Idebenone Drug Interactions, Uses, Effectiveness, Safety & More
What is this page for?
First and foremost: how Idebenone interacts with medications. The heart of this page is the interaction list — every drug Idebenone is known to interact with, and how serious each one is.
But these pages have grown well beyond that into a full monograph — what Idebenone is, what people use it for and how strong the evidence is, its safety and side effects, and answers to the questions we’re asked most — written and reviewed by the clinical staff at HelloPharmacist. It’s educational information from our licensed clinical databases, not medical advice, and we don’t sell or endorse products. Our editorial policy
Check Idebenone against your medication
Add one medicationDrugs that interact with Idebenone
0 medications have a known interaction with Idebenone, graded by severity. Select any drug for the full evidence-based detail.
We don’t currently list any known drug interactions for Idebenone. This doesn’t guarantee none exist — always confirm with your pharmacist before combining supplements with your medications.
What Severity, Likelihood & Evidence Mean
Severity — How Serious It Can Be
- Major. Clinically significant; generally best avoided, or used only under direct professional supervision.
- Moderate. May need monitoring, a dose adjustment, or separating the times you take each one.
- Minor. Generally not clinically significant, but still worth noting and mentioning to your pharmacist.
- No known interaction. Checked against our sources with nothing documented — not the same as proven safety.
Likelihood — How Well It’s Documented
- Likely. Well-controlled human studies have demonstrated the likely existence of this interaction
- Probable. Interaction 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.
- Possible. 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
- Unlikely. Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Where This Data Comes From
- Interaction records are evidence-graded and sourced from the Natural Medicines database (TRC Healthcare), the same reference used by pharmacists and hospitals.
- Each drug listed above links to the full report for that exact Idebenone combination — clinical detail, likelihood, evidence level, and citations.
- Content is reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.
Idebenone: Uses, Safety & Side Effects
Idebenone is a synthetic, lab-made antioxidant related to coenzyme Q10. It has been studied mostly as a prescription drug for certain rare mitochondrial and neurological conditions, and is also used in some skin-care products, but evidence for over-the-counter supplement use is limited. Talk with your pharmacist or doctor before using it.
- Part used
- Synthetic compound (a lab-made analog of coenzyme Q10)
- Common forms
- Capsules, tablets, topical creams and serums
- Antioxidant support
- Brain and memory health
- Mitochondrial disorders
- Anti-aging skin care
- General energy support
Popular and traditional uses — not proof it works. See “Uses & effectiveness” below for the evidence.
Generally tolerated in studies but long-term supplement safety is not well established.
Insufficient reliable information available; avoid using.
Read the full pregnancy detailInsufficient reliable information available; avoid using.
Read the full breastfeeding detailPregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center). Safety guidance is general; always confirm with your pharmacist or doctor for your situation.
Overview
Idebenone is a synthetic (man-made) compound. It is not an herb and does not come from a plant. It was created in a laboratory to be similar to coenzyme Q10 (CoQ10), a substance your body makes that helps cells produce energy and acts as an antioxidant.
In some countries, idebenone has been studied and used as a prescription medicine for certain rare inherited conditions that affect the eyes, brain, or muscles. In other places it is sold as a dietary supplement or used as an ingredient in anti-aging skin creams and serums.
People most often take idebenone hoping to support brain function, energy, and overall antioxidant protection, or apply it on the skin for anti-aging effects.
How it works
Idebenone is designed to act like coenzyme Q10. Inside cells, structures called mitochondria work like tiny power plants that make energy. Idebenone is thought to help cells produce energy and to work as an antioxidant, meaning it may protect cells from a type of damage called oxidative stress.
Because it is more easily absorbed and may dissolve differently than CoQ10, researchers have studied whether it can reach tissues that need protection. However, much of what we know about how idebenone works comes from laboratory and animal research, and the effects in healthy people taking supplements are not fully understood.
Does Idebenone work?
How to read these evidence grades
Natural Medicines’ 7-point scale. We show each rating’s label word-for-word.
