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CoQ-10 Update

A conversation with compounding pharmacist Arthur Margolis from America's Compounding Center, September 7, 2007 by teleconference.

Cristy Balcells, Executive Director: Welcome Arthur! We are so glad to have you as part of the call today, as many of our patients struggle to understand about CoQ10. We often hear questions about insurance coverage, best forms to take, ways to get high doses necessary for mitochondrial disease, etc.

Arthur: Thank you for having me! I am a third generation pharmacist, and I have many mitochondrial disease patients for whom I compound their medicines and supplements. Let me first explain that my goal as a compounding pharmacist is to help introduce the medicines into the body in a way that works for the patient and that avoids allergens, which are unique for every patient.

ubiquinone (coenzyme Q-10)

Typically, co-enzyme Q10 is given in high doses to mitochondrial disease patients in an oil base, but we have developed a new dosing method using a troche (pronounced TRO-KEY).

Cristy: Arthur, what is a troche?

Arthur: A troche is like a gummy bear. It is a soft gelatin square, almost the size of a chicklet, that can be flavored and that dissolves in the mouth easily and is easy to chew. We can concentrate the CoQ10 so that each troche contains 200 mg. We use a premium powdered form of the CoQ10. There is also a new water soluble version available.

Cristy: Many patients struggle to get coverage of their CoQ10 by insurance because it is considered a vitamin or supplement. Do you have any advice, and is it expensive?

Arthur: First of all, if the medicine is compounded then it is more likely to be covered by insurance than if the patient just walked into a drugstore and purchased the coq10 over the counter. I find that the CoQ10 formulations I prepare is covered by all the major insurances; we use it for ALS patients also.

Member: It is covered by MassHealth also, when it is compounded.

Arthur: It is also important to know the source of the CoQ10. PCCA is premium -- a manufacturer based in Texas. The source should be reliable and pure.

Cristy: Many doctors recommend Tischon formulations also, available on

Arthur: That is also a good form, but not what we use in compounding formulas.

Member: Does the powdered formula have magnesium stearate in it?

Arthur: No it does not.

Cristy: So Arthur, what would you recommend for all of us who cannot get to you as our pharmacist?

Arthur: Well, here are my recommendations. By the way, I take orders from all over and ship medicines to some of my patients.

Find a reliable compounding pharmacy. A good website to check is

Ask about compounding the CoQ10 in a 200 mg troche, or in a concentrated liquid (oil form), or in a 400 mg capsule for adults who can swallow. You must have a prescription in order to get any compounded medication. The compound can include other supplements or medications -- ask the pharmacist. In a Mito cocktail, which varies for every patient, there might be CoQ10, thiamine or the B-vitamins, Vitamin C, L-Carnitine, Folic Acid, etc. Folic acid, 1 mg/dose, is automatically covered by insurance if included in the compound and billed as the primary ingredient.

Cristy: Arthur, this is really useful information. I hope you will continue to be a part of our CoQ10 task force. Can we contact you with more questions?

Arthur: Of course. My website is and I am in Newton, MA at America's Compounding Center. My email is

I would be happy to help.

Cristy: Thank you!!

© 2007 Mitochondrial Disease Action Committee


View MitoAction Red Tape article "Financial Assistance for Mito Cocktail" here

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diseasefighter's picture



This is a super-enlightening article. I've done a little research since I have some patients with mitochondrial disease, but I'm not sure I discovered most of these facts. Thanks, Arthur. I really appreciate what you've shared in this interview.

Alex Jackson

Public Health Practitioner