Red Yeast

View the Cholesterol Levels Slideshow Pictures

What other names is Red Yeast known by?

Arroz de Levadura Roja, Cholestin, Hong Qu, Hongqu, Koji Rouge, Levure de Riz Rouge, Monascus, Monascus purpureus, Monascus Purpureus Went, Red Koji, Red Rice, Red Rice Yeast, Red Yeast Rice, Red Yeast Rice Extract, Riz Rouge, Xue Zhi Kang, XueZhiKang, XZK, Zhibituo, Zhi Tai.

What is Red Yeast?

Red yeast is the product of rice fermented with Monascus purpureus yeast. People use red yeast as medicine.

Red yeast is taken by mouth to maintain desirable cholesterol levels in healthy people, reduce cholesterol in people with high cholesterol, for indigestion, diarrhea, to improve blood circulation, and for spleen and stomach health. It is also taken by mouth for heart disease, abnormal levels of cholesterol or blood fats in patients with HIV/AIDS, high blood pressure, cancer, diabetes, and liver disease not associated with alcohol use.

In foods, red yeast is used as a food coloring for Peking duck.

The active ingredient in red yeast is the same as the active ingredient in prescription drugs called statins. Statins are used for high cholesterol. That's why red yeast has all the possible side effects, drug interactions, and precautions associated with this type of drug. The American Heart Association warns against using red yeast until the results of long-term studies are in. You should talk with your healthcare provider if you plan to take red yeast.

You may have come across a red yeast product called Cholestin, manufactured by Pharmanex. It was one of the most widely studied red yeast products. Originally, Cholestin contained the same active ingredient found in statin drugs. This caused the U.S. Food and Drug Administration (FDA) to call Cholestin an unapproved drug. Cholestin was reformulated so that its active ingredient is now something else.

Likely Effective for...

  • High cholesterol. Some research shows that taking red yeast products for up to 6 months can lower total cholesterol, low-density lipoprotein (LDL or "bad") cholesterol levels and triglycerides. However, these products contain large amounts of a chemical similar to "statin" drugs, such as lovastatin. Statins are approved by the FDA to lower cholesterol. In the U.S., the Food and Drug Administration (FDA) now considers this product and other red yeast products that contain statins to be illegal unapproved drugs. However, outside the U.S., these specific red yeast products are still available. Some red yeast products available in the U.S. these days contain little or no statins. It is not known if these products do much to reduce cholesterol levels in people with high cholesterol. Some other products still contain significant amounts of statins. One analysis shows that that some of these products can contain up to 5 mg of statins per tablet.

Possibly Effective for...

Possibly Ineffective for...

  • High blood pressure. Taking red yeast with prescription blood pressure-lowering drugs does not seem to enhance the effects of the drugs in people with high blood pressure. Some research suggests that taking red yeast along with the blood pressure-lowering drug valsartan may reduce a measure of heart damage caused by high blood pressure. In theory, this might reduce the risk of heart-related adverse events. However, taking red yeast with the blood pressure-lowering drug nifedipine doesn't seem to reduce measures of heart damage compared to nifedipine alone.

Insufficient Evidence to Rate Effectiveness for...

  • Cancer. Some clinical research shows that taking 1.2 grams of red yeast daily for about 4.5 years reduces the risk of dying from cancer by 22% to 56%. But it's not known if red yeast reduces the risk of developing cancer.
  • Diabetes. Some early research shows that taking 600 mg of red yeast daily for 8 weeks can lower total cholesterol, triglycerides, and blood sugar in people with diabetes. Other early research shows that taking 1.2 grams of red yeast daily for 12 weeks reduces low-density lipoprotein (LDL or "bad") cholesterol and triglycerides, as well as increases high-density lipoprotein (HDL or "good") cholesterol in people with diabetes and liver disease.
  • Liver disease not caused by alcohol use. Some research shows that taking 1.2 grams of red yeast daily for 12 weeks reduces levels of liver enzymes associated with liver damage and improves levels of blood fats in people with diabetes and a certain type of liver disease not caused by alcohol use.
  • Diarrhea.
  • Improving blood circulation.
  • Indigestion.
  • Spleen and stomach problems.
  • Other conditions.
More evidence is needed to rate the effectiveness of red yeast for these uses.

Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, and Insufficient Evidence to Rate (detailed description of each of the ratings).

Quick GuideLower Your Cholesterol, Save Your Heart

Lower Your Cholesterol, Save Your Heart

How does Red Yeast work?

Red yeast supplements are manufactured by culturing Monascus purpureus yeast on rice at carefully controlled temperature and growing conditions to increase the concentrations of chemicals that lower blood cholesterol and triglycerides. These chemicals are similar to the prescription drugs known as "statins," including lovastatin (Mevacor) and others.

Are there safety concerns?

Red yeast is POSSIBLY SAFE for most people when taken by mouth for up to 4.5 years.

