial ↑ (C)[3][4][5][6]
Studied dose range
200–300 mg/day in the trials graded here[2][6]
RDA / UL
None; no NIH ODS fact sheet[1]
Documented interactions
Warfarin and insulin (NCCIH); statins lower blood CoQ10[1][7]
Evidence base graded here
3 meta-analyses, 1 randomized trial and 1 open-label comparison[3][4][5][6][2]
Evidence base
4 graded human outcomes on this page
Last reviewed
October 8, 2026

How it works

ProposedCoQ10 is a cofactor for cellular energy production and an antioxidant (established physiology). Trials show statins lower circulating CoQ10; whether this contributes to statin-associated muscle symptoms is proposed, not established.[7][6]

What the human research says

Human trials only, one row per outcome. The form column shows what each trial actually tested. Grades follow our evidence-grading policy.

At a glance: strongest evidence per outcome

Evidence at a glance: strongest human evidence per outcome
OutcomeGradeEffectStrongest evidenceRows
HeartGrade CMixedMeta-analysis · n = 575 · 2018Form tested: CoQ10 (form not specified in abstract)3 rows
EnergyGrade DImprovedOpen-label · n = 12 · 2014Form tested: ubiquinol vs ubiquinone (identical softgel excipients)1 rowIncludes this form

Every graded row

Outcome
Grade
Form tested
Sort

Showing 4 of 4 outcomes. Human trials only.

OutcomeEffectGradeBest evidencePMID
Muscle symptoms in statin usersMixedGrade C

Meta-analysis · n = 575 · 2018

12 RCTs (575 patients) of CoQ10 for statin-associated muscle symptoms

Form: CoQ10 (form not specified in abstract) · Dose: Varied across trials · Duration: Varied across trials

CoQ10 reduced muscle pain, weakness, cramps and tiredness scores versus placebo; creatine kinase did not change.

30371340 (opens PubMed)Source [3]
Long-term clinical events (heart-failure trial)ImprovedGrade C

RCT · n = 420 · 2014

Adults with moderate to severe chronic heart failure on standard therapy (Q-SYMBIO)

Form: coenzyme Q10 · Dose: 100 mg three times daily (300 mg/day) · Duration: 2 years

No change in the 16-week endpoints. At 2 years, major adverse cardiovascular events occurred in 15% vs 26% (HR 0.50); cardiovascular and all-cause mortality and heart-failure hospital stays were also lower.

25282031 (opens PubMed)Source [6]
Blood pressureNo effectGrade C

Meta-analysis · n = 50 · 2016

2 double-blind RCTs in adults with primary hypertension

Form: coenzyme Q10 · Dose: Varied across trials · Duration: At least 3 weeks

No significant change in systolic (-3.68 mm Hg) or diastolic (-2.03 mm Hg) blood pressure; authors judged the evidence moderate quality for no clinically significant effect.

26935713 (opens PubMed)Source [5]
Blood CoQ10 levels: ubiquinol vs ubiquinoneImprovedGrade D

Open-label trial · n = 12 · 2014

Healthy volunteers

Form: ubiquinol vs ubiquinone (identical softgel excipients) · Dose: 200 mg/day of each, in sequence · Duration: 4 weeks each, with a 4-week washout

Plasma total CoQ10 rose from 0.9 to 4.3 µg/mL with ubiquinol versus 0.9 to 2.5 µg/mL with ubiquinone; the increase was significantly larger with ubiquinol. No side effects noted.

27128225 (opens PubMed)Source [2]

Forms

FormElemental %Absorption (human data)GI toleranceStudied for
Ubiquinone (oxidized CoQ10)Varies[8]Not a salt; labels state mg of CoQ10. Molecular weight 863.3 g/mol (PubChem)Raised plasma CoQ10 less than ubiquinol in one 12-person comparison.[2]Mild insomnia or digestive upset may occur; no serious side effects reported.[1]Outcome trials (form not stated in the outcome-trial abstracts graded here)
Ubiquinol (reduced CoQ10)Varies[8]Not a salt; molecular weight 865.4 g/mol (PubChem), essentially the same CoQ10 content per mg as ubiquinoneHigher plasma total CoQ10 than ubiquinone at 200 mg/day for 4 weeks (4.3 vs 2.5 µg/mL) in one small study.[2]No side effects noted in the comparison study.[2]Blood CoQ10 levels (bioavailability)

Studied doses

Doses studied in human trials ranged from 200 to 300 mg/day of CoQ10 in the trials graded here, for 4 weeks to 2 years. Doses in the pooled statin and blood-pressure trials are not reported in the meta-analysis abstracts.[2][6]

These are amounts used in research, not personal advice. Your clinician or pharmacist can say what fits you.

