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Red Yeast Rice - Drug Interactions

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Updated September 14, 2013

HMG Co-A Reductase Inhibitors / Statin Drugs:

e.g. atorvastatin (Lipitor), lovastatin (Mevacor), pravastatin (Pravachol)
Statin cholesterol-lowering drugs should not be taken with red yeast rice because it may increase the effect of these medications and raise the risk of side effects such as liver damage.

Fibrate Drugs:

e.g. fenofibrate ((Tricor, Triglide, Lofibra), gemfibrozil (Lopid), clofibrate (Atromid-S)
Drugs in the fibrate family are used to lower cholesterol and triglyceride levels in blood. Using them with red yeast rice may increase the effect of these medications.

Cyclosporine:

Cyclosporine (Sandimmune, Neoral Gengraf) should not be taken with red yeast rice. Because red yeast rice works in a similar way to statin drugs, taking them with cyclosporine increases blood levels of red yeast rice and raises the risk of the serious condition rhabdomyolysis.

Macrolide Antibiotics:

e.g. erythromycin, azithromycin (Zithromax), clarithromycin (Biaxin), dirithromycin (Dynabac), roxithromycin (Rulid, Surlid)
Macrolides are a class of drugs used to treat infections such as respiratory tract infections and soft tissue infections. They are known to interact with statin drugs (and therefore red yeast rice) and increase the risk of rhabdomyolysis.

Antifungal Drugs:

Antifungal agents, particularly the azole antifungals fluconazole (Diflucan), itraconazole (Sporanox), ketoconazole (Nizoral) are known to interact with statin drugs (and therefore red yeast rice) and increase the risk of rhabdomyolysis.

High-Dose Niacin:

Niacin supplements may increase the risk of myopathy if combined with red yeast rice.

Nefazodone:

Nefazadone is primarily used to treat depression. If combined with red yeast rice nefazodone may increase the risk of red yeast rice.

Protease Inhibitors:

Protease inhibitors, such as amprenavir, indinavir, nelfinavir, ritonavir, saquinavir, are used for HIV infection. Use of red yeast rice with a protease inhibitor may increase the risk of myopathy.

Warfarin (Coumadin®):

Red yeast rice used with warfarin may increase the risk of bleeding.

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