- Side Effects
- Drug Interactions
- Pregnancy & Breastfeeding
- What Else to Know
Generic Name: red yeast rice
Drug Class: Herbals
What is red yeast rice, and what is it used for?
Red yeast rice is a dietary supplement prepared by fermenting a type of yeast known as Monascus purpureus on rice. Red yeast rice has been used in China and other Asian countries for centuries as food and red yeast rice extract is used as a medicine to reduce blood cholesterol levels, and improve blood circulation and digestion. Reduction of blood cholesterol levels decreases the risk for cardiovascular diseases.
The fermentation of rice with M. purpureus enriches the rice with many bioactive substances including monacolin K, a natural chemical with structure similar to lovastatin, a cholesterol-lowering prescription drug. Like lovastatin, monacolin K reduces cholesterol levels by inhibiting 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase, an enzyme involved in the biosynthesis of cholesterol. In addition, red yeast rice has isoflavones, monounsaturated fatty acids and sterols which may also have cholesterol lowering effects.
Traditional red yeast rice may contain only trace amounts of monacolin K, far less than the dosage used with lovastatin. Commercial red yeast rice products have been found to contain widely variable quantities of monacolin K. Some researchers have reported that lovastatin is illegally added to some red yeast rice products, and the FDA has issued warnings to these manufacturers. The FDA has requested withdrawal of red yeast products with high monacolin K, considered to be unapproved new drugs that cannot be legally sold in the U.S.
Some red yeast rice products may be contaminated by citrinin, a toxic substance that can damage the kidneys. An analysis of 37 red yeast rice products conducted in 2021 found that only one product had citrinin levels lower than the maximum level currently set by the European Union. Four products that were contaminated with citrinin were labeled citrinin-free.
- Do not take if you are allergic to molds or any of the other ingredients in the red yeast rice product.
- Do not take red yeast rice if you have liver disease, risk for liver disease, impairment of liver function or abnormal liver function tests.
- Do not take red yeast rice if you have:
- Do not take red yeast rice if you drink more than two alcoholic drinks a day.
- Avoid red yeast rice if you are taking other drugs that are toxic to the liver.
- Red yeast rice can cause muscle disease (myopathy) and breakdown of muscle fibers (rhabdomyolysis).
What are the side effects of red yeast rice?
Common side effects of red yeast rice include:
- Stomach pain
- Gas (flatulence)
- Muscle pain and weakness
- Muscle damage (rhabdomyolysis)
- Increased creatine phosphokinase
- Liver damage
- Increase in blood levels of liver enzymes
Call your doctor immediately if you experience any of the following symptoms or serious side effects while using this drug:
- Serious heart symptoms include fast or pounding heartbeats, fluttering in your chest, shortness of breath, and sudden dizziness;
- Severe headache, confusion, slurred speech, severe weakness, vomiting, loss of coordination, feeling unsteady;
- Severe nervous system reaction with very stiff muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, and feeling like you might pass out; or
- Serious eye symptoms include blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights.
This is not a complete list of all side effects or adverse reactions that may occur from the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may also report side effects or health problems to the FDA at 1-800-FDA-1088.
What are the dosages of red yeast rice?
There isn’t enough scientific information on what might be an appropriate dosage of red yeast rice. Suggested dosage:
- 1200 mg orally twice daily
- Take with food
- Overdose of red yeast rice can cause gastrointestinal discomfort, and muscle, kidney, and liver damage.
- Overdose treatment may include discontinuation of red yeast rice and symptomatic and supportive care as required.
What drugs interact with red yeast rice?
Inform your doctor of all medications you are currently taking, who can advise you on any possible drug interactions. Never begin taking, suddenly discontinue, or change the dosage of any medication without your doctor’s recommendation.
- Severe interactions of red yeast rice include:
- Serious interactions of red yeast rice include:
- Moderate interactions of red yeast rice include:
- lanthanum carbonate
- St. John’s wort
- Red yeast rice has no known mild interactions with other drugs.
The drug interactions listed above are not all of the possible interactions or adverse effects. For more information on drug interactions, visit the RxList Drug Interaction Checker.
