Red Yeast Rice
Also known as: Monascus purpureus, red koji, hong qu, RYR, monacolin K
Red yeast rice is rice fermented with the mold Monascus purpureus, a traditional Chinese food and remedy. The fermentation produces monacolins, including monacolin K, which is chemically identical to the drug lovastatin. Meta-analyses of RCTs show consistent LDL-cholesterol reductions comparable to low-dose statins. Because of the monacolin K content, FDA has stated that products containing meaningful amounts may be unapproved drugs, and the EU restricts monacolins to under 3 mg per day, so formulators face real regulatory constraints. Citrinin contamination is another quality concern.
Research summary
Monacolin K inhibits HMG-CoA reductase, the rate-limiting enzyme in cholesterol synthesis; other monacolins and sterols contribute.
Dosage
Daily amounts, of extract.
| Lowest studied | Typical range | Highest studied | Upper limit |
|---|---|---|---|
| 1,200 mg | 1,200–2,400 mg | — | — |
1,200–2,400 mg of red yeast rice daily with the evening meal, typically split into two doses. Effects depend on monacolin K content, which varies widely between products and is often not labeled. FDA regulatory note: products with meaningful monacolin K may be considered unapproved drugs, and several have been subject to enforcement, so standardizing to a declared monacolin K level is legally risky in the US. Test every lot for citrinin, a nephrotoxic mold metabolite.
Standardization: often sold unstandardized; some grades declare monacolin K content (legally sensitive in the US; EU limit <3 mg/day)
Source material: rice fermented with Monascus purpureus
Format suitability
- Capsule
- Powder
- Tablet
- Softgel
- Gummy
- Liquid
Deep red powder that stains; capsules and tablets standard at gram-level doses. Not appropriate for gummies.
Formulation notes
Statin-like: additive with statins, and interacts with CYP3A4 inhibitors (grapefruit, some antifungals and antibiotics), cyclosporine, and fibrates. Muscle and liver effects mirror lovastatin. Not for use in pregnancy or breastfeeding. Restricted or dose-limited in the EU and other markets.
- Notable drug interactions
- Not for pregnancy
- Restricted in some countries
Sources
- Traditional Chinese lipid-lowering agent red yeast rice results in significant LDL reduction but safety is uncertain - a systematic review and meta-analysis. (Gerards, 2015)PubMed
- Impact of red yeast rice supplementation on lipid profile: a systematic review and meta-analysis of randomized-controlled trials. (Rahmani, 2023)PubMed
- NCCIH — Red Yeast RiceReference
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