Red Yeast Rice Plus 600 mg Ingredients & Drug Interactions
What is this page for?
First and foremost: checking Red Yeast Rice Plus 600 mg against your medications. The heart of this page is the interaction checker and the full interaction report — how this product’s ingredients may interact with prescription and over-the-counter medicines you may be taking.
Around that, we add a pharmacist’s high-level view of the product as a whole — what’s inside, the evidence for its stated use, how transparent the label is, and what safety data exists — so you can see the full picture in one place. It’s educational information from our licensed clinical databases and the clinical staff at HelloPharmacist — not medical advice — and we don’t sell or endorse products. Our editorial policy
Red Yeast Rice Plus 600 mg is a dietary supplement by Vitamin Discount Center with 4 active ingredients. Its ingredients are commonly taken for heart health, statin-related muscle aches, migraine prevention.Based on those ingredients, 1,298 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Milk Thistle, Red Yeast Rice, N-Acetyl-Cysteine. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Red Yeast Rice Plus 600 mg by Vitamin Discount Center
Ask about any prescription or over-the-counter medication and we check it for interactions with Red Yeast Rice Plus 600 mg by Vitamin Discount Center — and tell you which ingredient is responsible.
AI summaries are generated from our interaction database for education only — always confirm with your pharmacist. How we use AI
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HelloPharmacist Scorecard of Red Yeast Rice Plus 600 mg by Vitamin Discount Center
Four independent checks of what is known — a summary of the available information, not a grade of the product itself.
By FDA rules, dietary supplements can’t claim to treat, cure, or prevent disease — so labels speak in careful marketing language. We discern each product’s intended use from its name, label claims, and label statements, then grade the clinical evidence for that use. How these ratings are computed
The stated purpose hasn't been mapped to our evidence data yet.
Why this rating?
- We haven't mapped this product's purpose to our evidence data yet — it'll be graded on the next content refresh.
Every active ingredient lists its own amount on the label.
Why this rating?
- The label discloses an exact amount for 4 of its 4 active ingredients.
- “Milk Thistle” is listed as a grouped ingredient — the label gives one combined amount (25 mg) without saying how much of each component you get.
At least one ingredient has a documented Major-severity interaction. Check your medications for a personalized result.
Why this rating?
- 3 of the 3 matched ingredients can interact with medications — Red Yeast Rice, Coenzyme Q10, N-acetyl Cysteine (nac).
- The most serious interaction on file is rated Major.
- Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; immunosuppressants / transplant drugs.
- For scale: 762 individual medications appear in the full list. A big number alone doesn't make a product dangerous — what matters is whether YOUR medication is on it, so run yours through the interaction checker on this page.
Adverse-effect, pregnancy, and general safety data are on file for most of these ingredients.
Why this rating?
- We hold adverse-effect (side-effect) data for 3 of the 3 matched ingredients.
- Pregnancy & breastfeeding safety ratings cover 3 of 3.
- General safety write-ups exist for 3 of 3.
- Remember: this measures how much safety information exists. Thin data is not the same as being safe.
HelloPharmacist summaryFully disclosed formula with no assessable stated purpose. Major medication interactions have been identified, and safety information is well characterized.
Assessment coverage: 3 of 4 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Sep 25, 2023.
This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed
General information
Key facts about Red Yeast Rice Plus 600 mg, straight from the product label.
| Brand | Vitamin Discount Center |
|---|---|
| Net contents | 120 Vegetarian Capsule(s) |
| Market status | Off market |
| Date entered into DSLD | Sep 25, 2023 |
| DSLD ID | 297911 |
| Product type | Other Combinations |
| Supplement form | Capsule |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Adult (18 - 50 Years), Gluten Free, Dairy Free, Sugar Free |
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.
Supplement Facts
The label details for Red Yeast Rice Plus 600 mg by Vitamin Discount Center, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Coenzyme Q10 | 30 mg | -- |
| N-Acetyl-Cysteine | 50 mg | -- |
| Silymarin | 20 mg | -- |
| Red Yeast Rice | 600 mg | -- |
| Milk Thistle | 25 mg | -- |
Other ingredients: Cellulose, Water, Cellulose, Stearin, Magnesium Stearate, Silica
Tap any ingredient to jump to its full detail below.
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
Formulation
Contains no sugar, salt, dairy, wheat, gluten, preservatives, artificial colors or flavors.
Suggested/Recommended/Usage/Directions
Suggested Use: As a dietary supplement, adults take one (1) capsule, twice (2) daily with meals or as directed by a health care professional.
Storage
Store in a cool, dry place and away from direct light.
Precautions
Warning: Consult your physician prior to using this product if you are pregnant or nursing, taking medications such as cholesterol lowering drugs or have a medical condition like liver disease. Discontinue use two weeks prior to surgery.
Keep out of reach of children.
FDA Disclaimer Statement
These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.
Formula
w/ CoQ10, NAC & Milk Thistle
Red yeast rice is a traditional Asian food that dates back to 800 AD. Scientific studies have shown that red yeast rice can help to support healthy cholesterol levels that are already within the normal range. It is organically grown in the USA and is free of citrinin; a toxin that can be found in fermented foods. CoQ10, milk thistle and n-acetyl-cysteine are included for added liver support.
FDA Statement of Identity
Dietary Supplement
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Red Yeast Rice Plus 600 mg by Vitamin Discount Center label
The label scan from the NIH Dietary Supplement Label Database. Tap to enlarge.
Label images are published by the NIH Dietary Supplement Label Database for the version of this product on file. Always read your actual product label.
View the full label (PDF)The Ingredients in Red Yeast Rice Plus 600 mg by Vitamin Discount Center
These are the 4 active ingredients this product is made of. Select any to open its full monograph.
Serving size1 Capsule(s) Dosage formCapsule Servings per container120 Amounts shown are per serving.
Most supplement products combine several ingredients, and a medication can interact with the product through any one of them. Each ingredient below shows whether it has known drug interactions.
Coenzyme Q10
Interacts with198 drugs
CoQ10 is a vitamin-like substance your body makes naturally that helps cells produce energy and acts as an antioxidant. It is generally well tolerated...
Coenzyme Q10 monograph & interactionsN-Acetyl-Cysteine
Interacts with294 drugs
N-acetyl cysteine (NAC) is a supplement form of the amino acid cysteine and a building block for the antioxidant glutathione. It has well-established...
N-Acetyl-Cysteine monograph & interactionsRed Yeast Rice
Interacts with477 drugs
Red yeast rice contains monacolin K, which is chemically identical to the prescription statin lovastatin, and it can lower LDL ('bad') cholesterol. Be...
Red Yeast Rice monograph & interactionsMilk Thistle
Interacts with954 drugs
Milk thistle is a popular herbal supplement most often used for liver health, and its main active component is a group of compounds called silymarin....
Milk Thistle monograph & interactions- › Silymarin
Other (inactive) ingredients: Cellulose, Water, Cellulose, Stearin, Magnesium Stearate, Silica. These complete the product’s ingredient list but are not active constituents.
