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Red Yeast Rice

(Capsules)

Red yeast rice is a supplement that claims to help lower your blood cholesterol in combination with a healthy diet and exercise. This supplement isn’t approved by the FDA for medical use. If you have a condition that affects your cholesterol, talk to a healthcare provider before taking this supplement.

What is Red Yeast Rice Extract?

Red yeast rice extract (RYRE) is a traditional Chinese medicine believed to lower cholesterol. Several types of the extract are sold as supplements.

RYRE is a substance that's extracted from rice that's been fermented with a type of yeast called Monascus purpureus. It's been used in China and other Asian countries for centuries as a traditional medicine. It's also used as a food coloring, additive, and preservative.

RYRE naturally contains several ingredients that may help control cholesterol levels. These include a number of monacolins, most importantly monacolin K. It also contains sterols, isoflavones, and monounsaturated fatty acids, or "healthy fats."

Red yeast rice may be appealing because it's "natural," but you need to be careful. Experts have not studied it extensively. The ideal dosing and its long-term safety are unclear. It could be dangerous for some people. And because the ingredients of different brands of RYRE might vary so much, it's hard to make firm statements about its effectiveness or safety.

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

COMMON BRAND NAME(S): Red Yeast Rice Extract

What should I tell my care team before I take this medication?

They need to know if you have any of these conditions:

Frequently drink alcohol

Kidney disease

Liver disease

Muscle aches or weakness

Other medical condition

An unusual or allergic reaction to red yeast rice, went yeast, lovastatin, other 'statin' medications, other supplements, foods, dyes, or preservatives

Pregnant or trying to get pregnant

Breast-feeding

How should I use this medication?

Keep in mind that the amount of monacolin, perhaps the most important ingredient, in a red yeast rice product can vary a lot. There are many different strains of the yeast. Different types of fermentation are used. One study of different brands of red yeast rice supplements showed that the amount of monacolin ranged from 0% to 0.58%.

So even though studies have shown that RYRE can lower cholesterol, you can't really know if the supplement brand you're using will have that effect.

As with other supplements, the typical daily dosage of red yeast rice is high. Studies have evaluated the benefits of 600 milligrams taken two to four times a day, for a total of 1,200 to 2,400 milligrams. Since there is no way of knowing how much of the beneficial chemical compounds are present in your supplement, it’s best to start with a smaller dose and then have your cholesterol checked to see if it’s working.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

NOTE: This medicine is only for you. Do not share this medicine with others.

How Well Does Red Yeast Rice Lower Cholesterol?

Red yeast rice products can vary by type and chemical composition, so they don't all work similarly. Some are chemically similar to statins, which are medications known to help lower cholesterol. Other strains may contain these chemicals in varying concentrations.

Studies have shown that certain red yeast rice products that contain statin can significantly lower levels of total cholesterol, specifically LDL, or "bad" cholesterol. One showed that taking 2.4 grams per day reduced LDL levels by 22% and total cholesterol by 16% in 12 weeks. Another study showed that taking 1.2 grams per day lowered LDL levels by 26% in just 8 weeks.

However, the results of these studies depend on the amount of statin that is in the extract, and it can vary widely. The FDA considers extracts that contain statins to be illegal in the U.S., but many are still available.

Herbal supplements don’t have regulations or manufacturing protocols, so there is no guarantee that the red yeast rice supplement you are taking has a certain level of the component that helps lower cholesterol, monacolin K. It could have high levels, or it could have close to none. The label usually won’t say whether a particular supplement has monacolin K, and it won’t specify the amount.

What may interact with this medication?

Do not take this medication with any of the following:

Clarithromycin

Delavirdine

Erythromycin

Grapefruit juice

Protease inhibitors used to treat HIV infection

Medications for fungal infections, such as itraconazole, ketoconazole, posaconazole, and voriconazole

Mibefradil

Nefazodone

Other medications for high cholesterol

Telithromycin

Troleandomycin

This medication may also interact with the following:

Alcohol

Amiodarone

Colchicine

Cyclosporine

Danazol

Diltiazem

Fenofibrate

Fluconazole

Gemfibrozil

Mifepristone, RU-486

Niacin

St. John's Wort

Verapamil

Voriconazole

Warfarin

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medication?

