Red Yeast Rice — Supplements
Fermented rice product containing naturally occurring monacolin K (lovastatin) for cholesterol management.
Overview
Red yeast rice (RYR) is produced by fermenting rice with the yeast Monascus purpureus, producing monacolins including monacolin K, which is chemically identical to lovastatin. RYR has been used in Traditional Chinese Medicine for centuries. Clinical trials demonstrate LDL cholesterol reductions of 15-25%, comparable to low-dose statins. The CCSPS trial (n=4,870) showed 30% relative risk reduction in coronary events. However, monacolin content varies dramatically between products, and citrinin contamination is a safety concern.
Indications
- LDL cholesterol reduction
- Statin-intolerant patients seeking cholesterol management
- Cardiovascular risk reduction
Mechanism of Action
Monacolin K competitively inhibits HMG-CoA reductase, the rate-limiting enzyme in cholesterol synthesis
Dosing
| Compound | Dose | Frequency | Notes |
|---|---|---|---|
| Red Yeast Rice | 1,200 mg | Once daily with dinner | Choose citrinin-free, standardized products; monitor liver enzymes |
Safety & Contraindications
- Contains lovastatin equivalent; same risks as statin drugs (myopathy, rhabdomyolysis, hepatotoxicity)
- Citrinin (nephrotoxic mycotoxin) contamination is common in low-quality products
- Must not combine with prescription statins (dose stacking)
- Co-supplement with CoQ10 (same rationale as statin users)
- Contraindicated in pregnancy, liver disease, and heavy alcohol use