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In clinical trials, use of red yeast rice has not been associated with any significant side effects. However, red yeast rice contains naturally occurring statin drugs, and use of statin drugs can cause side effects ranging from minor to life-threatening. Some of the most common include muscle pain, joint pain, liver inflammation, and peripheral nerve damage; severe breakdown of muscle tissue (rhabdomyolysis) leading to kidney failure has also occurred. It is almost certain that red yeast rice can cause the same problems if it is used by enough people, and there are at least two case reports in the literature of muscle injury caused by red yeast rice; in one case, rhabdomyolosis developed. 1 Due to the relative lack of regulation of supplement manufacture, the statin content of red yeast rice products is unpredictable, and this could increase potential risk. In addition, red yeast rice may at times contain the toxic substance citrinin. 2 Based on the known effects of statins, pregnant or nursing women, women likely to become pregnant, young children, and people with liver or kidney disease should not use red yeast rice. Furthermore, red yeast rice should not be combined with fibrate drugs , cyclosporine , erythromycin-family drugs, antifungal drugs, or high-dose niacin . Finally, it would not make sense to combine red yeast rice with standard statin drugs.
Statin drugs are known to interfere with the body’s ability to produce the natural substance CoQ 10 , 3 4 and one animal study found the same effect with red yeast rice. 5 For this reason, people taking red yeast rice could conceivably benefit from CoQ 10 supplementation; however, this has not yet been proven. (See the full article on Statins for more information.)
Interactions You Should Know About
If you are taking fibrate drugs , cyclosporine , erythromycin-family drugs, antifungal drugs, or high-dose niacin , do not use red yeast rice.
If you use red yeast rice to keep your cholesterol levels down, taking the herb St. John’s wort may impair the effectiveness of red yeast rice and cause your cholesterol to rise.
- Prasad GV, Wong T, Meliton G, et al. Rhabdomyolysis due to red yeast rice ( Monascus purpureus ) in a renal transplant recipient. Transplantation. 2002;74:1200-1201.
- Liu BH, Wu TS, Su MC, et al. Evaluation of citrinin occurrence and cytotoxicity in Monascus fermentation products. J Agric Food Chem. 2005;53:170-175.
- Silver MA, Langsjoen PH, Szabo S, Patil H, Zelinger A. Effect of atorvastatin on left ventricular diastolic function and ability of coenzyme Q10 to reverse that dysfunction. Am J Cardiol. 94(10):1306-10.
- Rundek T, Naini A, Sacco R, Coates K, DiMauro S. Atorvastatin decreases the coenzyme Q10 level in the blood of patients at risk for cardiovascular disease and stroke. Arch Neurol. 61(6):889-92.
- Yang HT, Lin SH, Huang SY, et al. Acute administration of red yeast rice ( Monascus purpureus ) depletes tissue coenzyme Q(10) levels in ICR mice. Br J Nutr. 2005;93:131-135.