Study of the Efficacy of Coenzyme Q10, L-Carnitine and Meldonium and Some of Their Combinations for the Prevention and Treatment of Side Effects Caused by Statins in an Experiment

The most common side effects of statins are myopathy, myalgia, rare - severe rhabdomyolysis and significant - hepatoxicity. It is known that in the pathogenesis of side effects caused by statins, great importance is given to oxidative stress and disruption of mitochondrial respiration. Therefore, the use of antioxidants such as coenzyme Q10, carnitine L, mildronate can be considered a potentially effective treatment against damage caused by statins. The purpose of the study was to experimentally study the effectiveness of coenzyme Q10, L carnitine, and meldonium (mildronate) and some of their combinations in the prevention and treatment of side effects caused by statins. The experiments were carried out on white male rats (n=50) of the Wistar breed. From the data obtained, we can conclude that coenzyme Q10 and L carnitine equally improve hyperlipidemia parameters compared with atorvastatin monotherapy, although L carnitine improves HDL better than coenzyme Q10. The combination of coenzyme Q10 and L carnitine gave better lipid profiles than with monotherapy. Coenzyme Q10, L carnitine and their combinations significantly reduced the concentration of transaminases (ALT, AST) caused by atorvastatin, and meldonium reduced only the AST concentration and almost did not change the ALT parameter. The creatine kinase level significantly decreased with the use of coenzyme Q10. This parameter decreased better when using coenzyme Q10 and L carnitine combination. The remaining drugs did not significantly change this parameter. To prevent liver dysfunction caused by statins and prevent myopathy, a combination of coenzyme Q10 and L carnitine or monotherapy with coenzyme Q10 is recommended. The experiments indicate that meldonium did not significantly reduce or worsen ALT and CK levels worsened by statins. Based on this, we can conclude that it can be used in combination with statins for the treatment of cardiovascular diseases.