Drug & supplement interaction

Coenzyme Q10 + Nintedanib Esylate

Nintedanib Esylate brand name: Ofev.

No Known Interaction
The bottom line No known interaction

We found no known interaction between Coenzyme Q10 and Nintedanib Esylate in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the label for Nintedanib Esylate states a food rule worth keeping to, and the two are separately associated with some of the same side effects, which would make a new symptom harder to attribute to one or the other.

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Interaction report

Coenzyme Q10 and Nintedanib Esylate

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Nintedanib Esylate and Coenzyme Q10 in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Coenzyme Q10 safety at a glance

Coenzyme Q10 overall Generally safe CoQ10 is generally well tolerated by most adults when used as directed.
Pregnancy Use caution There is not enough reliable safety data, so it is best to avoid unless your doctor advises otherwise.
Breastfeeding Use caution Safety while breastfeeding has not been well studied, so use caution and check with your doctor.

Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Pharmacist analysis

Although CoQ10 is considered relatively safe for most individuals, it does have some reported interactions that are important to be aware of.

This includes:

  • Antihypertensives: Clinical research has shown that CoQ10 can significantly lower blood pressure but conflicting results have been reported.
  • Warfarin: Research is conflicting but concomitant use of CoQ10 and warfarin might reduce the anticoagulant effects of warfarin.
  • Alkylating Agents: Antioxidants such as CoQ10 might also protect tumor cells from chemotherapeutic agents that work by inducing oxidative stress, such as alkylating agents (e.g., cyclophosphamide) and radiation therapy.

Outside of the interactions I've listed above, CoQ10 is generally considered safe to supplement with in most situations.

In fact, some individuals taking certain medications (e.g., 'Statins') may be recommended to take it.

If you have any questions about CoQ10 supplements, be sure to speak to your healthcare professional. We are always happy to answer questions on the matter as well!

Still wondering about combining Nintedanib Esylate and Coenzyme Q10? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Nintedanib Esylate

Interactions in our licensed database are recorded against drug classes, not just single drug names. Nintedanib Esylate is filed under 5 classifications — including anticoagulant/antiplatelet drugs, p-glycoprotein substrates, cytochrome p450 3a4 (cyp3a4) substrates. Coenzyme Q10 has documented interactions with 3 drug classes — the most serious being alkylating agents (moderate), warfarin (coumadin) (moderate) and antihypertensive drugs (minor) — and none of Nintedanib Esylate’s classifications are among them.

Classification data comes from our licensed Natural Medicines dataset. A medication can belong to classes beyond those recorded there, so this describes how the check was run — it is not a safety guarantee.

Keep it in perspective

Coenzyme Q10 Does Interact With Other Medications

Coenzyme Q10 has 26 moderate, 172 minor known drug interactions in our database — Nintedanib Esylate isn’t one of them. If you take anything else, check it against the full list below.

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.

What to actually watch for

No Interaction Found — But Data Suggests Coenzyme Q10 and Nintedanib Esylate May Share Several of the Same Side Effects

This is not an interaction. Neither one changes how your body handles the other, and nothing here says they react together. What our sources do show is that each has separately been linked to the effects below — so taking both can make those effects more likely to turn up, and harder to pin on one or the other if they do. 4 of them are worth acting on rather than waiting out — marked below.

  • A heart attack Worth acting on Additional detail

    Coenzyme Q10

    “Palpitations have been reported as being possibly associated with coenzyme Q10 treatment. Death due to myocardial infarction occurred in one Parkinson disease patient taking coenzyme Q10; causality is unclear.”

    Coenzyme Q10 · Natural Medicines adverse-effect record, reported in myocardial infarction (mi).

    2 sources cited
    1. 89421. Parkinson Study Group QE3 Investigators, Beal MF, Oakes D, et al. A randomized clinical trial of high-dosage coenzyme Q10 in early Parkinson disease: no evidence of benefit. JAMA Neurol. 2014;71(5):543-52.
    2. 15395. Storch A, Jost WH, Vieregge P, et al. Randomized, double-blind, placebo-controlled trial on symptomatic effects of coenzyme Q10 in Parkinson disease. Arch Neurol 2007;64:938-44. DOI

    Nintedanib Esylate

    Listed in the ADVERSE REACTIONS section of the FDA label for Nintedanib Esylate. Read the label on DailyMed ›

  • A higher chance of infection / A low platelet count Worth acting on reported in 10.6% of FDA reports for Nintedanib Esylate Additional detail

    Coenzyme Q10

    “Thrombocytopenia was noted in one patient treated with oral coenzyme Q10; however, other factors (viral infection, other medications) may have been responsible for this adverse effect.”

