By Marcello Cherchi, MD PhD
For patients
Coenzyme Q10 (also called ubiquinol) can be taken as a pill. It does not have side effects. Taking coenzyme Q10 may make migraines shorter and happen less often.
For clinicians
Overview
Coenzyme Q10 (also called ubiquinol) is a mitochondrial enzyme. It is generally well-tolerated. In otoneurology it has been studied as a migraine prophylactic; its effect appears to be modest.
Introduction
Coenzyme Q10, also called ubiquinol, is a mitochondrial enzyme that plays an important role in energy metabolism.
Pharmacology
Human studies suggest that coenzyme Q10 achieves a peak serum concentration at about 6.5 hours, and has an elimination half-life of about 33 hours (Bhagavan and Chopra 2006).
Adverse effects, cautions and contraindications
Coenzyme Q10 has shown no significant toxicity in humans (Hidaka et al. 2008) and is generally well tolerated.
Relevance in otoneurology
Coenzyme Q10 has been studied in migraine prophylaxis. For this purpose, Coenzyme Q10 is taken at a dose of 100 mg three times per day. The efficacy of coenzyme Q10 becomes apparent around 12 weeks (Hershey et al. 2007).
A meta-analysis of coenzyme Q10 for migraine prophylaxis concluded that there was a reduction in migraine frequency and duration compared to placebo, but that the difference did not reach statistical significance (Sazali et al. 2021).
Other notes
Coenzyme Q10 is compatible with pregnancy and nursing.
References
Bhagavan HN, Chopra RK (2006) Coenzyme Q10: absorption, tissue uptake, metabolism and pharmacokinetics. Free Radic Res 40: 445-53. doi: 10.1080/10715760600617843
Hershey AD, Powers SW, Vockell AL, Lecates SL, Ellinor PL, Segers A, Burdine D, Manning P, Kabbouche MA (2007) Coenzyme Q10 deficiency and response to supplementation in pediatric and adolescent migraine. Headache 47: 73-80.
Hidaka T, Fujii K, Funahashi I, Fukutomi N, Hosoe K (2008) Safety assessment of coenzyme Q10 (CoQ10). Biofactors 32: 199-208. doi: 10.1002/biof.5520320124
Sazali S, Badrin S, Norhayati MN, Idris NS (2021) Coenzyme Q10 supplementation for prophylaxis in adult patients with migraine-a meta-analysis. BMJ Open 11: e039358. doi: 10.1136/bmjopen-2020-039358