Red Yeast Rice Plus 600 mg by Vitamin Discount Center Drug Interactions
Red Yeast Rice Plus 600 mg contains 4 ingredients, and 4 of them have known drug interactions. Altogether they interact with 1,298 medications. Here’s the picture, then you can look up your own drug.
Want to check YOUR meds against Red Yeast Rice Plus 600 mg?
Ask about interactions with your drugs in plain English — “Can I take it with lisinopril?” — and we find you the answer in seconds, ingredient by ingredient.
Go to the checkerIngredients driving the most interactions
Individual Drug Interactions
The ingredients in Red Yeast Rice Plus 600 mg interact with 1,298 drugs. Click any drug to see the details.
4 of the 4 ingredients in Red Yeast Rice Plus 600 mg interact with drugs. Each result below shows which ingredient is responsible. Milk Thistle Red Yeast Rice N-Acetyl-Cysteine Coenzyme Q10
NitroglycerinGonitro, Nitro Time, Nitro-Bid, Nitrocine Timecaps, Nitrogard, Nitrogard SR +7 more
How Nitroglycerin interacts with Red Yeast Rice Plus 600 mg — through 1 ingredient. Tap an ingredient for the detail:
N-acetyl-cysteineNitroglycerin Major
Interaction Summary
N-acetyl cysteine can increase the risk for hypotension and headaches when taken with intravenous or transdermal nitroglycerin.
Read the full N-acetyl-cysteine + Nitroglycerin interaction6-mercaptopurinePurinethol
How 6-mercaptopurine interacts with Red Yeast Rice Plus 600 mg — through 1 ingredient. Tap an ingredient for the detail:
Red Yeast RiceHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use might increase the risk of liver damage.
Read the full Red Yeast Rice + 6-mercaptopurine interactionAbacavir Sulfate, Dolutegravir, LamivudineTriumeq
How Abacavir Sulfate, Dolutegravir, Lamivudine interacts with Red Yeast Rice Plus 600 mg — through 1 ingredient. Tap an ingredient for the detail:
Red Yeast RiceHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use might increase the risk of liver damage.
Read the full Red Yeast Rice + Abacavir Sulfate, Dolutegravir, Lamivudine interactionAbacavir, LamivudineEpzicom
How Abacavir, Lamivudine interacts with Red Yeast Rice Plus 600 mg — through 1 ingredient. Tap an ingredient for the detail:
Red Yeast RiceHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use might increase the risk of liver damage.
Read the full Red Yeast Rice + Abacavir, Lamivudine interactionAbametapirXeglyze
How Abametapir interacts with Red Yeast Rice Plus 600 mg — through 1 ingredient. Tap an ingredient for the detail:
Red Yeast RiceCytochrome P450 3a4 (cyp3a4) Inhibitors Moderate
Interaction Summary
Theoretically, drugs that inhibit the CYP3A4 enzymes might increase levels of lovastatin from red yeast rice.
Read the full Red Yeast Rice + Abametapir interactionAbciximabReoPro
How Abciximab interacts with Red Yeast Rice Plus 600 mg — through 1 ingredient. Tap an ingredient for the detail:
N-acetyl-cysteineAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, N-acetyl cysteine might increase the risk of bleeding when taken with anticoagulant or antiplatelet drugs.
Read the full N-acetyl-cysteine + Abciximab interactionAbiraterone
How Abiraterone interacts with Red Yeast Rice Plus 600 mg — through 2 ingredients. Tap an ingredient for the detail:
Red Yeast RiceCytochrome P450 3a4 (cyp3a4) Inhibitors, Hepatotoxic Drugs Moderate
Interaction Summary
Theoretically, drugs that inhibit the CYP3A4 enzymes might increase levels of lovastatin from red yeast rice.
Read the full Red Yeast Rice + Abiraterone interactionMilk ThistleCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
It is unclear if milk thistle inhibits CYP3A4; research is conflicting.
Read the full Milk Thistle + Abiraterone interactionAbiraterone AcetateYonsa, Zytiga
How Abiraterone Acetate interacts with Red Yeast Rice Plus 600 mg — through 2 ingredients. Tap an ingredient for the detail:
Red Yeast RiceHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use might increase the risk of liver damage.
Read the full Red Yeast Rice + Abiraterone Acetate interactionMilk ThistleCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
It is unclear if milk thistle inhibits CYP3A4; research is conflicting.
Read the full Milk Thistle + Abiraterone Acetate interactionAbrocitinibCibinqo
How Abrocitinib interacts with Red Yeast Rice Plus 600 mg — through 2 ingredients. Tap an ingredient for the detail:
N-acetyl-cysteineAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, N-acetyl cysteine might increase the risk of bleeding when taken with anticoagulant or antiplatelet drugs.
Read the full N-acetyl-cysteine + Abrocitinib interactionMilk ThistleCytochrome P450 2c9 (cyp2c9) Substrates Minor
Interaction Summary
It is unclear if milk thistle inhibits CYP2C9; research is conflicting.
Read the full Milk Thistle + Abrocitinib interactionAcarboseGlucobay, Prandase, Precose
How Acarbose interacts with Red Yeast Rice Plus 600 mg — through 2 ingredients. Tap an ingredient for the detail:
Milk ThistleAntidiabetes Drugs Moderate
Interaction Summary
Taking milk thistle with antidiabetes drugs may increase the risk of hypoglycemia.
Read the full Milk Thistle + Acarbose interactionRed Yeast RiceHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use might increase the risk of liver damage.
Read the full Red Yeast Rice + Acarbose interactionAcebutololRhotral, Sectral
How Acebutolol interacts with Red Yeast Rice Plus 600 mg — through 3 ingredients. Tap an ingredient for the detail:
N-acetyl-cysteineAntihypertensive Drugs Moderate
Interaction Summary
Theoretically, N-acetyl cysteine might increase the risk of hypotension when taken with antihypertensive drugs.
Read the full N-acetyl-cysteine + Acebutolol interactionRed Yeast RiceHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use might increase the risk of liver damage.
Read the full Red Yeast Rice + Acebutolol interactionCoenzyme Q10Antihypertensive Drugs Minor
Interaction Summary
Theoretically, coenzyme Q10 might have additive effects with antihypertensive drugs.
Read the full Coenzyme Q10 + Acebutolol interactionAcenocoumarolSintrom
How Acenocoumarol interacts with Red Yeast Rice Plus 600 mg — through 1 ingredient. Tap an ingredient for the detail:
N-acetyl-cysteineAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, N-acetyl cysteine might increase the risk of bleeding when taken with anticoagulant or antiplatelet drugs.
Read the full N-acetyl-cysteine + Acenocoumarol interactionAcetaminophenChildren's Tylenol, Children's Tylenol Meltaways, Tylenol, Tylenol Ex Strength
How Acetaminophen interacts with Red Yeast Rice Plus 600 mg — through 2 ingredients. Tap an ingredient for the detail:
Red Yeast RiceHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use might increase the risk of liver damage.