    Coenzyme Q10 · Natural Medicines adverse-effect record, reported in thrombocytopenia.

    1 source cited
    1. 44296. Matthews, P. M., Ford, B., Dandurand, R. J., Eidelman, D. H., O'Connor, D., Sherwin, A., Karpati, G., Andermann, F., and Arnold, D. L. Coenzyme Q10 with multiple vitamins is generally ineffective in treatment of mitochondrial disease. Neurology 1993;43(5

    Nintedanib Esylate

    Listed in the ADVERSE REACTIONS section of the FDA label for Nintedanib Esylate, and in voluntary FDA adverse-event reports. Read the label on DailyMed ›

  • Bleeding or bruising Worth acting on Additional detail

    Coenzyme Q10

    “Gastrointestinal side effects of coenzyme Q10 have included nausea, vomiting, epigastric discomfort, constipation, diarrhea, stomach upset, loss of appetite, heartburn, and flatulence, although this occurs in less than 1% of patients. In one clinical study, gastrointestinal bleeding in association with angiodysplasia has been reported to be possibly related to coenzyme Q10 treatment.”

    Coenzyme Q10 · Natural Medicines adverse-effect record, reported in constipation.

    6 sources cited
    1. 3365. 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. PubMed
    2. 6409. Baggio E, Gandini R, Plauncher AC, et al. Italian multicenter study on the safety and efficacy of coenzyme Q10 as adjunctive therapy in heart failure. CoQ10 Drug Surveillance Investigators. Mol Aspects Med 1994;15 Suppl:S287-94. PubMed
    3. 8907. 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. PubMed
    4. 10152. Singh RB, Neki NS, Kartikey K, et al. Effect of coenzyme Q10 on risk of atherosclerosis in patients with recent myocardial infarction. Mol Cell Biochem 2003;246:75-82. DOI
    5. 43982. Rosenfeldt, F. L., Haas, S. J., Krum, H., Hadj, A., Ng, K., Leong, J. Y., and Watts, G. F. Coenzyme Q10 in the treatment of hypertension: a meta-analysis of the clinical trials. J Hum.Hypertens. 2007;21(4):297-306. PubMed
    6. 44172. Gane, E. J., Weilert, F., Orr, D. W., Keogh, G. F., Gibson, M., Lockhart, M. M., Frampton, C. M., Taylor, K. M., Smith, R. A., and Murphy, M. P. The mitochondria-targeted anti-oxidant mitoquinone decreases liver damage in a phase II study of hepatitis C

    Nintedanib Esylate

    Listed in the ADVERSE REACTIONS section of the FDA label for Nintedanib Esylate. Read the label on DailyMed ›

  • Diarrhea / Stomach upset / Vomiting / Nausea reported in 26.6% of FDA reports for Nintedanib Esylate Additional detail

    Coenzyme Q10

    “Orally, coenzyme Q10 is generally well tolerated. In clinical studies, no serious adverse effects have been reported.

    Most Common Adverse Effects:

    Orally: Gastrointestinal side effects such as appetite suppression, diarrhea, epigastric discomfort, heartburn, nausea, and vomiting. These generally occur in less than 1% of patients. Some of these adverse effects can be minimized if daily doses above 100 mg are divided.”

    Coenzyme Q10 · Natural Medicines adverse-effect record, reported in diarrhea.

    Nintedanib Esylate

    Listed in the ADVERSE REACTIONS section of the FDA label for Nintedanib Esylate, and in voluntary FDA adverse-event reports. Read the label on DailyMed ›

  • Reduced appetite Additional detail

    Coenzyme Q10

    Recorded for Coenzyme Q10 in the same Natural Medicines adverse-effect record shown under Bleeding or bruising above.

    Nintedanib Esylate

    Listed in the ADVERSE REACTIONS section of the FDA label for Nintedanib Esylate. Read the label on DailyMed ›

  • Itching Additional detail

    Coenzyme Q10

    “Two of 143 participants in a case series reported skin itching after starting treatment with oral coenzyme Q10. Allergic rash has also been reported.

    An itching exanthema was seen in two heart failure patients treated with intravenous coenzyme Q10.”

    Coenzyme Q10 · Natural Medicines adverse-effect record, reported in congestive heart failure (chf).