Possibly Effective Alzheimer disease
There is some evidence that taking idebenone 90-120 mg three times daily orally for 6 months slows cognitive function decline in patients with Alzheimer disease when compared with placebo. Idebenone appears most effective in patients with moderately severe Alzheimer disease, based on standard Alzheimer disease rating scales.
Possibly Effective Leber hereditary optic neuropathy
Small and low-quality research shows that taking oral idebenone 900 mg orally daily moderately improves or stabilizes visual acuity in patients with early Leber hereditary optic neuropathy (LHON). The efficacy of initiating treatment in patients with a long history of LHON is unknown.
Possibly Effective Muscular dystrophy
Idebenone is associated with a small improvement in respiratory function in adolescents and teens with Duchenne muscular dystrophy (DMD) who are not taking glucocorticoids.
Possibly Ineffective Friedreich ataxia
While some preliminary research shows conflicting results, higher quality clinical research shows that idebenone does not help control cardiac hypertrophy associated with Friedreich ataxia. Most clinical research also shows that taking idebenone does not treat or slow the progression of ataxia in children and young adults with this condition. Although some preliminary clinical research suggests that idebenone might improve neurological symptoms when taken in higher doses or for longer durations, current clinical management guidelines for Friedreich ataxia state that idebenone does not improve cardiac or neurological status in patients with Friedreich ataxia when used over an extended time period.
Also studied for 4 conditions — evidence insufficient to rate
Insufficient Reliable Evidence To Rate Depression
Preliminary clinical research in adults aged 55-75 years with post-stroke depression suggests that adding idebenone 30 mg three times daily to paroxetine treatment for 12 weeks increases the effectiveness (cured or improved) rate, as measured by the Hamilton Rating Scale for Depression, from 62% with paroxetine alone to 82% with the combination.
Insufficient Reliable Evidence To Rate Mitochondrial myopathies
There is preliminary clinical research that suggests idebenone given orally might reduce symptoms in patients with mitochondrial dysfunction associated with the syndrome of mitochondrial encephalopathy with lactic acidosis and stroke-like episodes.
Insufficient Reliable Evidence To Rate Multiple sclerosis (MS)
Preliminary clinical research in adults with primary progressive MS shows that taking a specific idebenone product (Santhera Pharmaceuticals) 750 mg three times daily for 2 years does not slow the progression of disability or attenuate central nervous system tissue destruction when compared with placebo.
Insufficient Reliable Evidence To Rate Wrinkled skin
Preliminary clinical research shows that topical application of a lotion containing 0.5% or 1% idebenone twice daily for 6 weeks reduces signs of photoaging when compared to baseline. Skin roughness and drying is reduced by up to 26%, and fine lines and wrinkles by up to 29%, while skin hydration is increased by 37%. Skin pigmentation is also improved.
Source & disclaimer. Effectiveness ratings and evidence summaries are provided by Natural Medicines (Therapeutic Research Center) and shown as licensed. Where Natural Medicines hasn’t rated a use, HelloPharmacist’s pharmacists may add their own reviewed rating and evidence (each such entry is labeled). This is educational information, not medical advice — talk with your pharmacist or doctor before starting, stopping, or changing a supplement.
Safety & precautions
In clinical studies, idebenone has generally been tolerated by many people, but the long-term safety of taking it as a supplement is not well established. Quality and strength of over-the-counter products can vary widely.
People with existing medical conditions, especially heart, liver, or neurological conditions, should talk with a doctor before using idebenone. Children should only use it under medical supervision.
Pregnancy and breastfeeding: There is not enough reliable safety information for these situations. To be safe, avoid idebenone if you are pregnant, trying to become pregnant, or breastfeeding unless your doctor specifically advises otherwise.
Always tell your pharmacist or doctor about any supplements you take, especially before surgery or if you start a new medication.
Side effects
Reported side effects are usually mild and may include stomach upset, nausea, diarrhea, headache, or dizziness. Some people may notice a reddish or orange color to their urine, which is generally harmless.
