Overview

Red yeast rice is the product of rice fermented with a type of yeast called Monascus purpureus. It contains monacolin K, which is identical to a statin drug.

Red yeast rice contains ten different chemicals known as monacolins. These chemicals affect cholesterol levels. Monacolin K, which is the same as the drug lovastatin, is the most abundant in red yeast rice. Because of this, it has many of the same effects and precautions as the statin drug.

People most commonly use red yeast rice for high levels of cholesterol and other fats in the blood. It is also used for heart attack, high blood pressure, heart disease, diabetes, cancer, and many other conditions, but there is no good scientific evidence to support many of these other uses.

The US FDA considers red yeast rice products that contain significant amounts of statin-like ingredients to be illegal, unapproved drugs. But many of these products are still available. Red yeast rice products do not always contain consistent amounts of statins, which can change their effects on health.

Uses & Effectiveness

Likely Effective for

  • High levels of cholesterol or other fats (lipids) in the blood (hyperlipidemia). Taking red yeast rice supplements by mouth can lower total cholesterol, low-density lipoprotein (LDL or "bad") cholesterol, and triglycerides. This is likely due to a chemical called monacolin K. This chemical is also known as the statin drug lovastatin. Statins are approved by the US FDA to lower cholesterol.

Possibly Effective for

  • Abnormal levels of blood fats in people with HIV/AIDS. Taking red yeast rice by mouth seems to reduce cholesterol and triglyceride levels in people with HIV.
  • Heart attack. Taking red yeast rice by mouth daily seems to reduce the risk of heart attacks and death in people with a history of heart attack.

Possibly Ineffective for

  • High blood pressure. Taking red yeast rice by mouth together with prescription blood pressure-lowering drugs doesn't seem to reduce blood pressure more than taking the drugs alone.
There is interest in using red yeast rice for a number of other purposes, but there isn't enough reliable information to say whether it might be helpful.

Side Effects

When taken by mouth: Red yeast rice is possibly safe for most people when taken for up to 4.5 years. Red yeast rice contains a chemical that is the same as the prescription drug lovastatin. Because of this, it might cause the same side effects as this drug, including liver damage, severe muscle pain, and muscle damage. Also, red yeast rice products that are fermented incorrectly are sometimes contaminated with a toxin called citrinin. This toxin has been linked with kidney damage.

Special Precautions and Warnings

When taken by mouth: Red yeast rice is possibly safe for most people when taken for up to 4.5 years. Red yeast rice contains a chemical that is the same as the prescription drug lovastatin. Because of this, it might cause the same side effects as this drug, including liver damage, severe muscle pain, and muscle damage. Also, red yeast rice products that are fermented incorrectly are sometimes contaminated with a toxin called citrinin. This toxin has been linked with kidney damage.

Pregnancy: Red yeast rice is likely unsafe when taken by mouth during pregnancy. Some chemicals in red yeast rice have caused birth defects in animals. Avoid using it while pregnant.

Breast-feeding: There isn't enough reliable information to know if it is safe to use red yeast rice when breast-feeding. Stay on the safe side and avoid use.

Liver problems: Red yeast rice contains a chemical that is the same as the statin drug lovastatin. Lovastatin can cause liver damage. Red yeast rice products should be used cautiously or avoided in people with liver problems.

Interactions

    Moderate Interaction

    Be cautious with this combination

  • Cyclosporine (Neoral, Sandimmune) interacts with RED YEAST RICE

    Red yeast rice might affect the muscles. Cyclosporine might also affect the muscles. Taking red yeast rice along with cyclosporine might increase the risk of muscle problems.

  • Gemfibrozil (Lopid) interacts with RED YEAST RICE

    Gemfibrozil can affect the muscles. Red yeast rice can also affect the muscles. Taking gemfibrozil along with red yeast rice might increase the risk of muscle problems.

  • Medications that can harm the liver (Hepatotoxic drugs) interacts with RED YEAST RICE

    Red yeast rice might harm the liver. Some medications can also harm the liver. Taking red yeast rice along with a medication that can harm the liver might increase the risk of liver damage.

  • Medications that decrease break down of other medications in the liver (Cytochrome P450 3A4 (CYP3A4) inhibitors) interacts with RED YEAST RICE

    Red yeast rice is changed and broken down by the liver. Some drugs decrease how quickly the liver changes and breaks down red yeast rice. This could change the effects and side effects of red yeast rice.

  • Medications used for lowering cholesterol (Statins) interacts with RED YEAST RICE

    Statins are medications that are used to lower cholesterol. Red yeast rice contains the statin drug lovastatin. Taking red yeast rice along with other statins might increase the risk of side effects. Do not take red yeast rice if you are already taking these medications.

  • Niacin interacts with RED YEAST RICE

    Niacin can affect the muscles. Red yeast rice can also affect the muscles. Taking niacin along with red yeast rice might increase the risk of muscle problems.

Dosing

Red yeast rice has most often been used by adults in doses of 600 mg by mouth twice daily, for up to 4.5 years. Speak with a healthcare provider to find out what dose might be best for a specific condition.

Keep in mind that red yeast rice products contain varying amounts of the chemical monacolin K, which is the same as the prescription drug lovastatin. Some products may contain none and others may contain high amounts, which are more likely to cause serious side effects. Red yeast rice products that contain significant amounts of statin-like ingredients are considered illegal, unapproved drugs.
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CONDITIONS OF USE AND IMPORTANT INFORMATION: This information is meant to supplement, not replace advice from your doctor or healthcare provider and is not meant to cover all possible uses, precautions, interactions or adverse effects. This information may not fit your specific health circumstances. Never delay or disregard seeking professional medical advice from your doctor or other qualified health care provider because of something you have read on WebMD. You should always speak with your doctor or health care professional before you start, stop, or change any prescribed part of your health care plan or treatment and to determine what course of therapy is right for you.

This copyrighted material is licensed from Therapeutic Research Center, LLC. Information from this source is evidence-based and objective, and without commercial influence. For professional medical information on natural medicines, see Natural Medicines Comprehensive Database Professional Version.
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