Red yeast rice is made by fermenting a type of yeast over rice. It has been used to promote heart health and lower cholesterol. Red yeast rice can be taken as a pill or powder. There are some warnings against certain red yeast products. The ones with ‘lovastatin’ are not safe.Dosages
600 milligrams 2 to 4 times daily
Editorial process and description of evidence categories can be found at EBSCO NAT Editorial Process.
It is likely safe for most adults to take red yeast rice in small doses for a short time. Red yeast rice may be unsafe for women who are pregnant. Not enough studies have been done to say whether it is safe to take for a long period. It is also not known whether it is safe to take by women who are breastfeeding.G1, G2
Talk to your doctor about any supplements or therapy you would like to use. Some can interfere with treatment or make conditions worse, such as:
A1. Zhao SP, Lu ZL, et al. Xuezhikang, an extract of cholestin, reduces cardiovascular events in type 2 diabetes patients with coronary heart disease: subgroup analysis of patients with type 2 diabetes from China coronary secondary prevention study (CCSPS). J Cardiovasc Pharmacol. 2007 Feb;49(2):81-84.
B1. Li Y, Jiang L, et al. A meta-analysis of red yeast rice: an effective and relatively safe alternative approach for dyslipidemia. PLoS One. 2014;9(6):e98611.
C. Heart Attack
C1. Lu Z, Kou W, et al. Effect of Xuezhikang, an extract from red yeast Chinese rice, on coronary events in a Chinese population with previous myocardial infarction. Am J Cardiol. 2008 Jun 15;101(12):1689-1693.
D. High Cholesterol
D1. Becker DJ, Gordon RY, et a;. Red yeast rice for dyslipidemia in statin-intolerant patients: a randomized trial. Ann Intern Med. 2009 Jun 16;150(12):830-839, W147-149.
D2. Halbert SC, French B, et al. Tolerability of red yeast rice (2,400 mg twice daily) versus pravastatin (20 mg twice daily) in patients with previous statin intolerance. Am J Cardiol. 2010 Jan 15;105(2):198-204.
D3. Affuso F, Ruvolo A, et al. Effects of a nutraceutical combination (berberine, red yeast rice and policosanols) on lipid levels and endothelial function randomized, double-blind, placebo-controlled study. Nutr Metab Cardiovasc Dis. 2010 Nov;20(9):656-661.
D4. Guardamagna O, Abello F, et al. The treatment of hypercholesterolemic children: efficacy and safety of a combination of red yeast rice extract and policosanols. Nutr Metab Cardiovasc Dis. 2011 Jun;21(6):424-429.
D5. Marazzi G, Cacciotti L, et al. Long-term effects of nutraceuticals (berberine, red yeast rice, policosanol) in elderly hypercholesterolemic patients. Adv Ther. 2011 Dec;28(12):1105-1113.
D6. Gerards MC, Terlou RJ, et al. Traditional Chinese lipid-lowering agent red yeast rice results in significant LDL cholesterol reduction but safety is uncertain-a systematic review and meta-analysis. Atherosclerosis. 2015;240(2):415-423.
D7. Cicero AF, Morbini M, et al. Middle-Term Dietary Supplementation with Red Yeast Rice Plus Coenzyme Q10 Improves Lipid Pattern, Endothelial Reactivity and Arterial Stiffness in Moderately Hypercholesterolemic Subjects. Ann Nutr Metab. 2016;68(3):213-219.
D8. Ong YC, Aziz Z. Systematic review of red yeast rice compared with simvastatin in dyslipidaemia. J Clin Pharm Ther. 2016 Apr;41(2):170-179.
D9. Millán J, Cicero AF, et al. Effects of a nutraceutical combination containing berberine (BRB), policosanol, and red yeast rice (RYR), on lipid profile in hypercholesterolemic patients: A meta-analysis of randomised controlled trials. Clin Investig Arterioscler. 2016 Jul-Aug;28(4):178-87.
D10. Tshongo Muhindo C, et al. Efficacy and safety of a combination of red yeast rice and olive extract in hypercholesterolemic patients with and without statin-associated myalgia. Complement Ther Med. 2017;35:140-144.
D11. Spigoni V, Aldigeri R, et al. Effects of a New Nutraceutical Formulation (Berberine, Red Yeast Rice and Chitosan) on Non-HDL Cholesterol Levels in Individuals with Dyslipidemia: Results from a Randomized, Double Blind, Placebo-Controlled Study. Int J Mol Sci. 2017 Jul 12;18(7). pii: E1498.
D12. Peng D, Fong A, et al. Original Research: The Effects of Red Yeast Rice Supplementation on Cholesterol Levels in Adults. Am J Nurs. 2017 Aug;117(8):46-54.
E1. Li JJ, Lu ZL, et al. Beneficial impact of Xuezhikang on cardiovascular events and mortality in elderly hypertensive patients with previous myocardial infarction from the China Coronary Secondary Prevention Study (CCSPS). J Clin Pharmacol. 2009 Aug;49(8):947-956.
E2. Xiong X, Wang P, et al. The effects of red yeast rice dietary supplement on blood pressure, lipid profile, and C-reactive protein in hypertension: A systematic review. Crit Rev Food Sci Nutr. 2017 Jun 13;57(9):1831-1851.
F. Metabolic Syndrome
F1. Verhoeven V, Van der Auwera A, et al. Can red yeast rice and olive extract improve lipid profile and cardiovascular risk in metabolic syndrome?: A double blind, placebo controlled randomized trial. BMC Complement Altern Med. 2015 Mar 10;15:52.
G1. Dujovne CA. Red Yeast Rice Preparations: Are They Suitable Substitutions for Statins? Am J Med. 2017 Oct;130(10):1148-1150.
G2. Raschi E, Girardi A, et al. Adverse Events to Food Supplements Containing Red Yeast Rice: Comparative Analysis of FAERS and CAERS Reporting Systems. Drug Saf. 2018 Aug;41(8):745-752.
Last reviewed July 2019 by EBSCO NAT Review Board
Eric Hurwitz, DC
Last Updated: 3/30/2020