Visit your care team for regular check-ups. You may need regular tests to make sure your liver is working properly.

Tell you care team right away if you get any unexplained muscle pain, tenderness, or weakness, especially if you also have a fever and tiredness.

Some medications may increase the risk of side effects from this supplement. If you are given certain antibiotics or antifungals, you should stop taking this supplement during those treatments. Check with your care team or pharmacist for advice.

If you are scheduled for any medical or dental procedure, tell your care team that you are taking this supplement. You may need to stop taking this supplement before the procedure.

Do not use this supplement if you are pregnant or breast-feeding. Serious side effects to an unborn child or to an infant are possible. Talk to your care team or pharmacist for more information.

Herbal or dietary supplements are not regulated like medications. Rigid quality control standards are not required for dietary supplements. The purity and strength of these products can vary. The safety and effect of this dietary supplement for a certain disease or illness is not well known. This product is not intended to diagnose, treat, cure or prevent any disease.

The Food and Drug Administration suggests the following to help consumers protect themselves:

Always read product labels and follow directions.

Natural does not mean a product is safe for humans to take.

Look for products that include USP after the ingredient name. This means that the manufacturer followed the standards of the US Pharmacopoeia.

Supplements made or sold by a nationally known food or drug company are more likely to be made under tight controls. You can write to the company for more information about how the product was made.

Side Effects?

Side effects that you should report to your care team as soon as possible:

Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat

Liver injury—right upper belly pain, loss of appetite, nausea, light-colored stool, dark yellow or brown urine, yellowing skin or eyes, unusual weakness or fatigue

Muscle injury—unusual weakness or fatigue, muscle pain, dark yellow or brown urine, decrease in amount of urine

Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):

Dizziness

Gas

Headache

Heartburn

This list may not describe all possible side effects. Call your doctor for medical advice about side effects.

You may report side effects to FDA at 1-800-FDA-1088. You can also report online at www.fda.gov/medwatch.

Red Yeast Rice Brands to Avoid

Since 1998, the FDA has said that red yeast rice products with significant amounts of monacolin K can't be marketed as dietary supplements. In recent years, the FDA has warned companies found to be selling these products and alerted consumers. The following brands of red yeast rice supplements were found to contain lovastatin:

CholesLo, a product promoted to lower cholesterol

Cholestene, a product promoted for cholesterol management

Cholestrix, sold by Sunburst Biorganics

Red Yeast Rice and Red Yeast Rice/Policosonal Complex, sold by Swanson Healthcare Products, Inc. and manufactured by Nature’s Value Inc. and Kabco Inc.

Red Yeast Rice FAQ's

What does red yeast rice do for the body?

The benefits of red yeast rice include:

Lower cholesterol. The monacolin K in red yeast rice helps lower the amounts of "bad" cholesterol (also known as LDL) in the body by lowering its production in the liver.

Lower stroke risk. Low cholesterol resulting from red yeast rice's effect on your body can also reduce your risk of developing blood clots that cause stroke and heart attacks.

Improved blood circulation. Red yeast rice has been shown to help improve circulation, allowing wounds to heal more quickly and letting your body function at its best.

When should I take red yeast rice, morning or night?

You can take red yeast rice at any time of the day, but some supplement directions will say to split it into two doses, one at morning and one at night. As red yeast rice acts similarly to the statin lovastatin, some people prefer to take it at night. This is because cholesterol production peaks for most people late in the evening, and the supplement can go to work at that time.

Does red yeast rice affect sleep?

It's possible to have insomnia (trouble sleeping) while taking red yeast rice supplements, but this is rare.

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Most recent revision June 30, 2025 08:08:49 PM

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