Topical (skin) products may cause redness, itching, or irritation in sensitive people. Stop use and check with a professional if you have a reaction.
Serious side effects appear to be uncommon in studies, but because supplement safety has not been fully tested, stop using idebenone and seek medical care if you have signs of an allergic reaction such as rash, swelling, or trouble breathing.
Idebenone: Reported Adverse Effects
Documented safety reports on Idebenone from the evidence-graded Natural Medicines (TRC Healthcare) database, shown word-for-word from the licensed record.
Orally, idebenone seems to be well-tolerated. In clinical studies, there have been no reports of serious adverse effects occurring more frequently than with placebo. Some people who take idebenone have experienced nausea and vomiting, abdominal pain, elevated alkaline phosphatase, and loose stools; however, these side effects are not common. High doses up to 2250 mg or 75 mg/kg per day have also been well-tolerated without a clinically significant increase in side effects.
Topically, contact allergic dermatitis has been reported, but this adverse effect is uncommon.
- Mariotti C, Solari A, Torta D, et al. Idebenone treatment in Friedreich patients: one-year-long randomized placebo-controlled trial. Neurology 2003;60:1676-9.
- Hausse AO, Aggoun Y, Bonnet D, et al. Idebenone and reduced cardiac hypertrophy in Friedreich's ataxia. Heart 2002;87:346-9.
- Weyer G, Babej-Dolle RM, Hadler D, et al. A controlled study of 2 doses of idebenone in the treatment of Alzheimer's disease. Neuropsychobiology 1997;36:73-82. .
- Pisano P, Durand A, Autret E, et al. Plasma concentrations and pharmacokinetics of idebenone and its metabolites following single and repeated doses in young patients with mitochondrial encephalomyopathy. Eur J Clin Pharmacol 1996;51:167-9.
- Gutzmann H, Hadler D. Sustained efficacy and safety of idebenone in the treatment of Alzheimer's disease: update on a 2-year double-blind multicentre study. J Neural Transm 1998;54:301-10.
- Di Prospero NA, Sumner CJ, Penzak SR, et al. Safety, tolerability, and pharmacokinetics of high-dose idebenone in patients with Friedreich ataxia. Arch Neurol 2007;64:803-8.
- Catarino CB, von Livonius B, Priglinger C, et al. Real-world clinical experience with idebenone in the treatment of leber hereditary optic neuropathy. J Neuroophthalmol. 2020 Dec;40(4):558-565.
- Kosa P, Wu T, Phillips J, et al. Idebenone does not inhibit disability progression in primary progressive MS. Mult Scler Relat Disord. 2020 Oct;45:102434.
- Zhao X, Zhang Y, Lu L, Yang H. Therapeutic effects of idebenone on leber hereditary optic neuropathy. Curr Eye Res. 2020 Oct;45(10):1315-1323.
- Buyse GM, Voit T, Schara U, DELOS Study Group. Efficacy of idebenone on respiratory function in patients with Duchenne muscular dystrophy not using glucocorticoids (DELOS): a double-blind randomised placebo-controlled phase 3 trial. Lancet. 2015;385(9979)
- Lynch DR, Perlman SL, Meier T. A phase 3, double-blind, placebo-controlled trial of idebenone in friedreich ataxia. Arch Neurol. 2010;67(8):941-7.
- Mc Aleer MA, Collins P. Allergic contact dermatitis to hydroxydecyl ubiquinone (idebenone) following application of anti-ageing cosmetic cream. Contact Dermatitis. 2008;59(3):178-9.
Dermatitis Immunologic
There is a case report of allergic contact dermatitis related to topical use of a cream containing idebenone. The 38-year old woman applied a facial cream (Prevage MD, Elizabeth Arden, Inc.) with reactions appearing with the second dose. Symptoms included a red, itchy, burning, swollen face. She was treated with topical hydrocortisone. She reacted to idebenone with patch testing. This was the fourth known topical allergic reaction to idebenone.
Irregular heartbeat Cardiovascular
In a clinical trial, tachycardia was reported by a single person taking idebenone orally. Treatment was not required.
