Dr. Désirée Lie from the University of California in Orange has reviewed the evidence.

Here are the highlights.

What it is.

  • Fermented red yeast (Monascus purpureus) grown on rice.
  • Studies show it may lower cholesterol and triglyceride levels.

What it contains.

  • Several compounds collectively known as monacolins.
  • Monacolin K is a powerful 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitor and the same chemical as lovastatin (Mevacor).
  • Monacolin K is not approved for use in the US, and the FDA ordered it taken off the market in 2001.

Is it safe?

  • Concerns about red yeast rice toxicity are based on monacolin K.
  • Myopathy and rhabdomyolysis — similar to that seen with lovastatin — have been reported.
  • Evidence for liver toxicity is controversial.

Drug/herbal/food interactions

  • Digoxin (Lanoxin)
  • Antibiotics, such as azithromycin (Zithromax), clarithromycin (Biaxin), and ketoconazole (Nizoral)
  • Thyroid drugs
  • Increase bleeding risk when taken with warfarin (Coumadin), heparin, clopidogrel (Plavix), nonsteroidal anti-inflammatory drugs, and herbals (ginkgo biloba, garlic)
  • Other cholesterol-lowering drugs, such as fibrates (fenofibrate [Tricor]) and niacin.
  • Grapefruit juice may increase the effects of red yeast rice.

The bottom line?
Monacolin K lowers cholesterol levels, and there is also some evidence that it has a positive effect on cardiovascular health, blood flow, and diabetes.

“However,” says Dr. Lie, “because red yeast rice products in the United States no longer include natural lovastatin and few red yeast rice products worldwide are standardized, such benefits are unclear.”

9/29/08 21:22 JR

Hi, I’m JR

John Russo, Jr., PharmD, is president of The MedCom Resource, Inc. Previously, he was senior vice president of medical communications at www.Vicus.com, a complementary and alternative medicine website.