Read the full Red Yeast Rice + Acetaminophen interactionMilk ThistleGlucuronidated Drugs Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle + Acetaminophen interactionAcetaminophen, AspirinGemnisyn
How Acetaminophen, Aspirin interacts with Red Yeast Rice Plus 600 mg — through 3 ingredients. Tap an ingredient for the detail:
Milk ThistleGlucuronidated Drugs Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle + Acetaminophen, Aspirin interactionN-acetyl-cysteineAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, N-acetyl cysteine might increase the risk of bleeding when taken with anticoagulant or antiplatelet drugs.
Read the full N-acetyl-cysteine + Acetaminophen, Aspirin interactionRed Yeast RiceHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use might increase the risk of liver damage.
Read the full Red Yeast Rice + Acetaminophen, Aspirin interactionAcetaminophen, Aspirin, CaffeineExcedrin, Excedrin Extra Strength, Excedrin Migraine
How Acetaminophen, Aspirin, Caffeine interacts with Red Yeast Rice Plus 600 mg — through 3 ingredients. Tap an ingredient for the detail:
Red Yeast RiceHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use might increase the risk of liver damage.
Read the full Red Yeast Rice + Acetaminophen, Aspirin, Caffeine interactionN-acetyl-cysteineAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, N-acetyl cysteine might increase the risk of bleeding when taken with anticoagulant or antiplatelet drugs.
Read the full N-acetyl-cysteine + Acetaminophen, Aspirin, Caffeine interactionMilk ThistleGlucuronidated Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle + Acetaminophen, Aspirin, Caffeine interactionAcetaminophen, Brompheniramine, PhenylpropanolamineDimetapp Cold and Flu
How Acetaminophen, Brompheniramine, Phenylpropanolamine interacts with Red Yeast Rice Plus 600 mg — through 2 ingredients. Tap an ingredient for the detail:
Red Yeast RiceHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use might increase the risk of liver damage.
Read the full Red Yeast Rice + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionMilk ThistleGlucuronidated Drugs Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionAcetaminophen, ButalbitalAxocet, Bancap, Bucet, Butex Forte, Esgic CF, Orbivan CF +5 more
How Acetaminophen, Butalbital interacts with Red Yeast Rice Plus 600 mg — through 2 ingredients. Tap an ingredient for the detail:
Red Yeast RiceHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use might increase the risk of liver damage.
Read the full Red Yeast Rice + Acetaminophen, Butalbital interactionMilk ThistleGlucuronidated Drugs Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle + Acetaminophen, Butalbital interactionAcetaminophen, Butalbital, CaffeineEsgic, Esgic Plus, Fiogesic, Fioricet, Repan, Tecnal +1 more
How Acetaminophen, Butalbital, Caffeine interacts with Red Yeast Rice Plus 600 mg — through 2 ingredients. Tap an ingredient for the detail:
Milk ThistleGlucuronidated Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle + Acetaminophen, Butalbital, Caffeine interactionRed Yeast RiceHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use might increase the risk of liver damage.
Read the full Red Yeast Rice + Acetaminophen, Butalbital, Caffeine interactionAcetaminophen, Butalbital, Caffeine, CodeineEsgic with Codeine, Fioricet w/ Codeine
How Acetaminophen, Butalbital, Caffeine, Codeine interacts with Red Yeast Rice Plus 600 mg — through 2 ingredients. Tap an ingredient for the detail:
Milk ThistleCytochrome P450 3a4 (cyp3a4) Substrates, Glucuronidated Drugs Moderate
Interaction Summary
It is unclear if milk thistle inhibits CYP3A4; research is conflicting.
Read the full Milk Thistle + Acetaminophen, Butalbital, Caffeine, Codeine interactionRed Yeast RiceHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use might increase the risk of liver damage.
Read the full Red Yeast Rice + Acetaminophen, Butalbital, Caffeine, Codeine interactionAcetaminophen, Butalbital, CodeineBancap w/ Codeine
How Acetaminophen, Butalbital, Codeine interacts with Red Yeast Rice Plus 600 mg — through 2 ingredients. Tap an ingredient for the detail:
Red Yeast RiceHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use might increase the risk of liver damage.
Read the full Red Yeast Rice + Acetaminophen, Butalbital, Codeine interactionMilk ThistleGlucuronidated Drugs Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle + Acetaminophen, Butalbital, Codeine interactionAcetaminophen, Butalbital, Codeine PhosphatePhrenilin #3
How Acetaminophen, Butalbital, Codeine Phosphate interacts with Red Yeast Rice Plus 600 mg — through 2 ingredients. Tap an ingredient for the detail:
Red Yeast RiceHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use might increase the risk of liver damage.
Read the full Red Yeast Rice + Acetaminophen, Butalbital, Codeine Phosphate interactionMilk ThistleGlucuronidated Drugs Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle + Acetaminophen, Butalbital, Codeine Phosphate interactionAcetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, PhenylephrineHycomine Compound
How Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interacts with Red Yeast Rice Plus 600 mg — through 2 ingredients. Tap an ingredient for the detail:
Red Yeast RiceHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use might increase the risk of liver damage.
Read the full Red Yeast Rice + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionMilk ThistleCytochrome P450 3a4 (cyp3a4) Substrates, Glucuronidated Drugs Moderate
Interaction Summary
It is unclear if milk thistle inhibits CYP3A4; research is conflicting.
Read the full Milk Thistle + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionAcetaminophen, Caffeine, CodeineGesic C15, Gesic C30, Gesic C8, Lenoltec 1, Lenoltec 2, Lenoltec 3 +1 more
How Acetaminophen, Caffeine, Codeine interacts with Red Yeast Rice Plus 600 mg — through 2 ingredients. Tap an ingredient for the detail:
Milk ThistleGlucuronidated Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle + Acetaminophen, Caffeine, Codeine interactionRed Yeast RiceHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use might increase the risk of liver damage.
Read the full Red Yeast Rice + Acetaminophen, Caffeine, Codeine interactionAcetaminophen, Caffeine, Codeine, SalicylamideCodalan No.1, Codalan No.2, Codalan No.3
How Acetaminophen, Caffeine, Codeine, Salicylamide interacts with Red Yeast Rice Plus 600 mg — through 2 ingredients. Tap an ingredient for the detail:
Red Yeast RiceHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use might increase the risk of liver damage.
Read the full Red Yeast Rice + Acetaminophen, Caffeine, Codeine, Salicylamide interactionMilk ThistleGlucuronidated Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle + Acetaminophen, Caffeine, Codeine, Salicylamide interactionAcetaminophen, Caffeine, DihydrocodeineDHC Plus, Panlor DC, Panlor SS
How Acetaminophen, Caffeine, Dihydrocodeine interacts with Red Yeast Rice Plus 600 mg — through 2 ingredients. Tap an ingredient for the detail:
Red Yeast RiceHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use might increase the risk of liver damage.
Read the full Red Yeast Rice + Acetaminophen, Caffeine, Dihydrocodeine interactionMilk ThistleCytochrome P450 3a4 (cyp3a4) Substrates, Glucuronidated Drugs Moderate
Interaction Summary
It is unclear if milk thistle inhibits CYP3A4; research is conflicting.
