CoQ10 and Xarelto

Susequent to our 7/21/16 discussion of Pradaxa’s effect on antiphospholipid antibody testing, Dr. J. S. also asked, “I read where one should not take Co Q-10 if they are on Coumadin (wonder why?). Does the same warning apply to Pradaxa or Xarelto?

Thank you for this follow-up question. CoQ10 has antiplatelet properties, as documented in Mortensen SA. Overview on coenzyme Q10 as adjunctive therapy in chronic heart failure. Rationale, design and end-points of “Q-symbio”–a multinational trial. Biofactors. 2003;18: 79-89. Its antiplatelet function supplements the anticoagulant function of Coumadin, Pradaxa, Xarelto, or any anticoagulant in an uncontrolled fashion, raising the bleeding risk, so it is most likely contraindicated.