Coenzyme Q10 - Toprol XL (Metoprolol) Interaction

Interaction Details

Metoprolol is classified as belonging to the following category: Antihypertensive Drugs

Theoretically, coenzyme Q10 might have additive effects with antihypertensive drugs.
Some clinical research shows that coenzyme Q10 can significantly lower blood pressure, although other studies have shown conflicting results.

Interaction Rating

Likelihood of Occurrence

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

Pharmacist Analysis

While there have been no specific studies evaluating the combined use of coenzyme Q10 with metoprolol, there is a theoretical interaction due to the purported blood-pressure-lowering effects of CoQ10.

However, the results of clinical studies have been conflicting, and a Cochrane review (widely regarded as one of the most reliable sources of evidence in healthcare) concluded that coenzyme Q10 likely does not have a significant effect on blood pressure.

Nevertheless, some small studies have shown CoQ10 having positive benefits in regard to lowering blood pressure, with some even reporting individuals being able to reduce the dosage of some of their BP meds when CoQ10 was added on.

Some additional positive news is that in studies that have shown positive benefits, CoQ10 has not been linked with causing hypotension (low blood pressure), even when combined with other agents.

All in all, this theoretical interaction is important to be aware of, and you should take care to monitor your blood pressure while taking any supplement, including CoQ10, as there is a theoretical risk of hypotension. Be sure to know the signs and symptoms of low blood pressure as well, such as dizziness, lightheadedness, and drowsiness.

It is also important to talk to your doctor before making any changes to your medication regimen.

Recommended To Supplement With CoQ10?

Some studies have suggested that long-term use of beta-blockers, like metoprolol, may reduce the body's natural production of CoQ10. This can potentially lead to lower levels of CoQ10 in the heart.

Supplementing with CoQ10 may help replenish the body's natural stores of this compound and potentially reduce the risk of some metoprolol-related side effects.

Additionally, some studies have suggested that CoQ10 may have a beneficial effect on cardiovascular health by reducing inflammation and improving the function of blood vessels, so it may be helpful for improving cardiovascular health overall.

CoQ10 is a supplement that is often recommended to be taken for those taking beta-blockers and it is generally safe to do so. As mentioned in the section above, it is important to monitor your blood pressure while taking it though.

References

• Langsjoen P, Willis R, Folkers K. Treatment of essential hypertension with coenzyme Q10. Mol Aspects Med 1994;S265-72.
• Singh RB, Niaz MA, Rastogi SS, et al. Effect of hydrosoluble coenzyme Q10 on blood pressures and insulin resistance in hypertensive patients with coronary artery disease. J Hum Hypertens 1999;13:203-8.
• Burke BE, Neuenschwander R, Olson RD. Randomized, double-blind, placebo-controlled trial of coenzyme Q10 in isolated systolic hypertension. South Med J 2001;94:1112-7.
• Hodgson JM, Watts GF, Playford DA, et al. Coenzyme Q10 improves blood pressure and glycaemic control: a controlled trial in subjects with type 2 diabetes. Eur J Clin Nutr 2002;56:1137-42.
• Digiesi V, Cantini F, Oradei A, et al. Coenzyme Q10 in essential hypertension. Mol Aspects Med 1994;15 Suppl:s257-63.
• Yamagami T, Takagi M, Akagami H, et al. Effect of coenzyme Q10 on essential hypertension, a double blind controlled study. In: Folkers KA, Yamamura Y, eds. Biomedical and Clinical Aspects of Coenzyme Q, Vol. 5. Amsterdam: Elsevier Science Publications, 19
• Ho MJ, Bellusci A, Wright JM. Blood pressure lowering efficacy of coenzyme Q10 for primary hypertension (review). Cochrane Database Syst Rev 2009;(4):CD007435.
• Young, J. M., Florkowski, C. M., Molyneux, S. L., McEwan, R. G., Frampton, C. M., Nicholls, M. G., Scott, R. S., and George, P. M. A randomized, double-blind, placebo-controlled crossover study of coenzyme Q10 therapy in hypertensive patients with the me
• Digiesi V, Cantini F, and Brodbeck B. Effect of coenzyme Q10 on essential arterial hypertension. Current Therapeutic Research 1990;47(5):841-845.
• Ho MJ, Li EC, Wright JM. Blood pressure lowering efficacy of coenzyme Q10 for primary hypertension. Cochrane Database Syst Rev. 2016 Mar 3;3:CD007435. doi: 10.1002/14651858.CD007435.pub3.
• Tabrizi R, Akbari M, Sharifi N, Lankarani KB, Moosazadeh M, Kolahdooz F, et al. The effects of coenzyme Q10 supplementation on blood pressures among patients with metabolic diseases: a systematic review and meta-analysis of randomized controlled trials.

Metoprolol Overview

• Metoprolol is used alone or in combination with other medications to treat high blood pressure. It also is used to treat chronic (long-term) angina (chest pain). Metoprolol is also used to improve survival after a heart attack. Metoprolol also is used in combination with other medications to treat heart failure. Metoprolol is in a class of medications called beta blockers. It works by relaxing blood vessels and slowing heart rate to improve blood flow and decrease blood pressure.

• High blood pressure is a common condition and when not treated, can cause damage to the brain, heart, blood vessels, kidneys and other parts of the body. Damage to these organs may cause heart disease, a heart attack, heart failure, stroke, kidney failure, loss of vision, and other problems. In addition to taking medication, making lifestyle changes will also help to control your blood pressure. These changes include eating a diet that is low in fat and salt, maintaining a healthy weight, exercising at least 30 minutes most days, not smoking, and using alcohol in moderation.

Coenzyme Q10 - More Interactions

Coenzyme Q10 interacts with 195 drugs

Interaction Rating Key

These severity listings are for informational use only. Never start, stop or otherwise change your therapy before speaking with your provider.