Read the full Milk Thistle + Acetaminophen, Caffeine, Dihydrocodeine interactionAcetaminophen, Caffeine, IsomethepteneMigralam
How Acetaminophen, Caffeine, Isometheptene interacts with Red Yeast Rice Plus 600 mg — through 2 ingredients. Tap an ingredient for the detail:
Milk ThistleGlucuronidated Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle + Acetaminophen, Caffeine, Isometheptene interactionRed Yeast RiceHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use might increase the risk of liver damage.
Read the full Red Yeast Rice + Acetaminophen, Caffeine, Isometheptene interactionAcetaminophen, Caffeine, PyrilamineMidol Max Strength Menstrual
How Acetaminophen, Caffeine, Pyrilamine interacts with Red Yeast Rice Plus 600 mg — through 2 ingredients. Tap an ingredient for the detail:
Red Yeast RiceHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use might increase the risk of liver damage.
Read the full Red Yeast Rice + Acetaminophen, Caffeine, Pyrilamine interactionMilk ThistleCytochrome P450 3a4 (cyp3a4) Substrates, Glucuronidated Drugs Moderate
Interaction Summary
It is unclear if milk thistle inhibits CYP3A4; research is conflicting.
Read the full Milk Thistle + Acetaminophen, Caffeine, Pyrilamine interactionAcetaminophen, Chlorpheniramine Maleate, Dextromethorphan HbrVicks Formula 44M Cough, Cold & Flu Relief
How Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interacts with Red Yeast Rice Plus 600 mg — through 2 ingredients. Tap an ingredient for the detail:
Milk ThistleGlucuronidated Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interactionRed Yeast RiceHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use might increase the risk of liver damage.
Read the full Red Yeast Rice + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interactionAcetaminophen, Chlorpheniramine, Codeine, PhenylephrineColrex
How Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interacts with Red Yeast Rice Plus 600 mg — through 2 ingredients. Tap an ingredient for the detail:
Red Yeast RiceHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use might increase the risk of liver damage.
Read the full Red Yeast Rice + Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interactionMilk ThistleGlucuronidated Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle + Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interactionAcetaminophen, Chlorpheniramine, DextromethorphanCoricidin II Extra Strength Cold and Flu
How Acetaminophen, Chlorpheniramine, Dextromethorphan interacts with Red Yeast Rice Plus 600 mg — through 2 ingredients. Tap an ingredient for the detail:
Red Yeast RiceHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use might increase the risk of liver damage.
Read the full Red Yeast Rice + Acetaminophen, Chlorpheniramine, Dextromethorphan interactionMilk ThistleGlucuronidated Drugs, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Read the full Milk Thistle + Acetaminophen, Chlorpheniramine, Dextromethorphan interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Red Yeast Rice Plus 600 mg with known interactions, here are the types of medications they can affect. Open any type for the detail — or search your exact drug in the checker above.
Milk Thistle
Antidiabetes Drugs
Taking milk thistle with antidiabetes drugs may increase the risk of hypoglycemia.
Clinical research shows that milk thistle extract, alone or along with tree turmeric extract, can lower blood glucose levels and glycated hemoglobin (HbA1c) in patients with type 2 diabetes, including those already taking antidiabetes drugs. Additionally, animal research shows that milk thistle extract increases the metformin maximum plasma concentration and area under the curve and decreases the renal clearance of metformin, due to inhibition of the multi-drug and toxin extrusion protein 1 (MATE1) renal tubular transport protein.
Cytochrome P450 2B6 (Cyp2B6) Substrates
Theoretically, milk thistle might inhibit CYP2B6.
An in vitro study shows that silybin, a constituent of milk thistle, binds to and noncompetitively inhibits CYP2B6. Additionally, silybin might downregulate the expression of CYP2B6 by decreasing mRNA and protein levels.
Glucuronidated Drugs
Theoretically, milk thistle might affect the clearance of drugs that undergo glucuronidation.
Laboratory research shows that milk thistle constituents inhibit uridine diphosphoglucuronosyl transferase (UGT), the major phase 2 enzyme that is responsible for glucuronidation. Theoretically, this could decrease the clearance and increase levels of glucuronidated drugs. Other laboratory research suggests that a milk thistle extract of silymarin might inhibit beta-glucuronidase, although the significance of this effect is unclear.
Ledipasvir
Theoretically, milk thistle might increase the levels and clinical effects of ledipasvir.
Animal research in rats shows that milk thistle increases the area under the curve (AUC) for ledipasvir and slows its elimination.
Morphine
Theoretically, concomitant use of milk thistle with morphine might affect serum levels of morphine and either increase or decrease its effects.
Animal research shows that milk thistle reduces serum levels of morphine by up to 66%. In contrast, laboratory research shows that milk thistle constituents inhibit uridine diphosphoglucuronosyl transferase (UGT), the major phase 2 enzyme that is responsible for glucuronidation. Theoretically, this could decrease the clearance and increase morphine levels. The effect of taking milk thistle on morphine metabolism in humans is not known.
Raloxifene (Evista)
Theoretically, milk thistle might decrease the clearance and increase levels of raloxifene.
Laboratory research suggests that the milk thistle constituents silibinin and silymarin inhibit the glucuronidation of raloxifene in the intestines.
Sirolimus (Rapamune)
Milk thistle might decrease the clearance of sirolimus.
Pharmacokinetic research shows that a milk thistle extract of silymarin decreases the apparent clearance of sirolimus in hepatically impaired renal transplant patients. It is unclear if this interaction occurs in patients without hepatic impairment.
Sofosbuvir (Solvaldi)
Theoretically, milk thistle might decrease the levels and clinical effects of sofosbuvir.
Animal research in rats shows that milk thistle reduces the metabolism of sofosbuvir, as well as the hepatic uptake of its active metabolite.
Tamoxifen (Nolvadex)
Theoretically, the milk thistle constituent silibinin might increase tamoxifen levels and interfere with its conversion to an active metabolite.
Animal research suggests that the milk thistle constituent silibinin might increase plasma levels of tamoxifen and alter its conversion to an active metabolite. The mechanism appears to involve inhibition of pre-systemic metabolism of tamoxifen by cytochrome P450 (CYP) 2C9 and CYP3A4, and inhibition of P-glycoprotein-mediated efflux of tamoxifen into the intestine for excretion. Whether this interaction occurs in humans is not known.
Warfarin (Coumadin)
Theoretically, milk thistle might increase the effects of warfarin.
In one case report, a man stabilized on warfarin experienced an increase in INR from 2.64 to 4.12 after taking a combination product containing milk thistle 200 mg daily, as well as dandelion, wild yam, niacinamide, and vitamin B12. Levels returned to normal after stopping the supplement. Although a direct correlation between milk thistle and the change in INR cannot be confirmed, some in vitro research suggests that milk thistle might inhibit cytochrome P450 2C9 (CYP2C9), an enzyme involved in the metabolism of various drugs, including warfarin.
Cytochrome P450 2C9 (Cyp2C9) Substrates
It is unclear if milk thistle inhibits CYP2C9; research is conflicting.
