NutriStack
Coenzyme Q10 Ubiquinol and Metoprolol, a synergy.
Beta-blockers including metoprolol inhibit CoQ10-dependent mitochondrial enzymes, reducing endogenous CoQ10 levels. Metoprolol inhibits NADH-oxidase (approximately one-fourth the potency of propranolol) and may contribute to fatigue, myalgia, and exercise intolerance experienced by some patients. CoQ10 supplementation may help alleviate these side effects by restoring mitochondrial bioenergetics.
One pair, every claim cited. The two substances, the type, the mechanism, the recommendation, and the primary literature.
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At a glance
- Substances
- Coenzyme Q10 Ubiquinol and Metoprolol
- Pair type
- Synergy
- Evidence (highest tier)
- Moderate
- Source citations
- 2 sources
- Stack Score effect
- +2 to your Stack Score (per scored synergy row).
- Scope
- Supplement × Prescription
- Last verified
- May 30, 2026
Synergy · Moderate evidence
Synergy
What is happening. Beta-blockers including metoprolol inhibit CoQ10-dependent mitochondrial enzymes, reducing endogenous CoQ10 levels. Metoprolol inhibits NADH-oxidase (approximately one-fourth the potency of propranolol) and may contribute to fatigue, myalgia, and exercise intolerance experienced by some patients. CoQ10 supplementation may help alleviate these side effects by restoring mitochondrial bioenergetics.
Mechanism. Metoprolol inhibits CoQ10-dependent mitochondrial enzymes including NADH-oxidase and succinoxidase, reducing cellular ATP production. CoQ10 (ubiquinone) is an essential electron carrier in the mitochondrial respiratory chain, and its depletion impairs oxidative phosphorylation in cardiac and skeletal muscle.
Recommendation. Consider supplementing with CoQ10 (100-200 mg/day) to offset potential depletion from metoprolol. CoQ10 is generally safe with beta-blockers and may improve energy levels and exercise tolerance. No dose adjustment of metoprolol is needed.
Sources (2)
- Kishi T et al. Bioenergetics in clinical medicine XV. Inhibition of coenzyme Q10-enzymes by clinically used adrenergic blockers of beta-receptors. Res Commun Chem Pathol Pharmacol. 1977;17(1):157-164. PMID 17892
- Kishi T et al. Bioenergetics in clinical medicine III. Inhibition of coenzyme Q10-enzymes by clinically used anti-hypertensive drugs. Res Commun Chem Pathol Pharmacol. 1975;12(3):533-540. PMID 1197930
Stack Score
How this pair moves the number.
Effect on the composite score
If both Coenzyme Q10 Ubiquinol and Metoprolol are in the same stack, this pair applies +2 to your Stack Score (per scored synergy row).
The full algorithm, the clamping rules, and four worked stacks are documented at /methodology/stack-score.
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