It is important to always tell your doctor, pharmacist, or health care provider about all prescription and over-the-counter medications you use, as well as the dosage for each, and keep a list of the information. Check with your doctor or healthcare provider if you have any questions about the medication.
Pregnancy and breastfeeding
- Red yeast rice may harm the fetus, do not take it if you are pregnant.
- There isn’t enough information on use of red yeast rice by nursing mothers, avoid if you are breastfeeding.
- Do not take any dietary supplement without first checking with your healthcare provider if you are pregnant or breastfeeding.
What else should I know about red yeast rice?
- Take red yeast rice exactly as per label instructions. Do not take higher than recommended or more frequent doses.
- Avoid taking red yeast rice for longer than 12 weeks, it is not known whether it is safe to take it for longer periods.
- Check with your healthcare provider before taking any dietary supplement, including red yeast rice.
- Dietary supplements often contain many ingredients. Check labels for the components in the red yeast rice product you choose.
- It is impossible to know monacolin K quantities present in commercial red yeast rice products, because it is not usually included in the product labels.
- A 2017 review analyzed 28 brands of red yeast rice products from mainstream retailers in the U.S., and none of them had the monacolin K quantity on the label.
- Monacolin K was not found in two brands, and in the 26 brands that contained it, the quantity ranged from 0.09 to 5.48 mg per 1,200 mg of red yeast rice.
- Red yeast products with high monacolin K levels are considered by the FDA to be unapproved new drugs and cannot be sold legally in the U.S.
- Some researchers reported that commercial lovastatin is illegally added to some red yeast rice products. The FDA has sent warning letters to companies selling red yeast rice products that had added lovastatin, telling them to correct the violations.
- Red yeast rice is marketed as a dietary supplement and is not stringently regulated by the FDA. Products may differ in formulations and strengths, and labels may not always match contents; exercise caution in choosing your product.
- Red yeast rice products may be contaminated by citrinin, a toxic substance that can damage the kidney.
- Store red yeast rice safely out of reach of children.
- In case of overdose, seek medical help or contact Poison Control.
Red yeast rice has been used in China and other Asian countries for centuries as food and red yeast rice extract is used as a medicine to reduce blood cholesterol levels, and improve blood circulation and digestion. Common side effects of red yeast rice include nausea, diarrhea, stomach pain, gas (flatulence), heartburn, gastritis, dizziness, muscle pain and weakness, muscle damage (rhabdomyolysis), increased creatine phosphokinase, liver damage, and increase in blood levels of liver enzymes. Do not take red yeast rice if pregnant or breastfeeding.
Multimedia: Slideshows, Images & Quizzes
Heart Disease: Causes of a Heart Attack
Heart disease prevention includes controlling risk factors like diet, exercise, and stress. Heart disease symptoms in women may...
Heart Disease: Foods That Are Bad for Your Heart
If you want a healthy ticker, there are some foods you’ll want to indulge in every now and then only. Find out which ones and how...
Cholesterol Levels: What's Normal and How to Lower High Cholesterol
What do cholesterol numbers mean? LDL, HDL, good, bad, and triglycerides - Get the facts on cholesterol, blood testing,...
Am I Having a Heart Attack? Symptoms of Heart Disease
Heart attacks symptoms vary greatly for men and women, from anxiety and fatigue to nausea and sweating. Learn the warning signs...
What Are the 10 Worst Foods for Cholesterol?
Do you know the foods that increase cholesterol? Learn the worst and best foods for LDL 'bad' cholesterol. Find out what foods...
Heart Disease: Symptoms, Signs, and Causes
What is heart disease (coronary artery disease)? Learn about the causes of heart disease, arrhythmias and myopathy. Symptoms of...
Heart Disease: How to Help Prevent an AFib Attack
These simple things can make a flare-up of atrial fibrillation less likely.
Heart Disease: Pill-Free Ways to Cut Your Heart Disease Risk
You don't have to take medicine to lower your heart disease risk. Find out more about how diet, exercise, and other lifestyle...
How to Lower Your Cholesterol & Save Your Heart
Need to lower your cholesterol levels? Use these smart diet tips to quickly and easily lower your blood cholesterol levels....