Interactions

Published interactions only: each row cites a source. No row means none was found in our sources, not that a combination is safe.

Medicines

  • WarfarinNIH fact sheete.g. warfarin (Coumadin)NCCIH: CoQ10 may interact with the anticoagulant warfarin.[1]
  • InsulinNIH fact sheetNCCIH: CoQ10 may interact with insulin.[1]
  • Some cancer treatmentsNIH fact sheetNCCIH: CoQ10 may not be compatible with some types of cancer treatment.[1]

Medicines that can lower levels

  • StatinsRCTe.g. lipophilic and hydrophilic statinsA meta-analysis of 12 RCTs (n=1,776) found statins lowered circulating CoQ10, regardless of statin type, intensity or treatment length.[7]

Who should be careful

People on warfarin or insulin
NCCIH lists possible interactions with warfarin and insulin; dose changes of those medicines may need monitoring.[1]
People in cancer treatment
NCCIH notes CoQ10 may not be compatible with some cancer treatments.[1]
Pregnancy and breastfeeding
Insufficient safety data in our sources.[1]
Side effects
No serious side effects reported; mild insomnia or digestive upset may occur.[1]
Before you start
Talk to your pharmacist or clinician before adding this supplement, especially if you take prescription medicines, are pregnant or breastfeeding, or have a chronic health condition.[1]

Talk to your pharmacist or clinician before starting a supplement, especially if you take prescription medicines.

Articles about CoQ10 (ubiquinol vs ubiquinone)

Plain-English answers to common questions, built on the evidence above.

Frequently asked questions

Is ubiquinol better than ubiquinone?

Ubiquinol raised blood CoQ10 more in one small study: 4.3 vs 2.5 µg/mL after 4 weeks at 200 mg/day in 12 healthy adults. The study was not randomized, and no trials show ubiquinol produces better health outcomes than ubiquinone.[2]

Should statin users consider CoQ10?

Statins lower blood CoQ10 in trials, but evidence on muscle symptoms conflicts: one meta-analysis of 12 trials found lower muscle-symptom scores, while another of 7 trials found no benefit. NCCIH concludes the overall evidence does not support a benefit. Discuss muscle symptoms with your prescriber.[7][3][4][1]

Does CoQ10 lower blood pressure?

Probably not meaningfully. A Cochrane review found no significant change in blood pressure, though only 50 participants could be pooled; NCCIH reaches the same conclusion.[5][1]

What are the side effects of CoQ10?

NCCIH reports no serious side effects. Mild insomnia or digestive upset may occur. It may interact with warfarin and insulin.[1]

Does CoQ10 help heart failure?

One 2-year trial of 420 people with chronic heart failure found fewer major cardiovascular events with 300 mg/day added to standard care, but it has not been replicated and NCCIH calls the research inconclusive. This is a matter for a cardiologist, not self-care.[6][1]

Sources

  1. [1]Coenzyme Q10. National Center for Complementary and Integrative Health (NCCIH), 2019. fact-sheet
  2. [2]Comparison study of plasma coenzyme Q10 levels in healthy subjects supplemented with ubiquinol versus ubiquinone.. Clin Pharmacol Drug Dev, 2014. open-label PMID 27128225
  3. [3]Effects of Coenzyme Q10 on Statin-Induced Myopathy: An Updated Meta-Analysis of Randomized Controlled Trials.. J Am Heart Assoc, 2018. meta-analysis PMID 30371340
  4. [4]Effect of Coenzyme Q10 on statin-associated myalgia and adherence to statin therapy: A systematic review and meta-analysis.. Atherosclerosis, 2020. meta-analysis PMID 32179207
  5. [5]Blood pressure lowering efficacy of coenzyme Q10 for primary hypertension.. Cochrane Database Syst Rev, 2016. meta-analysis PMID 26935713
  6. [6]The effect of coenzyme Q10 on morbidity and mortality in chronic heart failure: results from Q-SYMBIO: a randomized double-blind trial.. JACC Heart Fail, 2014. RCT PMID 25282031
  7. [7]The effect of statin treatment on circulating coenzyme Q10 concentrations: an updated meta-analysis of randomized controlled trials.. Eur J Med Res, 2018. meta-analysis PMID 30414615
  8. [8]Ubiquinone-10 (CID 5281915) and ubiquinol (CID 9962735): molecular weights. PubChem, NCBI, 2026. database

What changed

  1. October 8, 2026 · all · new pageFirst draft. Every evidence-row PMID checked with NCBI E-utilities (esummary + efetch abstract) and re-read in an independent adversarial pass.Writer: Kymata Health editorial team · No credentialed reviewer yet

How we write, grade and correct these pages: editorial and evidence policy.

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