Idebenone
A synthetic CoQ10 analogue approved in Europe for Leber's hereditary optic neuropathy and studied in Friedreich's ataxia. It has genuine clinical development for mitochondrial disease; nootropic use in healthy people is off-label and less supported.
01 Overview
Idebenone is a short-chain quinone antioxidant designed to support mitochondrial electron transport. It is approved in the EU (as Raxone) for Leber's hereditary optic neuropathy and has been trialled in Friedreich's ataxia and Duchenne muscular dystrophy, with mixed but sometimes positive results.
Because of its antioxidant and bioenergetic profile it is also marketed as a nootropic and anti-ageing supplement, though controlled cognitive-enhancement data in healthy adults is limited.
02 Mechanism
Acts as a CoQ10 analogue that can transfer electrons in the mitochondrial respiratory chain and scavenge free radicals, supporting cellular ATP production under oxidative stress.
03 Dosing
| Tier | Dose | Route | Notes |
|---|---|---|---|
| Common | 90–270 mg/day | Oral | Approved LHON dosing is 900 mg/day divided. |
| Therapeutic | 900–2250 mg/day | Oral | Higher ranges used in mitochondrial-disease trials. |
04 Effects
| Effect | Magnitude | Evidence | |
|---|---|---|---|
| Visual recovery in LHONBasis for EU approval; improves visual outcomes in some LHON patients. | Clinical | ||
| Antioxidant/bioenergetic supportSupports mitochondrial function in models; healthy-user cognitive benefit unproven. | Preclinical |
05 Side effects
| Effect | Severity | Frequency | Evidence | Countermeasures |
|---|---|---|---|---|
| Gastrointestinal upsetNausea, diarrhoea and abdominal discomfort reported in trials. | Mild | Common | Clinical | |
| Reddish urine discolourationHarmless discolouration from metabolites. | Mild | Common | Clinical |