In vitro research suggests that milk thistle might inhibit CYP2C9. Additionally, 3 case reports from the World Health Organization (WHO) adverse drug reaction database describe increased toxicity in patients taking milk thistle and cancer medications that are CYP2C9 substrates, including imatinib and capecitabine. However, contradictory clinical research shows that milk thistle extract does not inhibit CYP2C9 or significantly affect levels of the CYP2C9 substrate tolbutamide. Differences in results could be due to differences in dosages or formulations utilized.
Cytochrome P450 3A4 (Cyp3A4) Substrates
It is unclear if milk thistle inhibits CYP3A4; research is conflicting.
While laboratory research shows conflicting results, pharmacokinetic research shows that taking milk thistle extract 420-1350 mg daily does not significantly affect the metabolism of the CYP3A4 substrates irinotecan, midazolam, or indinavir. However, 8 case reports from the World Health Organization (WHO) adverse drug reaction database describe increased toxicity in patients taking milk thistle and cancer medications that are CYP3A4 substrates, including gefitinib, sorafenib, doxorubicin, and vincristine.
Estrogens
Theoretically, milk thistle might interfere with estrogen therapy through competition for estrogen receptors.
Animal research suggests that a milk thistle extract of silymarin binds to estrogen receptor beta.
Hmg-Coa Reductase Inhibitors ("Statins")
Theoretically, milk thistle might interfere with statin therapy by decreasing the activity of organic anion transporting polypeptide 1B1 (OATB1B1) and inhibiting breast cancer resistance protein (BCRP).
Preliminary evidence suggests that a milk thistle extract of silymarin can decrease the activity of the OATP1B1, which transports HMG-CoA reductase inhibitors into the liver to their site of action, and animal research shows this increases the maximum plasma concentration of pitavastatin and pravastatin. The silibinin component also inhibits BCRP, which transports statins from the liver into the bile for excretion. However, in a preliminary study in healthy males, silymarin 140 mg three times daily had no effect on the pharmacokinetics of a single 10 mg dose of rosuvastatin.
Indinavir (Crixivan)
Theoretically, milk thistle may induce cytochrome P450 3A4 (CYP3A4) enzymes and increase the metabolism of indinavir; however, results are conflicting.
One pharmacokinetic study shows that taking milk thistle (Standardized Milk Thistle, General Nutrition Corp.) 175 mg three times daily in combination with multiple doses of indinavir 800 mg every 8 hours decreases the mean trough levels of indinavir by 25%. However, results from the same pharmacokinetic study show that milk thistle does not affect the overall exposure to indinavir. Furthermore, two other pharmacokinetic studies show that taking specific milk thistle extract (Legalon, Rottapharm Madaus; Thisilyn, Nature's Way) 160-450 mg every 8 hours in combination with multiple doses of indinavir 800 mg every 8 hours does not reduce levels of indinavir.
Organic Anion-Transporting Polypeptide Substrates (Oatp)
Milk thistle may inhibit one form of OATP, OATP-B1, which could reduce the bioavailability and clinical effects of OATP-B1 substrates.
In vitro research shows that milk thistle inhibits OATP-B1. Two case reports from the World Health Organization (WHO) adverse drug reaction database describe increased toxicity in patients taking milk thistle and cancer medications that are OATP substrates, including sorafenib and methotrexate. OATPs are expressed in the small intestine and liver and are responsible for the uptake of drugs and other compounds into the body. Inhibition of OATP may reduce the bioavailability of oral drugs that are substrates of OATP.
P-Glycoprotein Substrates
Theoretically, milk thistle might increase the absorption of P-glycoprotein substrates. However, this effect does not seem to be clinically significant.
In vitro research shows that milk thistle can inhibit P-glycoprotein activity and 1 case report from the World Health Organization (WHO) adverse drug reaction database describes increased abdominal pain in a patient taking milk thistle and the cancer medication vincristine, a P-glycoprotein substrate, though this patient was also taking methotrexate. However, a small pharmacokinetic study in healthy volunteers shows that taking milk thistle (Enzymatic Therapy Inc.) 900 mg, standardized to 80% silymarin, in 3 divided doses daily for 14 days does not affect absorption of digoxin, a P-glycoprotein substrate.
Red Yeast Rice
Cyclosporine (Neoral, Sandimmune)
Theoretically, taking red yeast rice in combination with cyclosporine might increase the risk of myopathy.
Red yeast rice contains varying levels of the statin drug lovastatin. Cyclosporine has been reported to increase plasma levels of lovastatin by 5- to 20-fold, resulting in reports of myopathy and rhabdomyolysis.
Cytochrome P450 3A4 (Cyp3A4) Inhibitors
Theoretically, drugs that inhibit the CYP3A4 enzymes might increase levels of lovastatin from red yeast rice.
Red yeast rice contains varying levels of the statin drug lovastatin, which is metabolized by CYP3A4. Combining red yeast rice with CYP3A4 inhibitors might increase serum levels of lovastatin from red yeast rice.
Gemfibrozil (Lopid)
Theoretically, taking red yeast rice in combination with gemfibrozil might increase the risk of rhabdomyolysis.
Red yeast rice contains varying levels of the statin drug lovastatin. Gemfibrozil has been reported to increase the risk of rhabdomyolysis when used in combination with lovastatin.
Hepatotoxic Drugs
Theoretically, concomitant use might increase the risk of liver damage.
Red yeast rice contains varying levels of the drug lovastatin. Lovastatin can cause liver damage in some people. Some clinical research suggests that supplements containing red yeast rice might increase liver enzyme levels in some, but not all, participants. Cases of acute hepatitis have been associated with red yeast rice. Combining it with hepatotoxic drugs might further increase this risk.
Hmg-Coa Reductase Inhibitors ("Statins")
Theoretically, taking red yeast rice with other statins might increase the risk of potential adverse effects.
Red yeast rice contains varying levels of the statin drug lovastatin and might result in supratherapeutic levels when used with other statins. Based on evaluation of data from the US Food and Drug Administration's adverse event reporting system (FAERS), it is recommended that red yeast rice products be avoided in people taking prescription statins.
Niacin
Theoretically, taking red yeast rice in combination with high-dose niacin might increase the risk of rhabdomyolysis.
Red yeast rice contains varying levels of the statin drug lovastatin and has been linked to reports of myopathy. Niacin has been reported to increase the risk of rhabdomyolysis when used in combination with lovastatin.
N-Acetyl-Cysteine
Nitroglycerin
N-acetyl cysteine can increase the risk for hypotension and headaches when taken with intravenous or transdermal nitroglycerin.
Clinical research shows that concomitant administration of N-acetyl cysteine and intravenous or transdermal nitroglycerin can cause severe hypotension and intolerable headaches. Furthermore, in vitro research suggests that N-acetyl cysteine increases the anticoagulant activity of nitroglycerin.
Activated Charcoal
N-acetyl cysteine might reduce the effects of activated charcoal, while activated charcoal might reduce the absorption of N-acetyl cysteine.
N-acetyl cysteine appears to reduce the capacity of activated charcoal to adsorb acetaminophen and salicylic acid. Conversely, although clinical research suggests that although activated charcoal can reduce the absorption of N-acetyl cysteine by up to 40%, it does not seem to reduce its clinical effects. Other clinical evidence suggests that activated charcoal does not affect the absorption of N-acetyl cysteine.