    4 sources cited
    1. 6047. Langsjoen PH, Langsjoen PH, Folkers K. Long-term efficacy and safety of coenzyme Q10 therapy for idiopathic dilated cardiomyopathy. Am J Cardiol 1990;65:521-3. PubMed
    2. 6409. Baggio E, Gandini R, Plauncher AC, et al. Italian multicenter study on the safety and efficacy of coenzyme Q10 as adjunctive therapy in heart failure. CoQ10 Drug Surveillance Investigators. Mol Aspects Med 1994;15 Suppl:S287-94. PubMed
    3. 11872. Sandor PS, Di Clemente L, Coppola G, et al. Efficacy of coenzyme Q10 in migraine prophylaxis: A randomized controlled trial. Neurology 2005;64:713-5. PubMed
    4. 44284. Ishiyama, T., Morita, Y., Toyama, S., Yamagami, T., and Tsukamoto, N. A clinical study of the effect of coenzyme Q on congestive heart failure. Jpn.Heart J 1976;17(1):32-42. PubMed

    Nintedanib Esylate

    Listed in the ADVERSE REACTIONS section of the FDA label for Nintedanib Esylate. Read the label on DailyMed ›

Showing the 10 most notable of 14 shared effects — ranked by how unusual each one is, not just whether both lists mention it.

Reported for Coenzyme Q10 but not commonly for Nintedanib Esylate: bleeding in the gut, heart failure, constipation and a fast or pounding heartbeat.

Effects for Nintedanib Esylate come from the ADVERSE REACTIONS section of its FDA label; effects for Coenzyme Q10 come from the Natural Medicines adverse-effect record, quoted above. Where a percentage is shown, it is the share of 188 voluntary FDA FAERS reports for Nintedanib Esylate that mention that effect — a reporting proportion, not an incidence rate and not evidence the drug caused it. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

How to take them

Some Nintedanib Esylate Products Have a Food Rule — Coenzyme Q10 Should Not Break It

At least one FDA label for a product containing Nintedanib Esylate says to take it with food. If you take Coenzyme Q10 on an empty stomach out of habit, keep them separate — and take Nintedanib Esylate with a meal where the label says to.

This may not be true of your version. Food instructions belong to the product, not the ingredient: two Nintedanib Esylate products can carry different directions, and extended-release forms often differ from immediate-release ones. The label we read is quoted below — check the directions on your own box or bottle, or ask your pharmacist, for how to take the exact product you were given.

2 DOSAGE AND ADMINISTRATION Recommended dosage: 150 mg taken orally twice daily approximately 12 hours apart taken with food.

From the Dosage and Administration section of the FDA label we read for Nintedanib Esylate — where that label names a specific product, the instruction is that product's. Read the label on DailyMed ›

A food rule is not an interaction — it is about how much of the medicine you absorb. The directions that came with your own product, and your pharmacist, outrank anything on this page.

Everything else you take

See Every Supplement That Interacts With Nintedanib Esylate

This page covers Coenzyme Q10 only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Nintedanib Esylate page lists 285 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Danshen (major), Grapefruit (major), Piracetam (major) and St. John's Wort (major).

By severity: 5 major · 240 moderate · 40 minor.

From our pharmacist’s overview on the Nintedanib Esylate page

“You take Ofev (nintedanib) to slow lung scarring, and this page deserves a careful read before any supplement joins it. Of the 285 ingredients here, the biggest cluster, over 200, can add to bleeding risk, a real concern since nintedanib itself can make you bleed more easily.”

Reviewed by 2 · Jul 18, 2026

Open the Nintedanib Esylate 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. Even though Coenzyme Q10 itself has no known interaction with Nintedanib Esylate, another ingredient on your label might. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Coenzyme Q10 and Nintedanib Esylate 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%

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

29 days ago today
Medication Nintedanib Esylate
Steady interest

#1,962 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.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Coenzyme Q10 reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The Coenzyme Q10 and Nintedanib Esylate records this page draws on were last updated July 11, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
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.

Not applicable (naturally made in the body; supplements are produced by fermentation or synthesis) · Capsules, softgels, tablets, chewables, liquid, topical creams

An interaction check asks whether these two react with each other — it does not ask whether Coenzyme Q10 is a good idea for someone in your situation. Here is what our Coenzyme Q10 record says about it on its own.

Coenzyme Q10: dosing

There is no single official or standardized dose of CoQ10, and the amount studied has varied widely depending on the condition. Products also differ in their form (ubiquinone versus ubiquinol) and how well they are absorbed.Because CoQ10 is fat-soluble, it is generally absorbed better when taken with a meal that contains some fat. They can help you choose a reasonable dose and a quality product.

From our Coenzyme Q10 monograph — the full record covers uses, side effects and every documented interaction.

Read the full Coenzyme Q10 monograph & all interactions
Medication

About Nintedanib

What Is Nintedanib Used For?

Brand name: Ofev

Nintedanib capsules are approved for adults with idiopathic pulmonary fibrosis (IPF) — a chronic, progressive scarring of the lungs — and for adults with chronic fibrosing interstitial lung diseases (ILDs) with a progressive phenotype, meaning fibrosing lung diseases that continue to worsen over time despite treatment.