Cholesterol Drugs: What to Expect With Heart Medication
When diet and exercise aren't enough, should you turn to drugs? Learn cholesterol basics, drug classes, and available drugs along...
Cholesterol: Foods to Help Lower Bad LDL Cholesterol
When you're working on lowering your LDL ("bad") cholesterol, what you eat matters. WebMD shows you foods that can help.
Heart Disease: Alternative Treatments for AFib
Medication and surgery aren't the only things that can improve or prevent your AFib symptoms. Talk to your doctor about these...
Cardiac Arrest: What You Should Know
Cardiac arrest is a serious medical emergency that requires immediate medical care. Use this WebMD slideshow to know whether you...
Cholesterol: High Triglyceride Foods to Avoid
High triglycerides increase the risk of heart disease. Lower triglyceride levels and reduce cholesterol by eating foods that...
Heart Disease: Best and Worst Foods for Heart Failure
Learn which dietary changes help your heart, and which ones make it work harder.
High Cholesterol (Hyperlipidemia) Quiz: Test Your Medical IQ
High cholesterol can be a dangerous condition. Take the Cholesterol Quiz to understand what high cholesterol means in terms of...
Heart Disease Quiz: Test Your Medical IQ
Take our Heart Disease Quiz to get answers and facts about high cholesterol, atherosclerosis prevention, and the causes,...
Picture of Cholesterol
Cholesterol carried in particles of low density (LDL cholesterol) is referred to as the "bad" cholesterol because elevated levels...
Heart Disease: Understand Your Blood and Urine Test Results
Your blood and urine can reveal a lot about your health. Here's how to understand your lab test results.
Cholesterol & Triglycerides: Mistakes That Can Affect Your Cholesterol
High cholesterol can be trouble. Find out from WebMD's slideshow if you’re doing things that can make it harder to keep your...
Cholesterol & Triglycerides: Surprising Causes of High Cholesterol
You may think high cholesterol is linked to fatty foods and smoking. But some other causes may surprise you: certain coffees,...
Related Disease Conditions
What Are the Normal Cholesterol Levels According to Age?
Cholesterol is a waxy substance found in all the cells of the body. It is a type of fat that is produced by the liver. Cholesterol also comes from animal-derived foods, such as meat and dairy products.
High cholesterol and triglyceride levels increase the risk of cardiovascular disease. Getting your cholesterol and triglyceride levels in an optimal range will help protect your heart and blood vessels. Cholesterol management may include lifestyle interventions (diet and exercise) as well as medications to get your total cholesterol, LDL, HDL, and triglycerides in an optimal range.
Lower Cholesterol Levels with Diet and Medications
High-density lipoprotein (HDL) cholesterol is considered "good" cholesterol because it actually works to keep the LDL or "bad" cholesterol from building up in your arteries. Foods like extra lean meats, skim milk, and vegetable-based "butter-like" substitutes may help decrease LDL levels in the bloodstream.
Heart Disease: Sudden Cardiac Death
Second Source WebMD Medical Reference
Which Nuts Are Best to Lower Cholesterol?
Researchers discovered that consuming roughly half a cup of walnuts per day (especially in the morning) can somewhat lower low-density lipoprotein (LDL) cholesterol levels in healthy people.
Heart disease (coronary artery disease) occurs when plaque builds up in the coronary arteries, the vessels that supply blood to the heart. Heart disease can lead to heart attack. Risk factors for heart disease include: Smoking High blood pressure High cholesterol Diabetes Family history Obesity Angina, shortness of breath, and sweating are just a few symptoms that may indicate a heart attack. Treatment of heart disease involves control of heart disease risk factors through lifestyle changes, medications, and/or stenting or bypass surgery. Heart disease can be prevented by controlling heart disease risk factors.
Is a Cholesterol Level of 6.5 High?
A cholesterol level of 6.5 mmol/L is considered very high. Learn about normal vs. high cholesterol levels according to age and gender.
Is Squid Rich in Cholesterol?
Squid is part of the same family as oysters, scallops and octopus. Squid is often eaten deep fried. This is known as calamari. Unlike many other animal products, squid is low in saturated fat. Doctors usually do not advise saturated fat to people with high cholesterol. When squid is deep fried, total fat and saturated fat increase.
