Drug & supplement interaction

Coenzyme Q10 + Melphalan Flufenamide

Melphalan Flufenamide brand name: Pepaxto.

Moderate Interaction
Medically reviewed by · Updated September 2026
The bottom line Moderate

Coenzyme Q10 has a moderate interaction with Melphalan Flufenamide. Coenzyme Q10 has antioxidant effects. Theoretically, this may reduce the activity of chemotherapy drugs that generate free radicals.

Read the full interaction report
SeverityModerate
LikelihoodPossible
EvidenceD
What do Severity, Likelihood & Evidence mean?
Know someone taking this? Share
Facebook Post Reddit Email
On this page
Interaction report

Coenzyme Q10 and Melphalan Flufenamide

Here is the interaction we found between these two, with the evidence behind it.

Moderate

ALKYLATING AGENTS

Why this applies to Melphalan Flufenamide

Melphalan Flufenamide falls under ALKYLATING AGENTS — the group Coenzyme Q10 interacts with.

Coenzyme Q10 has antioxidant effects. Theoretically, this may reduce the activity of chemotherapy drugs that generate free radicals.
Theoretically, antioxidants such as coenzyme Q10 might protect tumor cells from chemotherapeutic agents that work by inducing oxidative stress, such as alkylating agents (e.g., cyclophosphamide) and radiation therapy. The clinical importance of this interaction is unknown.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here is the short version for melphalan flufenamide (Pepaxto). This is a strong chemotherapy drug, and part of how alkylating agents like this one fight cancer is by creating cellular stress and damaging the DNA inside cancer cells. CoQ10 is an antioxidant, meaning it mops up some of that oxidative stress. The theory is that taking an antioxidant could, in principle, blunt some of the chemo's cancer-killing power.

I want to be honest about the evidence here: this is a theoretical concern based on how these drugs work, not proven in real patients, and we truly do not know if it matters clinically. Still, with a serious cancer treatment, it is not worth the gamble. Please do not start or stop CoQ10 on your own. Loop in your oncology team or pharmacist first so the call fits your specific treatment plan.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Portakal O, Ozkaya O, Erden Inal M, et al. Coenzyme Q10 concentrations and antioxidant status in tissues of breast cancer patients. Clin Biochem 2000;33:279-84. PubMed
  2. Lund EL, Quistorff B, Spang-Thomsen M, Kristjansen PE. Effect of radiation therapy on small-cell lung cancer is reduced by ubiquinone intake. Folia Microbiol (Praha) 1998;43:505-6. PubMed

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Coenzyme Q10 Also Interacts With Other Medications

Coenzyme Q10 has 25 moderate, 172 minor known drug interactions in our database — the Melphalan Flufenamide one above is one of them. If you take anything else, check it against the full list below.

Moderate 25 Minor 172 No known interaction 2,633 (incl. Melphalan Flufenamide)
Taking anything else?

Check Another of Your Medications Against Coenzyme Q10

Covers the 2,830 medications we’ve checked against Coenzyme Q10. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Melphalan Flufenamide

This page covers Coenzyme Q10 only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Melphalan Flufenamide page lists 7 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Acerola (moderate), Alpha-lipoic Acid (moderate), Rose Hip (moderate), Turmeric (moderate) and Vitamin C (moderate).

By severity: 7 moderate.

From our pharmacist’s overview on the Melphalan Flufenamide page

“The single most important thing on this page is antioxidants. Melphalan flufenamide (Pepaxto) is a chemotherapy used for multiple myeloma, and part of how it kills cancer cells is by generating free radicals.”

Reviewed by 2 · Jul 18, 2026

Open the Melphalan Flufenamide interaction page

One more smart check

Taking Coenzyme Q10 as Part of a Dietary Supplement Product? Check It for Interactions

We hold 6,926 real supplement products containing Coenzyme Q10, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Coenzyme Q10. Your product may carry other ingredients that interact with Melphalan Flufenamide too, on top of Coenzyme Q10 — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Coenzyme Q10 and Melphalan Flufenamide Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Coenzyme Q10
Top 5%

#36 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Melphalan Flufenamide
Steady interest

#2,195 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Coenzyme Q10

What is Coenzyme Q10?

  • Heart health
  • Statin-related muscle aches
  • Migraine prevention
  • Energy and fatigue
  • Aging and antioxidant support

CoQ10 is a vitamin-like substance your body makes naturally that helps cells produce energy and acts as an antioxidant. It is generally well tolerated and is most studied for heart conditions, statin-related muscle symptoms, and migraine prevention, though the strength of the evidence varies. Talk with your pharmacist or doctor before starting it, especially if you take heart or blood pressure medicines.

Read the full Coenzyme Q10 monograph & all interactions
Medication

About Melphalan Flufenamide Injection

What Is Melphalan Flufenamide Injection Used For?

Brand name: Pepaxto

  • Melphalan flufenamide injection is used along with dexamethasone to treat multiple myeloma (a type of cancer of the bone marrow) in adults whose disease has returned or has not improved after receiving at least four other chemotherapy medications. Melphalan flufenamide is in a class of medications called alkylating agents. It works by stopping or slowing the growth of cancer cells in your body.

See full Melphalan Flufenamide Injection drug information
Keep checking

Other Drugs & Coenzyme Q10

Browse every other medication we’ve checked against Coenzyme Q10 — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
25Moderate
172Minor
2,632No known interaction
25 Moderate 172 Minor 2,632 No interaction
Moderate

25 interactions

Minor

172 interactions

Showing 60 of 172 minor interactions — see all 172 on the Coenzyme Q10 page.

No interaction 2,632 drugs checked — show the list

We also checked Coenzyme Q10 against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,632 medications checked with no known interaction — see the full Coenzyme Q10 list.

See the full Coenzyme Q10 interactions page
See every supplement checked against Melphalan Flufenamide, ranked by severity
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

Keep exploring
Coenzyme Q10 monograph › Uses, safety, and every drug interaction in one place Melphalan Flufenamide supplement interactions › Every supplement checked against Melphalan Flufenamide, ranked by severity Melphalan Flufenamide Injection drug information › The full plain-English guide to this medication Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Coenzyme Q10 and Melphalan Flufenamide Together: Common Questions

Can you take Coenzyme Q10 with Melphalan Flufenamide?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Coenzyme Q10 and Melphalan Flufenamide interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Melphalan Flufenamide and Coenzyme Q10?

Our pharmacists answer your medication & supplement questions — free.

Ask a pharmacist

This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.