Red yeast contains chemicals similar to the prescription drugs called "statins." Therefore, red yeast might also cause side effects similar to statin drugs, such as liver damage and severe muscle pain and muscle damage.

There is also concern about product quality. Many red yeast rice products have been found to contain varying amounts of the statin-like chemicals. Some products may contain none and others may contain high amounts, which are more likely to cause serious side effects.

Serious allergic reactions can occur after breathing in red yeast.

Red yeast that is not fermented correctly may contain citrinin. Citrinin is a poison that may cause kidney damage.

Special Precautions & Warnings:

Pregnancy and breast-feeding: Red yeast is LIKELY UNSAFE when taken by mouth during pregnancy. It has caused birth defects in animals. Not enough is known about the safety of using red yeast during breast-feeding. Don't use during pregnancy or breast-feeding.

Liver problems: Red yeast contains chemicals that are the same as the statin drug lovastatin. Lovastatin can cause liver damage. Some research shows that red yeast might also cause liver damage. However, other research shows that red yeast might improve liver function in people with certain liver problems. Because of the mixed results, red yeast products should be used cautiously or avoided in people with liver problems.

Are there any interactions with medications?



Alcohol
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Drinking alcohol might harm the liver. Red yeast might also harm the liver. Taking red yeast along with alcohol might increase the risk of liver damage. Do not drink alcohol if you are taking red yeast.



Cyclosporine (Neoral, Sandimmune)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Red yeast might affect the muscles. Cyclosporine (Neoral, Sandimmune) might also affect the muscles. Taking red yeast along with cyclosporine (Neoral, Sandimmune) might cause serious side effects.



Gemfibrozil (Lopid)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Gemfibrozil (Lopid) can affect the muscles. Red yeast can also affect the muscles. Taking gemfibrozil along with red yeast might increase the risk of muscle problems.



Medications that can harm the liver (Hepatotoxic drugs)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Red yeast contains the statin drug lovastatin. Lovastatin might harm the liver in some people. Taking red yeast along with other medications that might also harm the liver might increase the risk of liver damage.

Some medications that can harm the liver include acetaminophen (Tylenol and others), amiodarone (Cordarone), carbamazepine (Tegretol), isoniazid (INH), methotrexate (Rheumatrex), methyldopa (Aldomet), fluconazole (Diflucan), itraconazole (Sporanox), erythromycin (Erythrocin, Ilosone, others), phenytoin (Dilantin), lovastatin (Mevacor), pravastatin (Pravachol), simvastatin (Zocor), and many others.



Medications that decrease the break down of other medications in the liver (Cytochrome P450 3A4 (CYP3A4) inhibitors)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Some medications are changed and broken down by the liver. Some medications might decrease how quickly the liver breaks down red yeast. Taking red yeast along with some medications that decrease the breakdown of other medications in the liver can increase the effects and side effects of red yeast. Before taking red yeast, talk to your healthcare provider if you are taking any medications that are changed by the liver.

Some medications that might decrease how quickly the liver breaks down red yeast include amiodarone (Cordarone), clarithromycin (Biaxin), diltiazem (Cardizem), erythromycin (E-mycin, Erythrocin), indinavir (Crixivan), ritonavir (Norvir), saquinavir (Fortovase, Invirase), and many others.



Medications used for lowering cholesterol (Statins)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Red yeast contains the statin drug lovastatin.. Taking red yeast along with other statins, a type of medication used to lower cholesterol, might increase the risk of adverse effects. Do not take red yeast if you are already taking these medications.

Some medications used for high cholesterol include cerivastatin (Baycol), atorvastatin (Lipitor), lovastatin (Mevacor), pravastatin (Pravachol), simvastatin (Zocor), and others



Niacin
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Niacin can affect the muscles. Red yeast can also affect the muscles. Taking niacin along with red yeast might increase the risk of muscle problems.

Dosing considerations for Red Yeast.

The following doses have been studied in scientific research:

BY MOUTH: BY MOUTH:
  • High cholesterol: 1200 mg to 2400 mg of red yeast once or twice daily for up to 24 weeks. Only products containing chemicals similar to the prescription "statin" cholesterol drugs have been shown to lower cholesterol levels. Many of these products provide approximately 5-10 mg of the statin drug called lovastatin. These products have included Cholestin (non-US, Pharmanex), Xuezhikang (Beijing WBL Peking University Biotech Co.), HypoCol (AsiaPharm Biotech), Zhibituo, and Red Yeast Rice (Sylvan Bioproducts).
  • High cholesterol related to HIV infection: 1200 mg of a specific red yeast formulation (Cholestin, Pharmanex LLC, Provo, Utah) twice daily for 8 weeks.
  • Heart disease: A specific product (Xuezhikang, Beijing Peking University WBL Biotech Co., Ltd.) containing 1200 mg of red yeast extract daily for about 4.5 years.
FDA Logo

Report Problems to the Food and Drug Administration

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.

Reviewed on 3/29/2011 12:35:40 PM

Health Solutions From Our Sponsors