Red Yeast Rice : Safety and Interactions

by MedlinePlus

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Safety

Allergies

There is one report of anaphylaxis (a severe allergic reaction) in a butcher who touched meat containing red yeast.

Side Effects and Warnings

There is limited evidence about the side effects of red yeast. Mild headache and abdominal discomfort can occur. Side effects may be similar to those for the prescription drug lovastatin (Mevacor®). Heartburn, gas, bloating, muscle pain or damage, dizziness, asthma, and kidney problems are possible. People with liver disease should not use red yeast products.

In theory, red yeast may increase the risk of bleeding. Caution is advised in patients with bleeding disorders or taking drugs that may increase the risk of bleeding. Dosing adjustments may be necessary. A metabolite of Monascus species called mycotoxin citrinin (CTN) in fermentation may be harmful.

Pregnancy and Breastfeeding

Prescription drugs with similar chemicals as red yeast cannot be used during pregnancy. Therefore, it is strongly recommended that pregnant or breast-feeding women not take red yeast.

Interactions

Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy.

Interactions with Drugs

There are not many studies of the interactions of red yeast rice extract with drugs. However, because red yeast rice extract contains the same chemicals as the prescription drug lovastatin, the interactions may be the same. Fibrate drugs or other cholesterol -lowering medication may cause additive effects or side effects when taken with red yeast. Alcohol and other drugs that may be toxic to the liver should be avoided with red yeast rice extract. Taking cyclosporine, ranitidine (Zantac®) and certain antibiotics with red yeast rice extract may increase the risk of muscle breakdown or kidney damage.

Certain drugs may interfere with the way the body processes red yeast using the liver's "cytochrome P450" enzyme system. Inhibitors of cytochrome P450 may increase the chance of muscle and kidney damage if taken with red yeast. Check with your doctor and pharmacist.

In theory, red yeast may increase the risk of bleeding when taken with drugs that increase the risk of bleeding. Some examples include aspirin, anticoagulants ("blood thinners") such as warfarin (Coumadin®) or heparin, anti-platelet drugs such as clopidogrel (Plavix®), and non-steroidal anti-inflammatory drugs such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®, Aleve®).

Red yeast may produce gamma-aminobutyric acid (GABA), and therefore can have additive effects when taken with drugs that affect GABA such as neurontin (Gabapentin®).

Interactions with Herbs and Dietary Supplements

Red yeast may interact with products that cause liver damage or are broken down in the liver. Grapefruit juice may increase the blood levels of red yeast. Milk thistle, St. John's wort, niacin and vitamin A may interact with red yeast rice extract. Coenzyme Q levels may be lowered by red yeast rice extract. Cholesterol-lowering herbs and supplements like guggul or fish oils may have increased effects when taken with red rice yeast

Certain herbs and supplements may interfere with the way the body processes red yeast using the liver's "cytochrome P450" enzyme system. Inhibitors of cytochrome P450 may increase the chance of muscle and kidney damage if taken with red yeast. Check with your doctor and pharmacist. Examples include bloodroot, cat's claw, chamomile, chaparral, chasteberry, damiana, Echinacea angustifolia , goldenseal, grapefruit juice, licorice, oregano, red clover, St. John's wort, wild cherry, and yucca. If you are using any medications, check the package insert and speak with your healthcare provider and pharmacist about possible interactions.

In theory, red yeast may increase the risk of bleeding when taken with herbs and supplements that are believed to increase the risk of bleeding. Multiple cases of bleeding have been reported with the use of Ginkgo biloba , and fewer cases with garlic and saw palmetto. Numerous other agents may theoretically increase the risk of bleeding, although this has not been proven in most cases. Some examples include: alfalfa, American ginseng, angelica, anise, Arnica montana , asafetida, aspen bark, bilberry, birch, black cohosh, bladderwrack, bogbean, boldo, borage seed oil, bromelain, capsicum, cat's claw, celery, chamomile, chaparral, clove, coleus, cordyceps, danshen, devil's claw, dong quai, EPA (eicosapentaenoic acid, found in fish oils), evening primrose oil, fenugreek, feverfew, fish oil, flaxseed/flax powder (not a concern with flaxseed oil), ginger, grapefruit juice, grapeseed, green tea, guggul, gymnestra, horse chestnut, horseradish, licorice root, lovage root, male fern, meadowsweet, nordihydroguairetic acid (NDGA), omega-3 fatty acids, onion, papain, panax ginseng, parsley, passionflower, poplar, prickly Ash, propolis, quassia, red clover, reishi, Siberian ginseng, sweet clover, rue, sweet birch, sweet clover, turmeric , vitamin E, white willow, wild carrot, wild lettuce, willow, wintergreen, and yucca.

Interactions with Food

Food may enhance the absorption of red yeast.

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