Taking CoQ10 With Black Pepper Extract And Lisinopril

CoQ10 may lower blood pressure but there are no other known interactions.

Question

Is it safe for me to take Coq10 with black pepper extract since I am taking lisinopril, 10 mg in the morning and 10 mg in the evening? Looking for a good, organic Coq10. Thank you!

Asked by Renee On Jan 23, 2019

Answered by
Medical Content Reviewed By PharmacistAnswers Staff

On Jan 23, 2019

Answer

There is no known interaction between coenzyme Q10 (CoQ10) with black pepper extract (also known as piperine) and lisinopril.

However, coenzyme Q10 supplementation may reduce blood pressure on its own. Combining those effects with lisinopril, especially if your blood pressure is already well controlled, could potentially cause hypotension (low blood pressure).

In other words, coenzyme Q10 could have additive blood pressure lowering effects. Therefore, it should be used with caution and be sure to check your blood pressure periodically as well as look for signs of hypotension such as dizziness and lightheadedness.

The combination of coenzyme Q10 and cardiac medication is actually relatively common as a number of studies have shown potential benefits with coenzyme Q10 supplementation.

Specifically, there is a large body of evidence that suggests that heart failure is associated with low coenzyme Q10 levels and that low coenzyme Q10 levels are a predictor of heart failure. One study, published in the Journal of the American College of Cardiology, concluded the following:

Plasma CoQ(10) concentration was an independent predictor of mortality in this cohort. The CoQ(10) deficiency might be detrimental to the long-term prognosis of CHF, and there is a rationale for controlled intervention studies with CoQ(10).

Additionally, although more evidence is needed, coenzyme Q10 supplementation may help reduce blood pressure and allow for a dosage reduction antihypertensive medications (like lisinopril).

In regard to black pepper, there is no known interaction between that and lisinopril either. Black pepper extract is a common additive to many dietary supplements as it can increase absorption. One study looking at coenzyme Q10 supplementation in particular, found that adding black pepper extract increased absorption around 30%.

Be sure to let your doctor know that you are interested in taking this supplement (CoQ10 with black pepper) so you can be appropriately monitored.

Answer Summary

There is no known interaction between coenzyme Q10, black pepper extract (piperine) and lisinopril. However, coenzyme Q10 supplementation may lower blood pressure, so caution is advised in those taking antihypertensive drugs.
References
  • Elsevier ClinicalKey: Lisinopril Monograph (Accessed 1/23/19)
  • Treatment of essential hypertension with coenzyme Q10. PubMed (Accessed 1/23/19)
  • Coenzyme Q10: an independent predictor of mortality in chronic heart failure. PubMed (Accessed 1/23/19)
  • Coenzyme Q10: clinical benefits with biochemical correlates suggesting a scientific breakthrough in the management of chronic heart failure. PubMed (Accessed 1/23/19)
  • Piperine derived from black pepper increases the plasma levels of coenzyme Q10 following oral supplementation. PubMed (Accessed 1/23/19)

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