Nausea and vomiting Gastrointestinal
Orally, adverse effects related to idebenone have included nausea and vomiting, abdominal pain, elevated alkaline phosphatase, and loose stools. Increased appetite leading to weight gain has also been reported.
- Buyse GM, Voit T, Schara U, DELOS Study Group. Efficacy of idebenone on respiratory function in patients with Duchenne muscular dystrophy not using glucocorticoids (DELOS): a double-blind randomised placebo-controlled phase 3 trial. Lancet. 2015;385(9979)
- Lynch DR, Perlman SL, Meier T. A phase 3, double-blind, placebo-controlled trial of idebenone in friedreich ataxia. Arch Neurol. 2010;67(8):941-7.
- Catarino CB, von Livonius B, Priglinger C, et al. Real-world clinical experience with idebenone in the treatment of leber hereditary optic neuropathy. J Neuroophthalmol. 2020 Dec;40(4):558-565.
- Zhao X, Zhang Y, Lu L, Yang H. Therapeutic effects of idebenone on leber hereditary optic neuropathy. Curr Eye Res. 2020 Oct;45(10):1315-1323.
- Hausse AO, Aggoun Y, Bonnet D, et al. Idebenone and reduced cardiac hypertrophy in Friedreich's ataxia. Heart 2002;87:346-9.
Adverse-effects data: Natural Medicines, Therapeutic Research Center
Dosing
There is no standard supplement dose of idebenone that experts agree on. Doses used in medical studies for specific diseases were set by researchers and differ from what is found in over-the-counter products.
If you choose to use an idebenone supplement, follow the directions on the product label and do not exceed the recommended amount. For skin products, follow the application instructions provided.
Because the right dose depends on your health and goals, it is best to check with your pharmacist or doctor before starting idebenone.
Idebenone & Pregnancy
Idebenone & Breastfeeding
© 2026 Therapeutic Research Center
Pregnancy & lactation ratings: Natural Medicines, Therapeutic Research Center
References & further reading
The 25 references that drive our Idebenone 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.
- Mariotti C, Solari A, Torta D, et al. Idebenone treatment in Friedreich patients: one-year-long randomized placebo-controlled trial. Neurology 2003;60:1676-9. PubMed
- Filla A, Moss AJ. Idebenone for treatment of Friedreich's ataxia? Neurology 2003;60:1569-70. PubMed
- Hausse AO, Aggoun Y, Bonnet D, et al. Idebenone and reduced cardiac hypertrophy in Friedreich's ataxia. Heart 2002;87:346-9. PubMed
- Schols L, Vorgerd M, Schillings M, et al. Idebenone in patients with Friedreich ataxia. Neurosci Lett 2001;306:169-72. PubMed
- Lerman-Sagie T, Rustin P, Lev D, et al. Dramatic improvement in mitochondrial cardiomyopathy following treatment with idebenone. J Inherit Metab Dis 2001;24:28-34. PubMed
- Rustin P, von Kleist-Retzow JC, Chantrel-Groussard K, et al. Effect of idebenone on cardiomyopathy in Friedreich's ataxia: a preliminary study. Lancet 1999;354:477-9. PubMed
- Weyer G, Babej-Dolle RM, Hadler D, et al. A controlled study of 2 doses of idebenone in the treatment of Alzheimer's disease. Neuropsychobiology 1997;36:73-82. . PubMed
- Ikejiri Y, Mori E, Ishii K, et al. Idebenone improves cerebral mitochondrial oxidative metabolism in a patient with MELAS. Neurology 1996;47:583-5. PubMed
- Pisano P, Durand A, Autret E, et al. Plasma concentrations and pharmacokinetics of idebenone and its metabolites following single and repeated doses in young patients with mitochondrial encephalomyopathy. Eur J Clin Pharmacol 1996;51:167-9. PubMed
- Ihara Y, Namba R, Kuroda S, et al. Mitochondrial encephalomyopathy (MELAS): pathological study and successful therapy with coenzyme Q10 and idebenone. J Neurol Sci 1989;90:263-71. PubMed
