NutriStack
Coenzyme Q10 and Metoprolol, a caution.
Beta-blockers including metoprolol may reduce endogenous CoQ10 levels by inhibiting CoQ10-dependent mitochondrial enzymes. Some studies suggest CoQ10 supplementation may mitigate statin-like myopathy symptoms seen with beta-blockers.
One pair, every claim cited. The two substances, the type, the mechanism, the recommendation, and the primary literature.
Same shape as the other 1,729 pairs in the public database.
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What the row says.
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At a glance
- Substances
- Coenzyme Q10 and Metoprolol
- Pair type
- Caution
- Evidence (highest tier)
- Emerging
- Source citations
- 5 sources
- Stack Score effect
- −5 to your Stack Score (per scored caution row).
- Scope
- Supplement × Prescription
- Last verified
- May 30, 2026
Caution · Emerging evidence
Caution
What is happening. Beta-blockers including metoprolol may reduce endogenous CoQ10 levels by inhibiting CoQ10-dependent mitochondrial enzymes. Some studies suggest CoQ10 supplementation may mitigate statin-like myopathy symptoms seen with beta-blockers.
Mechanism. Beta-blockers may inhibit mitochondrial CoQ10-dependent enzymes in the electron transport chain, reducing cellular energy production. Metoprolol inhibits mevalonate pathway enzymes upstream of CoQ10 synthesis.
Recommendation. Consider CoQ10 supplementation (100-200mg/day) if experiencing fatigue or muscle weakness on metoprolol. CoQ10 does not interfere with metoprolol's antihypertensive effect.
Sources (5)
- Kishi T et al. Bioenergetics in clinical medicine: studies on coenzyme Q10 and essential hypertension. Res Commun Chem Pathol Pharmacol. 1977;17(2):283-288. PMID 897340
- Tsai IC, Hsu CW, Chang CH et al.. Effectiveness of Coenzyme Q10 Supplementation for Reducing Fatigue: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.. Frontiers in Pharmacology. 2022. PMID 36091835
- Liu Z, Tian Z, Zhao D et al.. Effects of Coenzyme Q10 Supplementation on Lipid Profiles in Adults: A Meta-analysis of Randomized Controlled Trials.. Journal of Clinical Endocrinology and Metabolism. 2022. PMID 36337001
- Hou S, Tian Z, Zhao D et al.. Efficacy and Optimal Dose of Coenzyme Q10 Supplementation on Inflammation-Related Biomarkers: A GRADE-Assessed Systematic Review and Updated Meta-Analysis of Randomized Controlled Trials.. Molecular Nutrition & Food Research. 2023. PMID 37118903
- Sazali S, Badrin S, Norhayati MN et al.. Coenzyme Q10 supplementation for prophylaxis in adult patients with migraine-a meta-analysis.. BMJ Open. 2021. PMID 33402403
Stack Score
How this pair moves the number.
Effect on the composite score
If both Coenzyme Q10 and Metoprolol are in the same stack, this pair applies −5 to your Stack Score (per scored caution row).
The full algorithm, the clamping rules, and four worked stacks are documented at /methodology/stack-score.
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