red yeast rice (Monascus purpureus, Xue Zhi Kang)
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Introduction
produced by fermenting rice with Monascus purpureus yeast. contains monacolin(s), natural HMG CoA reductase inhibitor(s)
Uses
- hypercholesterolemia
- coronary artery disease
- diabetes mellitus
- used in China to treat indigestion, diarrhea
Dosage
1800 mg of red yeast rice contains monacolin K in an amount equipotent to 6 mg of lovastatin with respect to inhibition of HMG-CoA reductase
Adverse effects
- nausea/vomiting[4]
- GI upset
- myalgia, myopathy, rhabdomyolysis
- abnormal liver function tests[6]
- case report of hepatitis
Drug interactions
- other anti-hyperlipidemic agents (use caution)[4]
- may interact with drugs metabolized by CYP3A4[6]
Mechanism of action
- contains lovastatin[2]
- lowers total serum cholesterol & LDL cholesterol
- lowers LDL-cholesterol 35-43 mg/dL within 12 weeks vs 11-15 mg/dL for placebo[2]
- no change in HDL-cholesterol, serum triglycerides[2]
- in combination with probiotic Bifidobacterium longum BB536 lowers serum LDL cholesterol 26% in 12 weeks in patients with mean LDL cholesterol of 183 mg/dL[7]
Notes
- marked variation among commercial products[5]
- some products may citrinin as a contaminant which may cause renal failure[6]
More general terms
References
- ↑ Prescriber's Letter 15(12): 2008 Safety of Red Yeast Rice Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=241203&pb=PRL (subscription needed) http://www.prescribersletter.com
- ↑ 2.0 2.1 2.2 2.3 2.4 Becker DJ Red Yeast Rice for Dyslipidemia in Statin-Intolerant Patients A Randomized Trial Annals of Internal Medicine 2009, 150(12):830 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/19528562 <Internet> http://www.annals.org/cgi/content/abstract/150/12/830
- ↑ Mayo Clinic: Red yeast rice (Monascus purpureus) http://www.mayoclinic.com/health/red-yeast-rice/NS_patient-redyeast
- ↑ 4.0 4.1 4.2 Geriatrics at your Fingertips, 13th edition, 2011 Reuben DB et al (eds) American Geriatric Society
- ↑ 5.0 5.1 Gordon RY, Cooperman T, Obermeyer W, Becker DJ. Marked variability of monacolin levels in commercial red yeast rice products: buyer beware! Arch Intern Med. 2010 Oct 25;170(19):1722-7. PMID: https://www.ncbi.nlm.nih.gov/pubmed/20975018
- ↑ 6.0 6.1 6.2 6.3 Medical Knowledge Self Assessment Program (MKSAP) 17, 18, 19 American College of Physicians, Philadelphia 2015, 2018, 2022
- ↑ 7.0 7.1 Wendling P Probiotic, Red Yeast Rice Extract Combo May Cut Cholesterol Medscape - May 05, 2017. http://www.medscape.com/viewarticle/879583