What Is the Normal Range for Cholesterol Levels?
What is the normal range for cholesterol levels? Learn what cholesterol levels are, why cholesterol levels change, how doctors diagnose cholesterol levels, and what you can do to treat high cholesterol levels.
What Home Remedy Can I Use to Lower My Cholesterol?
Learn the 15 home remedies you can use to help keep your cholesterol levels in check.
Stress and Heart Disease
Stress itself may be a risk factor for heart disease, or high levels of stress may make risk factors for heart disease worse. The warning signs of stress can be physical, mental, emotional, or behavioral. Check out the center below for more medical references on stress and heart disease, including multimedia (slideshows, images, and quizzes), related diseases, treatment, diagnosis, medications, and prevention or wellness.
HDL vs. LDL Cholesterol (Good and Bad)
HDL (high-density lipoprotein), or the "good" cholesterol, and LDL (low-density lipoprotein), or the "bad" cholesterol, are lipoproteins that carry cholesterol through the veins and arteries of the body. HDL and LDL combined, is your "total" blood cholesterol. The difference between the two are that high levels of the "good," or HDL cholesterol, may protect against narrowing of the blood vessels in the body, which protects you against heart attack, stroke, and other cardiovascular diseases. But high levels of LDL, or the "bad" cholesterol, may worsen the narrowing of the blood vessels in the body, which puts you at a greater risk of stroke, heart attack, and cardiovascular diseases, some of which are life threatening.Triglycerides are found in body fat and from the fats you eat.
What Level of Cholesterol Is Too Low?
You know high cholesterol is bad, but can your cholesterol be too low? Yes. While less common, low cholesterol can affect your health as well.
What Are the Worst Foods for High Cholesterol?
What foods are high in bad cholesterol? Learn about the worst foods to avoid if you have high cholesterol.
Heart Disease in Women
Heart disease in women has somewhat different symptoms, risk factors, and treatment compared to heart disease in men. Many women and health professionals are not aware of the risk factors for heart disease in women and may delay diagnosis and treatment. Lifestyle factors such as diet, exercise, tobacco use, overweight/obesity, stress, alcohol consumption, and depression influence heart disease risk in women. High blood pressure, high cholesterol, and diabetes also increase women's risk of heart disease. Electrocardiogram (EKG or ECG), stress-ECG, endothelial testing, ankle-brachial index (ABI), echocardiogram, nuclear imaging, electron beam CT, and lab tests to assess blood lipids and biomarkers of inflammation are used to diagnose heart disease. Early diagnosis and treatment of heart disease in women saves lives. Heart disease can be prevented and reversed with lifestyle changes.
Are Plant Sterols Good for Lowering Cholesterol?
Plant sterols were initially discovered to have cholesterol-lowering properties. Plant sterol-enriched diets have an even higher influence on decreasing “bad” or low-density lipoprotein (LDL) cholesterol levels.
How Dangerous Is High Cholesterol?
Cholesterol is an important molecule that serves many vital functions in the body. High cholesterol is dangerous because it may lead to atherosclerosis, which can result in conditions such as angina, heart attack, stroke and hypertension.
How Much Does Treatment for Heart Disease Cost?
Treatment costs for heart disease depend on the type of treatment, doctors, hospitals, and insurance plans. The cost could be a couple of hundred dollars for medication and $20,000 (USD) for surgery.
Smoking and Heart Disease
Smoking increases the risk of heart disease in women and men. Nicotine in cigarettes decrease oxygen to the heart, increases blood pressure, blood clots, and damages coronary arteries. Learn how to quit smoking today, to prolong your life.
What Reduces Cholesterol Quickly?
High blood cholesterol levels can be managed to a great extent with lifestyle changes. However, not taking medicine isn’t a solution because only lifestyle changes may not be sufficient to treat high cholesterol levels.
Are Cholesterol Tests Always Accurate?
Home cholesterol tests are about 95% accurate, although the accuracy of the results depends on whether the test was performed correctly.
What Are the Causes of High Cholesterol?
