Interactions between ubiquinone and Warfarin (warfarin)
warfarin and ubiquinone (Moderate Drug-Drug)
GENERALLY AVOID: Coadministration with coenzyme Q10 (also known as ubiquinone or ubidecarenone) may reduce the hypoprothrombinemic effect of warfarin and other oral anticoagulants. The exact mechanism of interaction is unknown, although coenzyme Q10 is structurally related to menaquinone (vitamin K2) and may have procoagulant effects. There have been reports of decreased warfarin response in patients using coenzyme Q10 and a return to normal anticoagulation following its discontinuation. In contrast, a study consisting of 24 patients stabilized on warfarin for at least several months found no significant effect of coenzyme Q10 on INR or warfarin dosage compared to placebo, and no thromboembolic events were observed in the study. However, it is important to recognize that pharmacologic effects of herbal products may be highly variable due to inconsistencies in formulation and potency of commercial preparations.
MANAGEMENT: In general, patients should consult a healthcare provider before taking any herbal or alternative medicine. Given the potential for interaction and the narrow therapeutic index of oral anticoagulants, these drugs should preferably not be used with coenzyme Q10. If they are given together, the INR must be checked frequently and anticoagulant dosage adjusted accordingly, particularly following initiation, discontinuation or change of dosage of coenzyme Q10 in patients who are stabilized on their anticoagulant regimen.