Anticoagulant/Antiplatelet Drugs
Theoretically, N-acetyl cysteine might increase the risk of bleeding when taken with anticoagulant or antiplatelet drugs.
Clinical research suggests that intravenous N-acetyl cysteine decreases prothrombin time, prolongs coagulation time, decreases platelet aggregation, and increases blood loss in surgical patients. Furthermore, in vitro research suggests that N-acetyl cysteine increases the anticoagulant activity of nitroglycerin.
Antihypertensive Drugs
Theoretically, N-acetyl cysteine might increase the risk of hypotension when taken with antihypertensive drugs.
Animal research suggests that N-acetyl cysteine potentiates the hypotensive effects of the angiotensin-converting enzyme inhibitors (ACEIs) captopril and enalaprilat. Theoretically, combining N-acetyl cysteine with other antihypertensive drugs might increase the risk of hypotension.
Chloroquine (Aralen)
Theoretically, N-acetyl cysteine might interfere with the antimalarial effects of chloroquine.
Animal research suggests that N-acetyl cysteine might reduce the antimalarial effects of chloroquine by increasing cellular levels of glutathione.
Coenzyme Q10
Alkylating Agents
Coenzyme Q10 has antioxidant effects. Theoretically, this may reduce the activity of chemotherapy drugs that generate free radicals.
Theoretically, antioxidants such as coenzyme Q10 might protect tumor cells from chemotherapeutic agents that work by inducing oxidative stress, such as alkylating agents (e.g., cyclophosphamide) and radiation therapy. The clinical importance of this interaction is unknown.
Warfarin (Coumadin)
Coenzyme Q10 is chemically similar to menaquinone and might have vitamin K-like procoagulant effects, which could decrease the effects of warfarin.
Concomitant use of coenzyme Q10 and warfarin might reduce the anticoagulant effects of warfarin. Four cases of decreased warfarin efficacy thought to be due to coenzyme Q10 have been reported. However, there is some preliminary clinical research that suggests coenzyme Q10 might not significantly decrease the effects of warfarin in patients who have a stable INR.
Antihypertensive Drugs
Theoretically, coenzyme Q10 might have additive effects with antihypertensive drugs.
Some clinical research shows that coenzyme Q10 can significantly lower blood pressure, although other studies have shown conflicting results.
Brand information
Manufacturer and brand details for Red Yeast Rice Plus 600 mg, from the product label.
Vitamin Discount Center
See all Vitamin Discount Center products- Name
- Vitamin Discount Center, LLC
- Street Address
- 5519 Southern Comfort Blvd
- City
- Tampa
- State
- Florida
- ZipCode
- 33634
- Phone Number
- 1-877-832-8722
- Web Address
- VitaminDiscountCenter.com
Red Yeast Rice Plus 600 mg by Vitamin Discount Center: Common Questions
Does Red Yeast Rice Plus 600 mg by Vitamin Discount Center interact with any medications?
How can one product interact with so many drugs?
Where does this information come from?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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The Full Monographs Behind Red Yeast Rice Plus 600 mg’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Coenzyme Q10
Interacts with 198 drugsCoQ10 is a vitamin-like substance your body makes naturally that helps cells produce energy and acts as an antioxidant. It is generally well tolerated and is most studied for heart condition...
Read the full Coenzyme Q10 monograph → Herb & supplement monographN-acetyl Cysteine (nac)
Interacts with 294 drugsN-acetyl cysteine (NAC) is a supplement form of the amino acid cysteine and a building block for the antioxidant glutathione. It has well-established prescription uses for acetaminophen over...
Read the full N-acetyl Cysteine (nac) monograph → Herb & supplement monographRed Yeast Rice
Interacts with 477 drugsRed yeast rice contains monacolin K, which is chemically identical to the prescription statin lovastatin, and it can lower LDL ('bad') cholesterol. Because of this, it carries the same risks...
Read the full Red Yeast Rice monograph → Herb & supplement monographMilk Thistle
Interacts with 954 drugsMilk thistle is a popular herbal supplement most often used for liver health, and its main active component is a group of compounds called silymarin. While it is generally well tolerated, th...
Read the full Milk Thistle monograph →Sources & How We Checked
Red Yeast Rice Plus 600 mg's label data comes from the NIH Dietary Supplement Label Database; the ingredient interaction data is from the Natural Medicines database, reviewed by our pharmacists.
- NIH Dietary Supplement Label Database (DSLD) — The official product label on file for this supplement.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference behind the ingredient interaction data.
Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.
The 245 references behind this product’s interaction data
Every citation that drives the interaction findings for this product’s ingredients, from the evidence-graded Natural Medicines (TRC Healthcare) database. Open an ingredient to browse its citations — links open the study on PubMed or the publisher’s site.
Coenzyme Q10 40 references
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- Langsjoen P, Willis R, Folkers K. Treatment of essential hypertension with coenzyme Q10. Mol Aspects Med 1994;S265-72. PubMed
- Spigset O. Reduced effect of warfarin caused by ubidecarenone. Lancet 1994;334:1372-3. PubMed
- Singh RB, Niaz MA, Rastogi SS, et al. Effect of hydrosoluble coenzyme Q10 on blood pressures and insulin resistance in hypertensive patients with coronary artery disease. J Hum Hypertens 1999;13:203-8. PubMed
- Portakal O, Ozkaya O, Erden Inal M, et al. Coenzyme Q10 concentrations and antioxidant status in tissues of breast cancer patients. Clin Biochem 2000;33:279-84. PubMed
- Lund EL, Quistorff B, Spang-Thomsen M, Kristjansen PE. Effect of radiation therapy on small-cell lung cancer is reduced by ubiquinone intake. Folia Microbiol (Praha) 1998;43:505-6. PubMed
- Langsjoen PH, Langsjoen PH, Folkers K. Long-term efficacy and safety of coenzyme Q10 therapy for idiopathic dilated cardiomyopathy. Am J Cardiol 1990;65:521-3. PubMed
- Heck AM, DeWitt BA, Lukes AL. Potential interactions between alternative therapies and warfarin. Am J Health Syst Pharm 2000;57:1221-7. DOI
- Landbo C, Almdal TP. [Interaction between warfarin and coenzyme Q10]. Ugeskr Laeger 1998;160:3226-7.
- Baggio E, Gandini R, Plauncher AC, et al. Italian multicenter study on the safety and efficacy of coenzyme Q10 as adjunctive therapy in heart failure. CoQ10 Drug Surveillance Investigators. Mol Aspects Med 1994;15 Suppl:S287-94. PubMed
- Burke BE, Neuenschwander R, Olson RD. Randomized, double-blind, placebo-controlled trial of coenzyme Q10 in isolated systolic hypertension. South Med J 2001;94:1112-7. PubMed
- The Huntington Study Group. A randomized, placebo-controlled trial of coenzyme Q10 and remacemide in Huntington's disease. Neurology 2001;57:397-404.