Nintedanib capsules (including Ofev) are also indicated to slow the rate of decline in lung function in adults with systemic sclerosis-associated interstitial lung disease (SSc-ILD), a lung complication of the autoimmune condition systemic sclerosis (scleroderma). Note that the Nintedanib esylate capsule product is approved for IPF and chronic fibrosing ILDs with a progressive phenotype, but SSc-ILD approval is carried by Ofev and other nintedanib capsule products — always confirm with your prescriber which product you have been prescribed.

See full Nintedanib 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
26Moderate
172Minor
2,631No known interaction
Moderate

26 interactions

Minor

172 interactions

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

No interaction 2,631 drugs checked — show the list
Evidence & sources

Coenzyme Q10 References

The 40 references that drive our Coenzyme Q10 monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. Kamikawa T, Kobayashi A, Yamashita T, et al. Effects of coenzyme Q10 on exercise tolerance in chronic stable angina pectoris. Am J Cardiol 1985;56:247-51. PubMed
  2. Langsjoen P, Willis R, Folkers K. Treatment of essential hypertension with coenzyme Q10. Mol Aspects Med 1994;S265-72. PubMed
  3. Spigset O. Reduced effect of warfarin caused by ubidecarenone. Lancet 1994;334:1372-3. PubMed
  4. 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. PubMed
  5. 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
  6. 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
  7. Langsjoen PH, Langsjoen PH, Folkers K. Long-term efficacy and safety of coenzyme Q10 therapy for idiopathic dilated cardiomyopathy. Am J Cardiol 1990;65:521-3. PubMed
  8. Heck AM, DeWitt BA, Lukes AL. Potential interactions between alternative therapies and warfarin. Am J Health Syst Pharm 2000;57:1221-7. DOI
  9. Landbo C, Almdal TP. [Interaction between warfarin and coenzyme Q10]. Ugeskr Laeger 1998;160:3226-7.
  10. Baggio E, Gandini R, Plauncher AC, et al. Italian multicenter study on the safety and efficacy of coenzyme Q10 as adjunctive therapy in heart failure. CoQ10 Drug Surveillance Investigators. Mol Aspects Med 1994;15 Suppl:S287-94. PubMed
  11. 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. PubMed
  12. The Huntington Study Group. A randomized, placebo-controlled trial of coenzyme Q10 and remacemide in Huntington's disease. Neurology 2001;57:397-404.
  13. 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. PubMed
  14. Singh RB, Neki NS, Kartikey K, et al. Effect of coenzyme Q10 on risk of atherosclerosis in patients with recent myocardial infarction. Mol Cell Biochem 2003;246:75-82. DOI
  15. Porterfield LM. Why did the response to warfarin change? RN 2000;63:107.

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking Coenzyme Q10 and Nintedanib Esylate Together: Common Questions

Is it safe to take Coenzyme Q10 with Nintedanib Esylate?
We do not list a known interaction between Coenzyme Q10 and Nintedanib Esylate. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
Do Coenzyme Q10 and Nintedanib Esylate have any of the same side effects?
Yes — our sources link each of them separately to 10 of the same effects. That is not an interaction: neither changes how your body handles the other. It does mean that if one of those effects turns up, it can be harder to tell which one is behind it. They are listed on this page with the source behind each.
Should I take Coenzyme Q10 and Nintedanib Esylate at the same time of day?
At least one FDA label for a product containing Nintedanib Esylate says to take it with food. If you take Coenzyme Q10 on an empty stomach out of habit, keep them separate and take Nintedanib Esylate with a meal where the label says to. Food instructions belong to the product rather than the ingredient — two Nintedanib Esylate products can differ — so check the directions on your own box. This is about absorption, not an interaction.
How was the Coenzyme Q10 and Nintedanib Esylate combination checked?
Interactions in our licensed database are recorded against drug classes. Nintedanib Esylate is filed under 5 classifications, and Coenzyme Q10 has documented interactions with 3 drug classes — none of Nintedanib Esylate's classifications are among them. A medication can belong to classes beyond those recorded in our dataset, so this describes how the check was run rather than guaranteeing safety.
Does Coenzyme Q10 interact with any other medications?
Yes. Coenzyme Q10 has 198 documented drug interactions in our database — Nintedanib Esylate is simply not one of them. If you take anything else, it is worth checking each one; they are all listed on this page.
Does Nintedanib Esylate interact with any supplements?
Yes. Nintedanib Esylate has documented interactions with 285 supplements in our database — Coenzyme Q10 is not one of them. The Nintedanib Esylate interaction page linked on this page lists every one, ranked by severity.

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

Still Have a Question About Nintedanib Esylate and Coenzyme Q10?

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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.