- Gutzmann H, Hadler D. Sustained efficacy and safety of idebenone in the treatment of Alzheimer's disease: update on a 2-year double-blind multicentre study. J Neural Transm 1998;54:301-10. PubMed
- Di Prospero NA, Sumner CJ, Penzak SR, et al. Safety, tolerability, and pharmacokinetics of high-dose idebenone in patients with Friedreich ataxia. Arch Neurol 2007;64:803-8. PubMed
- Buyse GM, Voit T, Schara U, DELOS Study Group. Efficacy of idebenone on respiratory function in patients with Duchenne muscular dystrophy not using glucocorticoids (DELOS): a double-blind randomised placebo-controlled phase 3 trial. Lancet. 2015;385(9979) PubMed
- Corben LA, Lynch D, Pandolfo M, Schulz JB, Delatycki MB; Clinical Management Guidelines Writing Group. Consensus clinical management guidelines for Friedreich ataxia. Orphanet J Rare Dis. 2014;9:184. DOI
- Di Prospero NA, Baker A, Jeffries N, Fischbeck KH. Neurological effects of high-dose idebenone in patients with Friedreich's ataxia: a randomised, placebo-controlled trial. Lancet Neurol. 2007;6(10):878-86. PubMed
- Lagedrost SJ, Sutton MS, Cohen MS, et al. Idebenone in Friedreich ataxia cardiomyopathy-results from a 6-month phase III study (IONIA). Am Heart J. 2011;161(3):639-645.e1. PubMed
- Lynch DR, Perlman SL, Meier T. A phase 3, double-blind, placebo-controlled trial of idebenone in friedreich ataxia. Arch Neurol. 2010;67(8):941-7. PubMed
- Mc Aleer MA, Collins P. Allergic contact dermatitis to hydroxydecyl ubiquinone (idebenone) following application of anti-ageing cosmetic cream. Contact Dermatitis. 2008;59(3):178-9. PubMed
- McDaniel DH, Neudecker BA, DiNardo JC, Lewis JA 2nd, Maibach HI. Clinical efficacy assessment in photodamaged skin of 0.5% and 1.0% idebenone. J Cosmet Dermatol. 2005;4(3):167-73. PubMed
- Meier T, Perlman SL, Rummey C, Coppard NJ, Lynch DR. Assessment of neurological efficacy of idebenone in pediatric patients with Friedreich's ataxia: data from a 6-month controlled study followed by a 12-month open-label extension study. J Neurol. 2012;25 PubMed
- Pineda M, Arpa J, Montero R, et al. Idebenone treatment in paediatric and adult patients with Friedreich ataxia: long-term follow-up. Eur J Paediatr Neurol. 2008;12(6):470-5. PubMed
- Catarino CB, von Livonius B, Priglinger C, et al. Real-world clinical experience with idebenone in the treatment of leber hereditary optic neuropathy. J Neuroophthalmol. 2020 Dec;40(4):558-565.
- Kosa P, Wu T, Phillips J, et al. Idebenone does not inhibit disability progression in primary progressive MS. Mult Scler Relat Disord. 2020 Oct;45:102434. PubMed
- Zhao X, Zhang Y, Lu L, Yang H. Therapeutic effects of idebenone on leber hereditary optic neuropathy. Curr Eye Res. 2020 Oct;45(10):1315-1323. PubMed
- Yuan LL, Chen TY, Huang ZQ. Effects of paroxetine hydrochloride combined with idebenone on inflammatory factors and antioxidant molecules in treatment of depression after ischemic stroke. Pak J Med Sci 2023;39(1):17-22. PubMed
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.
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
Brands that make products with Idebenone
12 brands in our database make a supplement containing Idebenone.
Supplement products with Idebenone
17 products in our database contain Idebenone. Open any to see its full ingredient list and every drug interaction we check.
Idebenone: Common Questions
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Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
Products that contain Idebenone
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