- Hodgson JM, Watts GF, Playford DA, et al. Coenzyme Q10 improves blood pressure and glycaemic control: a controlled trial in subjects with type 2 diabetes. Eur J Clin Nutr 2002;56:1137-42. PubMed
- Singh RB, Neki NS, Kartikey K, et al. Effect of coenzyme Q10 on risk of atherosclerosis in patients with recent myocardial infarction. Mol Cell Biochem 2003;246:75-82. DOI
- Porterfield LM. Why did the response to warfarin change? RN 2000;63:107.
- Sandor PS, Di Clemente L, Coppola G, et al. Efficacy of coenzyme Q10 in migraine prophylaxis: A randomized controlled trial. Neurology 2005;64:713-5. PubMed
- Engelsen J, Nielsen JD, Winther K. Effect of coenzyme Q10 and Ginkgo biloba on warfarin dosage in stable, long-term warfarin treated outpatients. A randomised, double blind, placebo-crossover trial. Thromb Haemost 2002;87:1075-6. DOI
- Berman M, Erman A, Ben-Gal T, et al. Coenzyme Q10 in patients with end-stage heart failure awaiting cardiac transplantation: a randomized, placebo-controlled study. Clin Cardiol 2004;27:295–9. PubMed
- Storch A, Jost WH, Vieregge P, et al. Randomized, double-blind, placebo-controlled trial on symptomatic effects of coenzyme Q10 in Parkinson disease. Arch Neurol 2007;64:938-44. DOI
- Digiesi V, Cantini F, Oradei A, et al. Coenzyme Q10 in essential hypertension. Mol Aspects Med 1994;15 Suppl:s257-63. PubMed
- Yamagami T, Takagi M, Akagami H, et al. Effect of coenzyme Q10 on essential hypertension, a double blind controlled study. In: Folkers KA, Yamamura Y, eds. Biomedical and Clinical Aspects of Coenzyme Q, Vol. 5. Amsterdam: Elsevier Science Publications, 19
- Ho MJ, Bellusci A, Wright JM. Blood pressure lowering efficacy of coenzyme Q10 for primary hypertension (review). Cochrane Database Syst Rev 2009;(4):CD007435. PubMed
- Rosenfeldt, F. L., Haas, S. J., Krum, H., Hadj, A., Ng, K., Leong, J. Y., and Watts, G. F. Coenzyme Q10 in the treatment of hypertension: a meta-analysis of the clinical trials. J Hum.Hypertens. 2007;21(4):297-306. PubMed
- Stamelou, M., Reuss, A., Pilatus, U., Magerkurth, J., Niklowitz, P., Eggert, K. M., Krisp, A., Menke, T., Schade-Brittinger, C., Oertel, W. H., and Hoglinger, G. U. Short-term effects of coenzyme Q10 in progressive supranuclear palsy: a randomized, place DOI
- Keogh A, Fenton S, Leslie C, et al. Randomised double-blind, placebo-controlled trial of coenzyme Q, therapy in class II and III systolic heart failure. Heart Lung Circ. 2003;12:135-41.
- Gane, E. J., Weilert, F., Orr, D. W., Keogh, G. F., Gibson, M., Lockhart, M. M., Frampton, C. M., Taylor, K. M., Smith, R. A., and Murphy, M. P. The mitochondria-targeted anti-oxidant mitoquinone decreases liver damage in a phase II study of hepatitis C
- Lynch, D. R., Perlman, S. L., and Meier, T. A phase 3, double-blind, placebo-controlled trial of idebenone in friedreich ataxia. Arch Neurol. 2010;67(8):941-947. PubMed
- Young, J. M., Florkowski, C. M., Molyneux, S. L., McEwan, R. G., Frampton, C. M., Nicholls, M. G., Scott, R. S., and George, P. M. A randomized, double-blind, placebo-controlled crossover study of coenzyme Q10 therapy in hypertensive patients with the me
- Ishiyama, T., Morita, Y., Toyama, S., Yamagami, T., and Tsukamoto, N. A clinical study of the effect of coenzyme Q on congestive heart failure. Jpn.Heart J 1976;17(1):32-42. PubMed
- Matthews, P. M., Ford, B., Dandurand, R. J., Eidelman, D. H., O'Connor, D., Sherwin, A., Karpati, G., Andermann, F., and Arnold, D. L. Coenzyme Q10 with multiple vitamins is generally ineffective in treatment of mitochondrial disease. Neurology 1993;43(5
- Malm, C., Svensson, M., Sjoberg, B., Ekblom, B., and Sjodin, B. Supplementation with ubiquinone-10 causes cellular damage during intense exercise. Acta Physiol Scand. 1996;157(4):511-512. PubMed
- Singh, R. B., Wander, G. S., Rastogi, A., Shukla, P. K., Mittal, A., Sharma, J. P., Mehrotra, S. K., Kapoor, R., and Chopra, R. K. Randomized, double-blind placebo-controlled trial of coenzyme Q10 in patients with acute myocardial infarction. Cardiovasc. PubMed
- Digiesi V, Cantini F, and Brodbeck B. Effect of coenzyme Q10 on essential arterial hypertension. Current Therapeutic Research 1990;47(5):841-845.
- Parkinson Study Group QE3 Investigators, Beal MF, Oakes D, et al. A randomized clinical trial of high-dosage coenzyme Q10 in early Parkinson disease: no evidence of benefit. JAMA Neurol. 2014;71(5):543-52.
- Alehagen U, Johansson P, Bjornstedt M, et al. Cardiovascular mortality and N-terminal-proBNP reduced after combined selenium and coenzyme Q10 supplementation: A 5-year prospective randomized double-blind placebo-controlled trial among elderly Swedish citi
- Ho MJ, Li EC, Wright JM. Blood pressure lowering efficacy of coenzyme Q10 for primary hypertension. Cochrane Database Syst Rev. 2016 Mar 3;3:CD007435. doi: 10.1002/14651858.CD007435.pub3. PubMed
- Tabrizi R, Akbari M, Sharifi N, Lankarani KB, Moosazadeh M, Kolahdooz F, et al. The effects of coenzyme Q10 supplementation on blood pressures among patients with metabolic diseases: a systematic review and meta-analysis of randomized controlled trials. PubMed
- Tsai IC, Hsu CW, Chang CH, Tseng PT, Chang KV. Effectiveness of coenzyme Q10 supplementation for reducing fatigue: A systematic review and meta-analysis of randomized controlled trials. Front Pharmacol 2022;13:883251. PubMed
- Yaghini O, Hoseini N, Ghazavi MR, et al. A comparative study on the efficacy of coenzyme Q10 and amitriptyline in the prophylactic treatment of migraine headaches in children: A randomized controlled trial. Adv Biomed Res 2022;11:43. PubMed
- Hansen KS, Mogensen TH, Agergaard J, et al. High-dose coenzyme Q10 therapy versus placebo in patients with post COVID-19 condition: A randomized, phase 2, crossover trial. Lancet Reg Health Eur 2022. PubMed
N-acetyl Cysteine (nac) 86 references
- Ellenhorn MJ, et al. Ellenhorn's Medical Toxicology: Diagnoses and Treatment of Human Poisoning. 2nd ed. Baltimore, MD: Williams & Wilkins, 1997.
