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coronary artery bypass sur- gery:  the suggested dosage is 50 mg three times a day beginning 7 days prior to sur- gery.   • Patients taking doxorubicin (Adriamycin):  a dosage of 50 mg once a day has been associated with decreased toxicity of the heart muscle (3). REFERENCES 1. Greenberg S, Fishman WH. "Coenzyme Q10: A New Drug for Cardiovascular Disease." J Clin Pharmacol 1990;30:596-608 2. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999. 3. Micromedex Healthcare Series. Englewood, CO: MICROMEDIX Inc. 4. Zamora R et al. Comparative antioxidant effectiveness of dietary beta carotene, vitamin E, selenium and co-enzyme Q10 in rat erythrocytes and plasma. J Nutr 1991;121:50 5. Gaby AR. Coenzyme Q10. In: Pizzorno JE, Murray MT, eds. Textbook of Natural Medicine. 2nd Ed. New York: Churchill Livingston, 1999;663 6. Folkers K, et al, eds. Biomedical and Clinical Aspects of Coenzyme Q10, Vol. 1-4. Amsterdam: Elsevioer Science Publishers; Vol. 1, 1977;Vol. 2, 1980; Vol. 3, 1982; Vol. 4 1984 7. Mortensen SA,. Coenzyme Q10: Clinical benefits with biochemical correlates suggesting a scientific breakthrough in the management of chron- ic heart failure. Int J. Tissue React 1990;12:155- 162 8. Khatta M, Alexander BS, Krichten CM, et al. The effect of coenzyme Q10 in patients with congestive heart failure. Ann Intern Med 2000;132(8):636-640 9. Lininger SW. The Natural Pharmacy. 1st ed. Rocklin, CA: Prima Publishing; 1998 10. Chello M, Mastroroberto P, Romano R, et al. Protection by coenzyme Q10 from myocardial reperfusion injury during coronary artery bypass grafting. Annals of Thoracic Surgery 1994;58:1427- 1432 11. Morisco C, Trimarco B, Condorelli M. Effect of coenzyme Q10 therapy in patients with congestive heart failure: A long-term multicenter randomized study.  Clin Invest 1993;71(Suppl. 8):S134- 136 12. Hofman-Bang C, et al. Coenzyme Q10 as an adjunctive treatment of congestive heart failure. J Card Fail 1995;1:101-107 concerning glimepiride (Amaryl).   ARE THERE ANY INTERAC- TIONS WITH LABORATORY TESTS? Liver tests such as SGOT and LDH concentrations can elevate in patients taking coenzyme Q-10 in excess of 300 mg per day. WHERE CAN IT BE FOUND NATURALLY? Common dietary sources for coenzyme Q-10 include cer- tain types of fish and shell- fish, beef, pork and lamb. The compound is also found in vegetables such as broc- coli and spinach, and in veg- etable oils.  However, the quantities in these sources are low.  Therapeutic doses require dietary supplementa- tion. WHAT IS THE MOST APPROPRIATE DOSAGE? Dosage varies, depending on the condition being treated:   • Congestive heart failure: the most common dosage is 100 mg per day,  divided into two or three doses.   • Angina: 50 mg three times per day has been recom- mended (16).   • High blood pressure: although no specific dose has been identified, 200 to 300 mg in two or three divided doses is most likely appropri- ate. • Patients about to undergo

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