Red Yeast Rice Interactions Overview

Additional Details

Is Red Yeast Rice Safe? Are There Any Warnings?

Red yeast rice is generally considered safe when taken orally in appropriate doses. Clinical studies have used doses of 1.2 grams daily for up to 4.5 years without significant issues. However, it's important to note that some red yeast rice products contain a compound similar to the drug lovastatin, which can lead to side effects. People taking red yeast rice should be monitored for potential liver and muscle-related adverse effects similar to those seen with lovastatin. Pregnant and breastfeeding individuals should avoid using red yeast rice due to potential risks to the fetus and lack of sufficient information.

How Does Red Yeast Rice Work? What is the Mechanism of Action?

Red yeast rice is created by fermenting rice with Monascus purpureus yeast. This fermentation process produces a red color and various compounds. The most significant compounds are mevinic acids, also known as monacolins, with lovastatin (monacolin K) being the most prominent. Lovastatin is similar to the drug used to lower cholesterol levels. These monacolins work by inhibiting an enzyme called HMG-CoA reductase, which is involved in cholesterol production. Additionally, red yeast rice contains other components like sterols, isoflavones, and fatty acids that might help lower cholesterol absorption and improve cardiovascular health. Some evidence also suggests that red yeast rice has anti-inflammatory, antioxidant, and immune-modulating effects.

Pharmacokinetics

When taken orally, red yeast rice is absorbed by the body. The maximum concentration of lovastatin in the blood after taking red yeast rice is lower compared to taking lovastatin as a pharmaceutical drug. Red yeast rice compounds are metabolized in the body, and some of the metabolites are different from those of lovastatin.

Interaction Overview

Red yeast rice can interact with various drugs and supplements. For instance, it might interact with cyclosporine, drugs that inhibit CYP3A4 enzymes, gemfibrozil, and other hepatotoxic drugs, potentially increasing the risk of adverse effects. Similar caution is advised when combining red yeast rice with other statins or high-dose niacin. Additionally, supplements like coenzyme Q10 and St. John's wort might be affected by red yeast rice.

Common Side Effects To Watch For

Common side effects of red yeast rice include abdominal discomfort, diarrhea, dizziness, flatulence, headache, heartburn, myopathy (muscle problems), and nausea. Serious adverse effects are rare but can include liver issues and muscle problems. There's also a possibility of kidney toxicity from contaminated red yeast rice.

Are Supplements Standardized?

Red yeast rice supplements are typically standardized to a compound called monacolin K, which is similar to lovastatin. However, it's important to note that the monacolin K content in these supplements can vary significantly. Some products might claim to be standardized to other active ingredients, but accuracy in these claims can vary.

What Is Red Yeast Rice Typically Used For?

Red yeast rice supplements are often used to lower cholesterol levels, particularly in cases of hyperlipidemia and HIV/AIDS-related dyslipidemia. There's evidence that they can also help reduce the risk of recurrence of non-fatal myocardial infarction (heart attack). However, their effectiveness for conditions like hypertension, atherosclerosis, diabetes, and cancer is still uncertain and requires more research.

Drugs that interact with Red Yeast Rice