Does Red Yeast Rice Interact With Tagrisso?
In our latest question and answer, our pharmacist discusses the interaction between Tagrisso and red yeast rice.
Does Red Yeast Rice interact with Tagrisso (osimertinib)? Thank you.
Feb 02, 2023- Red yeast rice can interact with Tagrisso because Tagrisso blocks an enzyme that breaks down red yeast rice, potentially causing it to build up in your blood. This interaction may increase the risk of muscle pain and weakness similar to side effects seen with statin medications. It's important to tell your doctor about all supplements you're taking, including red yeast rice, and report any muscle symptoms that develop.
Answer
Thanks for reaching out! Yes, red yeast rice has a theoretical interaction with Tagrisso (osimertinib).
We have comprehensive interaction details that can be found on the 'drug-herbal interaction' part of our website, but the summary of the interaction is as follows:
- Red yeast rice is metabolized, at least partially, by the CYP3A4 enzyme
- Tagrisso is known to be an inhibitor of the CYP3A4 enzyme
- Taking red yeast rice and Tagrisso may increase the risk of certain side effects, such as muscle pain and weakness, due to increased concentrations of red yeast rice in the blood due to CYP3A4 inhibition
What Is Red Yeast Rice?
Red yeast rice is a type of yeast that is grown on rice and is commonly used as a dietary supplement. It contains compounds known as monacolins, which are natural inhibitors of the enzyme HMG-CoA reductase. Inhibiting HMG-CoA reductase is the same mechanism via which 'statin' drugs, like Lipitor and Zocor, work.
HMG-CoA reductase is involved in the production of cholesterol in the body, and blocking its activity leads to a reduction in cholesterol levels.
Interaction Details
Now, the interaction between Tagrisso and red yeast rice is an interesting one since, in this case, we have a drug potentially interfering with an herbal. The prescribing information for Tagrisso states the following:
Osimertinib is a competitive inhibitor of CYP3A, but not CYP2C8, 1A2, 2A6, 2B6, 2C9, 2C19, 2D6 and 2E1 in vitro.
Since red yeast rice works in essentially the same way as 'statin' medications, this interaction increases the risk of statin-like side effects, such as muscle pain and weakness.
It is not known how severe this interaction is, or at what doses of red yeast rice it becomes clinically significant as comprehensive research hasn't been done in this area.
It is crucial to be aware of the potential effects of taking red yeast rice and Tagrisso (osimertinib) together.
If you experience any adverse effects from the combination, it is important to seek medical attention.
To ensure proper monitoring and prevent any potential interactions, it is important to inform your doctor of all medications, including supplements, that you are taking.
Final Words
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References & sources
- Interaction between Red Yeast Rice and CYP450 Enzymes/P-Glycoprotein and Its Implication for the Clinical Pharmacokinetics of Lovastatin — PubMed
- Assessment of Extracts from Red Yeast Rice for Herb-Drug Interaction by in-vitro and in-vivo assays — Nature
- Red Yeast Rice: A Systematic Review of the Traditional Uses, Chemistry, Pharmacology, and Quality Control of an Important Chinese Folk Medicine — Frontiers
- Tagrisso Prescribing Information — AccessFDA
Glossary — Terms in This Answer
- CYP3A4 enzyme
- A protein in your body that breaks down and processes many medications and supplements.
- Inhibitor
- A substance that blocks or slows down the activity of an enzyme or other biological process.
- Monacolins
- Active compounds found in red yeast rice that work to lower cholesterol levels.
- HMG-CoA reductase
- An enzyme in your body that is involved in making cholesterol.
- Statins
- A class of medications that lower cholesterol by blocking the enzyme that produces it.
- Osimertinib
- The generic name for the drug Tagrisso, used to treat certain types of cancer.
- Competitive inhibitor
- A substance that blocks an enzyme's activity by competing with other molecules for the same binding site.
- Adverse effects
- Unwanted or harmful reactions that occur from taking a medication or supplement.
Dr. Brian Staiger, PharmD
Doctor of Pharmacy, board certified clinical pharmacist (BCPS), American Herbalist Guild, Medication Therapy Management certified
Brian Staiger, PharmD, BCPS, is a licensed pharmacist with more than 13 years of experience across retail pharmacy, clinical pharmacy, medication safety, pharmacy program development, and healthcare administration. He is the founder of HelloPharmacist.com, where he helps patients...
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