Cholesterol/LipidsRed Yeast Rice

Benefit of red yeast rice in statin-intolerant patients

People experiencing statin-associated myopathy include pain and muscle weakness. This muscle pain (myalgia) is estimated to affect 10% to 15% of patients taking statins.

Researchers at the University of Pennsylvania School of Medicine, Philadelphia evaluated the tolerability of red yeast rice vs pravastatin (Pravachol) in patients unable to tolerate statins because of myalgia.

First, the details.

  • 43 adults with high cholesterol blood levels and a history of stopping treatment with a statin because of muscle pain were randomly assigned to a treatment group for 12 weeks.
    • Red yeast rice 2,400 mg twice daily
    • Pravastatin 20 mg twice daily
  • Patients were also enrolled in a 12-week therapeutic lifestyle change program.

And, the results.

  • The incidence of withdrawal from medication owing to myalgia was 5% (1 patient) in the red yeast rice group and 9% (2 patients) in the pravastatin group — not significant.
  • Average pain severity did not differ significantly between the groups.
  • No difference was found in muscle strength between the groups at weeks 4, 8 or 12.
  • LDL (bad) cholesterol levels decreased 30% in the red yeast rice group vs 27% with pravastatin.

The bottom line?

The authors concluded, “Red yeast rice was tolerated as well as pravastatin and achieved a comparable reduction of low-density lipoprotein cholesterol in a population previously intolerant to statins.”

Others have reported the effectiveness of red yeast rice.

This study is important because it’s the first to show that red yeast rice is as well tolerated as pravastatin in patients with a history of muscle pain due to prescription statins.

However, high cholesterol is not something to be treated without the oversight of a qualified medical doctor. There are recognized target blood levels for cholesterol, and these targets must be monitored routinely.

Members of the statin group of drugs include the following.

  • Atorvastatin (Lipitor)
  • Fluvastatin (Lescol)
  • Lovastatin (Mevacor, Altoprev)
  • Pravastatin (Pravachol)
  • Rosuvastatin Calcium (Crestor)
  • Simvastatin (Zocor)

The other suggestion from these data is that a past history statin-associated myalgia does not rule out the option of trying another statin later.  After all, the active ingredient in red yeast rice is the same as in lovastatin.

1/22/10 19:02 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, a complementary and alternative medicine website.