Red Yeast Rice: Benefits, Dosage, Contraindications

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Red yeast rice is the product of rice fermented by the yeast Monascus purpureus. Red yeast rice contains monacolins, including monacolin K, also known as mevinolin, which is identical to lovastatin and other 'statin'-type compounds inhibiting HMG-CoA reductase. Like most statins, red yeast rice can reduce circulating cholesterol levels. It is particularly used in cases of hypercholesterolemia or cardiovascular diseases.

Other name(s) 

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Scientific name(s)

Monascus purpureus

Family or group: 

Probiotics

Active ingredients:

Monacolin K


Indications

Rating methodology

EFSA approval.

Several clinical trials (> 2) randomized controlled with double blind, including a significant number of patients (>100) with consistently positive outcomes for the indication.
Several clinical trials (> 2) randomized controlled with double blind, and including a significant number of patients (>100) with positive outcomes for the indication.
One or more randomized studies or multiple cohorts or epidemiological studies with positive outcomes for the indication.
Clinical studies exist but are uncontrolled, with conclusions that may be positive or contradictory.
Lack of clinical studies to date that can demonstrate the indication.


Hypercholesterolemia
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Clinical research shows that taking red yeast rice products, 1 to 5 grams per day, can significantly reduce total cholesterol by 11 to 23% and low-density lipoprotein (LDL) cholesterol by 22 to 34%, when used for up to 24 weeks. Most studies show that red yeast rice products can significantly reduce triglycerides and increase high-density lipoprotein (HDL) cholesterol in patients with hyperlipidemia. It may take up to 12 weeks to observe the effects of red yeast rice on lipid parameters. These products provide up to 10-20 mg per day of monacolin K, which is identical to the 'statin' drug, lovastatin. EFSA has stated that red yeast rice can contribute to "maintaining normal LDL cholesterol levels" provided a daily intake of monacolin K (lovastatin) equal to 10 mg is administered.

Posologie

posologieOral

posologie1 - 5 g

duration24 - weeks

formulationStandardized extract in monacolin K


Cardiovascular diseases
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Taking red yeast rice extract at a dose of 1.2 grams per day for an average of 4.5 years reduces the incidence of coronary events by up to 51%, non-fatal myocardial infarctions by up to 64%, all-cause mortality by up to 36%, and mortality due to coronary heart disease by up to 32% in people who have already had a myocardial infarction, compared to placebo.

Posologie

posologieOral

posologie1.2 g

duration5 - years

formulationDry extract


Properties


Cholesterol-lowering

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Red yeast rice contains 10 mevinic acids, also known as monacolins. These compounds, which naturally make up about 0.4% of red yeast rice, competitively inhibit the 3-hydroxy-3-methyl-glutaryl-coenzyme A (HMG-CoA) reductase, blocking cholesterol biosynthesis. Red yeast rice also contains sterols, including beta-sitosterol, campesterol, stigmasterol, and sapogenin; isoflavones and isoflavone glycosides; and monounsaturated fatty acids. These phytosterols, isoflavones, and fatty acids may inhibit cholesterol absorption or increase cholesterol clearance in circulation.

Usages associés

Hypercholesterolemia

Cardiovascular

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Some evidence suggests that red yeast rice may increase the number and improve the function of circulating endothelial progenitor cells (CEPC). CEPCs are thought to help protect and repair the vascular endothelium. Red yeast rice may also improve cardiovascular health by improving left ventricular mass index and left ventricular diastolic function. These effects have been attributed to the antifibrotic and anti-inflammatory effects of red yeast rice.

Usages associés

Cardiovascular diseases

Anti-inflammatory

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Red yeast rice decreases levels of C-reactive protein and inhibits certain inflammatory markers such as TNF and interleukins.


Antioxidant

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The tannins from red yeast rice protect lipids from peroxidation according to some in vivo studies. Animal research suggests that red yeast rice may increase exercise endurance by reducing exercise-induced oxidative stress.


Safety dosage

Adult from 18 years: 1200 mg - 2400 mg (standardized extract)

Red yeast rice products have been used safely in clinical studies for up to 4.5 years. However, red yeast rice products may contain an HMG-CoA reductase inhibitor identical to lovastatin, and may cause the same side effects as this medication. It is recommended that individuals taking red yeast rice products be monitored for the same hepatic and muscular side effects seen with lovastatin. Doses range from 1200 mg to 2400 mg per day, providing between 7 and 10 mg of Monacolin K.


Interactions

Médicaments

Gemfibrozil: moderate interaction

Red yeast rice contains lovastatin, a statin-based medication, and has been associated with cases of myopathy. In theory, taking red yeast rice in conjunction with Gemfibrozil could increase the risk of myopathy.

Statins: moderate interaction

Red yeast rice contains lovastatin, a statin-based medication. Theoretically, taking red yeast rice with other statins could increase the risk of potential adverse effects. It is recommended to avoid red yeast rice products in individuals taking prescription statins (HMG-CoA reductase inhibitors).

Plantes ou autres actifs

Red yeast rice: weak interaction

St. John's wort induces enzyme 3A4 of cytochrome P450 and can lower serum levels of lovastatin, a statin family medication. Red yeast rice contains statin-type medications such as lovastatin. Theoretically, St. John's wort could reduce serum levels of lovastatin from red yeast rice.

Red yeast rice: moderate interaction

Red yeast rice could lower levels of coenzyme Q-10.


Precautions

Breastfeeding women: avoid

Avoid due to lack of data.

Liver insufficiency: avoid

Red yeast rice contains lovastatin, a statin-based drug. Lovastatin may cause liver damage in some individuals. Some clinical research suggests that supplements containing red yeast rice might increase liver enzyme levels in some individuals. Some cases of acute hepatitis have been associated with the use of red yeast rice. However, other clinical evidence suggests that taking red yeast rice may decrease liver enzyme levels. Due to the inconsistency of results, red yeast rice should be used cautiously or avoided in individuals with liver dysfunction, at risk of liver dysfunction, or with abnormal liver function test results.


Contraindications

Pregnant women: prohibited

Lovastatin, a constituent of red yeast rice, has caused fetal skeletal malformations in animals; contraindicated for pregnant women.