Risks of Red Yeast Rice Supplements

Medically Reviewed

Q. Can I use red yeast rice to lower my cholesterol?

A. A traditional Chinese medicine, red yeast rice—created by combining rice with strains of red yeast—is touted as a way to lower cholesterol and lipid levels.

Red yeast rice contains a substance called monacolin K, the active ingredient in the cholesterol lowering drug lovastatin.

However, U.S. Food and Drug Administration (FDA) tests on a variety of consumer red yeast rice brands revealed that some supplements contained significant amounts of monacolin K and others just traces. Even worse, some products contained the toxic chemical citrinin, which has caused kidney problems in animal experiments as well as damage to human cells in studies.

The FDA considers any red yeast rice products containing more than trace amounts of monacolin K to be unapproved drugs that can’t be sold legally as dietary supplements. You may be taking a big risk by using them.

Not only do you not know how much monacolin K you’re ingesting, but you also don’t know what other substances are in the products. Monacolin K, whether ingested in red yeast rice or lovastatin, can cause side effects such as muscle pain and weakness, rhabdomyolysis (a dangerous breakdown of muscle tissue), and liver poisoning.

Bottom line

If you’re determined to try red yeast rice, talk with your doctor first and never take a statin at the same time. Red yeast rice—as well as lovastatin—also interacts with certain antibiotics, the antidepressant nefazodone, antifungals, and HIV drugs.