Your body naturally produces all the LDL (bad) cholesterol it needs. An unhealthy lifestyle – not enough exercise, too many unhealthy foods – makes your body produce more LDL cholesterol than it needs. This is the cause of high LDL cholesterol for most people.
Heart Disease Treatment in Women
Heart disease treatment in women should take into account female-specific guidelines that were developed by the American Heart Association. Risk factors and symptoms of heart disease in women differ from those in men. Treatment may include lifestyle modification (diet, exercise, weight management, smoking cessation, stress reduction), medications, percutaneous intervention procedure (PCI), and coronary artery bypass grafting (CABG). Heart disease is reversible with treatment.
What Are the Normal Cholesterol Levels By Age?
Cholesterol is a waxy substance found in all the cells of the body. It is a type of fat that is produced by the liver. Cholesterol also comes from animal-derived foods, such as meat and dairy products. It is an essential substance needed by the body for various purposes. Too much cholesterol, however, harms the body and increases the risk of various medical conditions, such as high blood pressure and heart diseases.
Does Psoriasis Cause Cardiovascular Disease?
Long-lasting inflammation due to psoriasis can affect your heart and blood vessels, increasing your risk of developing cardiovascular disease, heart attack, or stroke.
Treatment & Diagnosis
- Heart Disease FAQs
- High Cholesterol (Hyperlipidemia) FAQs
- Heart Risks - Reduced By Walking & Vigorous Exercise
- Heart Disease In Women
- Ramipril, Heart Disease, Stroke & Diabetes
- Heart Disease & Stroke - Progress
- Cholesterol: Questions To Ask Your Doctor
- Cholesterol: The Truth About Cholesterol
- Cholesterol: HDL cholesterol ratio
- Cholesterol - Mr. D.T.'s Story of Hope
- Heart Disease Stroke and Diabetes
- Beta Carotene Supplements Not the Answer for Cancer or Heart Disease
- Heart Disease Risks Reduced With Running
- Statins - - Doing More Than Lowering Your Cholesterol?
- Exercise Therapy in Type 2 Diabetes - Part 1
- Heart Disease - Lessons Learned From Pitcher's Early Death
- Cholesterol Guidelines
- Heart Disease: Antioxidant Supplements and Women
- Heart Disease Risk and C-reactive Protein (CRP)
- Hormone Therapy and and Heart Disease in Women
- Heart Attack Prevention From a Doctor's Perspective
- What Should Cholesterol Levels Be After Heart Attack?
- What are The Complications of Rheumatic Heart Disease?
- What are Cholesterol-Lowering Statins?
- Do Bile Acid Resins Lower Cholesterol?
- Can Fibrate Drugs Lower Cholesterol?
- Can Menopause Cause High Cholesterol?
- How Do I Lower My Cholesterol (Triglycerides)
- Can I Still Get Heart Disease if I Take Blood Pressure Medication?
- Does Hypothyroidism Cause High Cholesterol?
- What Is Arteriosclerotic Cardiovascular Disease?
- Does Exercise Lower Cholesterol?
- What Foods Lower Cholesterol?
- Does Stress Cause High Cholesterol?
- Does Hashimoto's Affect Heart Disease and Osteoporosis?
- Heart Disease Prevention in Women
- Cholesterol Treatment
- Heart Healthy Diet: Hypertension & Heart Disease
- Cholesterol, The Basics Of Prevention
Medications & Supplements
Prevention & Wellness
- Which Seafood Is Highest in Cholesterol?
- 16 Best Cholesterol-Lowering Snacks
- Is Eating Chicken Heart Good for You? Is it High in Cholesterol?
- What Fish Is Best for Lowering Cholesterol?
- Which Exercise Is Best to Reduce Cholesterol?
- Lamb and Cholesterol: Know the Facts
- Red Yeast Rice and Cholesterol
- Do Eggs Raise Cholesterol Levels?
- What Foods Are High in Cholesterol?
- What Can You Eat on a Low Cholesterol Diet?
- 26 Natural Ways to Lower Your Cholesterol Levels
- Can High Cholesterol Be Genetic?
- What Is the Best Diet for High Cholesterol?
- 10 Myths About Dietary Fat and Cholesterol
- 17 Cholesterol-Lowering Foods to Add to Your Diet Today
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.