Idebenone (Catena)

Class

Synthetic short-chain benzoquinone antioxidant

Mechanism

Scavenges reactive oxygen species and facilitates mitochondrial electron transport, enhancing ATP production and reducing oxidative stress.

FDA-Approved Use

None in the United States (approved in Europe for Friedreich’s ataxia)

Off-Label Use

Cognitive impairment in neurodegenerative diseases (e.g., Alzheimer’s disease [AD], Parkinson’s disease [PD]); mitochondrial disorders

Formulation

Oral tablets

Titration

90–270 mg p.o. daily, divided in 2–3 doses

Dose Range

90–270 mg/day

Kinetics

Oral bioavailability improved when taken with food; metabolized hepatically

Common AEs

Diarrhea, nausea, abdominal discomfort

Serious/Rare AEs

None commonly reported

Monitoring

Monitor liver function periodically in prolonged use

Black Box Warning

None

Considerations

Limited evidence for dementia and Parkinson’s disease; use cautiously in hepatic impairment due to metabolism concerns.