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Red Yeast Rice × Statins

CRITICAL INTERACTION — Well-Established Evidence

⚠️ Mechanism

Red yeast rice contains monacolin K (lovastatin). Combined with prescription statins, this doubles statin dose and increases myopathy/rhabdomyolysis risk.

📋 Effect

Additive statin effect; increased myopathy and rhabdomyolysis risk

💊 Management

Avoid combination. Red yeast rice IS a statin — do not combine with prescription statins.

Plain Language Summary

This combination is dangerous because red yeast rice contains the same active ingredient found in prescription statins. Taking them together can act like a double dose, which increases the risk of serious muscle damage.

Source

FDA warning; Gordon RY et al. Am J Cardiol 2010

Supporting Research

Impact of red yeast rice supplementation on lipid profile: a systematic review and meta-analysis of randomized-controlled trials PMID:36259545 DOI:10.1080/17512433.2023.2138342 2023
Low Dose Monacolin K Combined with Coenzyme Q10, Grape Seed, and Olive Leaf Extracts Lowers LDL Cholesterol in Patients with Mild Dyslipidemia: A Multicenter, Randomized Controlled Trial PMID:37375586 DOI:10.3390/nu15122682 2023
Original Research: The Effects of Red Yeast Rice Supplementation on Cholesterol Levels in Adults PMID:28749884 DOI:10.1097/01.NAJ.0000521973.38717.2e 2017
Randomized, Double-Blind, Placebo-Controlled Trial to Test the Effects of a Nutraceutical Combination Monacolin K-Free on the Lipid and Inflammatory Profile of Subjects with Hypercholesterolemia PMID:35889769 DOI:10.3390/nu14142812 2022
Low dose red yeast rice with monacolin K lowers LDL cholesterol and blood pressure in Japanese with mild dyslipidemia: A multicenter, randomized trial PMID:34587702 DOI:10.6133/apjcn.202109_30(3).0009 2021
Impact of Monacolin K-Containing Supplements on Lipid Profile: A Meta-Analysis of Randomised Controlled Trials PMID:41681060 DOI:10.1002/edm2.70166 2026
Traditional Chinese lipid-lowering agent red yeast rice results in significant LDL reduction but safety is uncertain - a systematic review and meta-analysis PMID:25897793 DOI:10.1016/j.atherosclerosis.2015.04.004 2015
Effects of a nutraceutical combination containing berberine (BRB), policosanol, and red yeast rice (RYR), on lipid profile in hypercholesterolemic patients: A meta-analysis of randomised controlled trials PMID:27131395 DOI:10.1016/j.arteri.2016.03.002 2016
Medical Disclaimer: This interaction record is for informational and educational purposes only and does not constitute medical advice. Drug-supplement interactions can be dangerous. Always consult your healthcare provider or pharmacist before combining any supplement with prescription medications. Do not stop or change any medication without professional guidance.