Red yeast rice

Red yeast rice is a product made by fermenting red rice with a specific type of yeast. It is also known as Cholestin, Hypocol, Xuezhikang, or Zhitai.

Red yeast rice supplements are different from the red yeast rice sold in Chinese grocery stores.

Red yeast rice has been used in alternative medicine as a likely effective way to lower "bad" cholesterol (low-density lipoprotein, or LDL) and triglycerides in the blood.

Red yeast rice has been used as a possibly effective way to reduce the risk of heart disease, heart attacks, or death in people who have a history of heart attack.

Red yeast rice has also been used as a possibly effective way to lower cholesterol and triglyceride levels in people with human immunodeficiency virus (HIV).

Red yeast rice has been used to treat high blood pressure. However, research has shown that red yeast rice may not be effective for this condition.

Other uses that have not been proven by research include: lowering cholesterol and blood sugar levels in people with diabetes, improving blood circulation, lowering liver enzymes related to liver damage, and treating diarrhea, indigestion, or other stomach issues.

It is not clear if red yeast rice is effective in treating any medical condition. The FDA has not approved the medicinal use of this product. Red yeast rice should not be used instead of medication prescribed by your doctor.

Red yeast rice is often sold as an herbal supplement. Many herbal compounds do not have regulated manufacturing standards, and some supplements on the market have been found to be contaminated with toxic metals or other drugs. Herbal/health supplements should be bought from a trusted source to reduce the risk of contamination.

Red yeast rice may also be used for purposes not listed in this product guide.

Red yeast rice contains an active ingredient called monacolin K, which is the same as the active drug in the "statin" cholesterol medicine lovastatin (Advicor, Altoprev, Mevacor). Because of this, red yeast rice supplements may cause the same side effects and drug interactions as statin cholesterol medications and may lower the levels of other products like coenzyme Q-10.

The US Food and Drug Administration (FDA) considers red yeast products that have more than small amounts of this statin-like ingredient to be illegal and unapproved drugs. Red yeast rice products sold in the United States are made not to have high levels of monacolin K. However, red yeast rice with higher levels of monacolin K can still be found in other countries.

When thinking about using herbal supplements, talk to your doctor. You may also want to consult a practitioner who is trained in the use of herbal/health supplements.

If you decide to use red yeast rice, follow the instructions on the package or those given by your doctor, pharmacist, or other healthcare provider. Do not use more of this product than what is recommended on the label.

Red yeast rice works best if you take it with food.

Do not inhale the powder from a red yeast rice capsule. It may cause an allergic reaction.

Call your doctor if the condition you are treating with red yeast rice does not improve, or if it gets worse while using this product.

Store at room temperature away from moisture and heat.

Follow all instructions on the product label and package. Inform each of your healthcare providers about all your medical conditions, allergies, and all medicines you are taking.

You should not use red yeast rice if you are allergic to it, or:

• if you already take a cholesterol-lowering medication, such as lovastatin, simvastatin, atorvastatin, rosuvastatin, Zocor, Lipitor, Pravachol, Crestor, Vytorin, and many others.

Talk with your healthcare provider before using red yeast rice to lower your cholesterol. You should not use red yeast rice instead of any medication that has been prescribed by your doctor.

Ask a doctor, pharmacist, or other healthcare provider if it is safe for you to use this product if you have or have ever had:

• liver disease; or
• kidney disease.

Red yeast rice has caused birth defects in animals and is likely unsafe to use during pregnancy. Do not use this product without medical advice if you are pregnant.

It is not known whether red yeast rice passes into breast milk or if it could harm a nursing baby. Do not use this product without medical advice if you are breastfeeding a baby.

Do not give any herbal/health supplement to a child without medical advice.

Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Although not all side effects are known, red yeast rice is thought to be possibly safe when taken as directed for up to 4.5 years.

Stop using red yeast rice and call your healthcare provider immediately if you have:

• unexplained muscle pain, tenderness, or weakness;
• fever, unusual tiredness; or
• nausea, upper stomach pain, itching, tiredness, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Common side effects of red yeast rice may include:

• constipation; or
• stomach discomfort.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Skip the missed dose and take your next dose at the usual time. Do not take two doses at once.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Drinking alcohol may increase your risk of liver damage.

• Avoid using red yeast rice together with other herbal/health supplements that can harm your liver, such as androstenedione, chaparral, comfrey, DHEA, germander, kava, niacin, pennyroyal oil, and others.

Grapefruit may interact with red yeast rice and cause side effects. Avoid consuming grapefruit products.

• Avoid taking an herbal supplement containing St. John's wort.

Do not take red yeast rice without medical advice if you are using a medication to treat any of the following conditions:

• any type of infection (viral, bacterial, or fungal), including HIV or tuberculosis;
• arthritis, including gold injections;
• cancer;
• depression or a psychiatric disorder;
• high blood pressure, high cholesterol, or a heart condition;
• pain or headaches, especially if you take an NSAID (nonsteroidal anti-inflammatory drugs) such as aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others;
• prevention of organ transplant rejection; or
• seizures.

This list is not complete. Other drugs may affect red yeast rice, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.