- Jepsen S, Hansen AB. The influence of N-acetylcysteine on the measurement of prothrombin time and activated partial thromboplastin time in healthy subjects. Scand J Clin Lab Invest 1994;54:543-7. PubMed
- van Zandwijk N, Dalesio O, Pastorino U, et al. EUROSCAN, a randomized trial of vitamin A and N-acetylcysteine in patients with head and neck cancer or lung cancer. For the European Organization for Research and Treatment of Cancer Head and Neck and Lung C DOI
- Horowitz RS, Dart RC, Jarvie DR, et al. Placental transfer of N-acetylcysteine following human maternal acetaminophen toxicity. J Toxicol Clin Toxicol 1997;35:447-51.
- Bailey B, McGuigan MA. Management of anaphylactoid reactions to intravenous N-acetylcysteine. Ann Emerg Med 1998;31:710-5. PubMed
- Spiller HA, Krenzelok EP, Grande GA, et al. A prospective evaluation of the effect of activated charcoal before oral N-acetylcysteine in acetaminophen overdose. Ann Emerg Med 1994;23:519-23. PubMed
- Ardissino D, Merlini PA, Savonitto S, et al. Effect of transdermal nitroglycerin or N-acetylcysteine, or both, in the long-term treatment of unstable angina pectoris. J Am Coll Cardiol 1997;29:941-7. PubMed
- Horowitz JD, Henry CA, Syrjanen ML, et al. Nitroglycerine/N-acetylcysteine in the management of unstable angina pectoris. Eur Heart J 1988;9:95-100. PubMed
- Louwerse ES, Weverling GJ, Bossuyt PM, et al. Randomized, double-blind, controlled trial of acetylcysteine in amyotrophic lateral sclerosis. Arch Neurol 1995;52:559-64. PubMed
- Wiklund O, Fager G, Andersson A, et al. N-acetylcysteine treatment lowers plasma homocysteine but not serum lipoprotein(a) levels. Atherosclerosis 1996;119:99-106. PubMed
- De Flora S, Grassi C, Carati L. Attenuation of influenza-like symptomatology and improvement of cell-mediated immunity with long-term N-acetylcysteine treatment. Eur Respir J 1997;10:1535-41. PubMed
- Iversen HK. N-acetylcysteine enhances nitroglycerin-induced headache and cranial arterial responses. Clin Pharmacol Ther 1992;52:125-33. PubMed
- Behr J, Maier K, Degenkolb B, et al. Antioxidative and clinical effects of high-dose N-acetylcysteine in fibrosing alveolitis. Adjunctive therapy to maintenance immunosuppression. Am J Respir Crit Care Med 1997;156:1897-901.
- Tenenbein PK, Sitar DS, Tenenbein M. Interaction between N-acetylcysteine and activated charcoal: implications for the treatment of acetaminophen poisoning. Pharmacotherapy 2001;21:1331-6.
- Arstall MA, Yang J, Stafford I, et al. N-acetylcysteine in combination with nitroglycerin and streptokinase for the treatment of evolving acute myocardial infarction. Safety and biochemical effects. Circulation 1995;92:2855-62.
- Estensen RD, Levy M, Klopp SJ, et al. N-acetylcysteine suppression of the proliferative index in the colon of patients with previous adenomatous colonic polyps. Cancer Lett 1999;147:109-14. PubMed
- Pela R, Calcagni AM, Subiaco S, et al. N-acetylcysteine reduces the exacerbation rate in patients with moderate to severe COPD. Respiration 1999;66:495-500.. PubMed
- Oldemeyer JB, Biddle WP, Wurdeman RL, et al. Acetylcysteine in the prevention of contrast-induced nephropathy after coronary angiography. Am Heart J 2003;146:E23. . PubMed
- Ekins BR, Ford DC, Thompson MI, et al. The effect of activated charcoal on N-acetylcysteine absorption in normal subjects. Am J Emerg Med. 1987;5(6):483-7. PubMed
- Chamberlain JM, Gorman RL, Oderda GM, Klein-Schwartz W, Klein BL. Use of activated charcoal in a simulated poisoning with acetaminophen: a new loading dose for N-acetylcysteine? Ann Emerg Med. 1993;22(9):1398-402. PubMed
- Renzi FP, Donovan JW, Martin TG, Morgan L, Harrison EF. Concomitant use of activated charcoal and N-acetylcysteine. Ann Emerg Med. 1985;14(6):568-72. DOI
- North DS, Peterson RG, Krenzelok EP. Effect of activated charcoal administration on acetylcysteine serum levels in humans. Am J Hosp Pharm. 1981;38(7):1022-4. DOI
- Loscalzo J. N-Acetylcysteine potentiates inhibition of platelet aggregation by nitroglycerin. J Clin Invest. 1985;76(2):703-8. PubMed
- Ruiz FJ, Salom MG, Inglés AC, et al. N-acetyl-L-cysteine potentiates depressor response to captopril and enalaprilat in SHRs. Am J Physiol. 1994;267(3 Pt 2):R767-72. PubMed
- Deharo E, Barkan D, Krugliak M, Golenser J, Ginsburg H. Potentiation of the antimalarial action of chloroquine in rodent malaria by drugs known to reduce cellular glutathione levels. Biochem Pharmacol. 2003;66(5):809-17. PubMed
- Buckley, N. A., Whyte, I. M., O'Connell, D. L., and Dawson, A. H. Oral or intravenous N-acetylcysteine: which is the treatment of choice for acetaminophen (paracetamol) poisoning? J Toxicol.Clin Toxicol. 1999;37(6):759-767.
- Sunman, W., Hughes, A. D., and Sever, P. S. Anaphylactoid response to intravenous acetylcysteine. Lancet 5-16-1992;339(8803):1231-1232. PubMed
- Reynard, K., Riley, A., and Walker, B. E. Respiratory arrest after N-acetylcysteine for paracetamol overdose. Lancet 9-12-1992;340(8820):675. PubMed
- BERNSTEIN, I. L. and AUSDENMOORE, R. W. IATROGENIC BRONCHOSPASM OCCURRING DURING CLINICAL TRIALS OF A NEW MUCOLYTIC AGENT, ACETYLCYSTEINE. Dis.Chest 1964;46:469-473. PubMed
- REAS, H. W. THE USE OF N-ACETYLCYSTEINE IN THE TREATMENT OF CYSTIC FIBROSIS. J Pediatr 1964;65:542-557. PubMed
- Bibi, H., Seifert, B., Oullette, M., and Belik, J. Intratracheal N-acetylcysteine use in infants with chronic lung disease. Acta Paediatr. 1992;81(4):335-339. PubMed
- Jepsen, S., Herlevsen, P., Knudsen, P., Bud, M. I., and Klausen, N. O. Antioxidant treatment with N-acetylcysteine during adult respiratory distress syndrome: a prospective, randomized, placebo-controlled study. Crit Care Med 1992;20(7):918-923. PubMed
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See these in context on the N-acetyl Cysteine (nac) monograph →
Red Yeast Rice 50 references
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Milk Thistle 69 references
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DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.
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