Red yeast rice: benefits, dosage, contraindications
Scientific name(s)
Monascus purpureus
Family or group:
Probiotics
Active ingredients:
Monacolin K
Indications
Scoring methodology
EFSA approval.
Hypercholesterolemia ✪✪✪✪✪
Clinical research shows that taking red yeast rice–based 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 periods of up to 24 weeks. Most studies show that red yeast rice–based products can significantly reduce triglycerides and increase high-density lipoprotein (HDL) cholesterol in patients with hyperlipidemia. It can sometimes 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.nnThe EFSA has stated that red yeast rice can contribute to "maintaining a normal LDL cholesterol level" provided it delivers a daily dose of monacolin K (lovastatin) equal to 10 mg.nn
Posologie
Oral
1 - 5 g
24 - weeks
extract standardized to monacolin K
Red yeast rice for dyslipidemia in statin-intolerant patients: A randomized trial.
Multicenter clinical trial of the serum lipid-lowering effects of a monascus purpureus (red yeast) rice preparation from traditional Chinese medicine.
Efficacy of Monascus purpureus Went rice on lowering lipid ratios in hypercholesterolemic patients.
Chinese red yeast rice (Monascus purpureus) for primary hyperlipidemia: a meta-analysis of randomized controlled trials.
Tolerability of red yeast rice (2,400 mg twice daily) versus pravastatin (20 mg twice daily) in patients with previous statin intolerance
Cholesterol-lowering effects of a proprietary Chinese red-yeast-rice dietary supplement.
Efficacy and safety of Monascus purpureus Went rice in subjects with hyperlipidemia.
Xuezhikang decreases serum lipoprotein(a) and C-reactive protein concentrations in patients with coronary heart disease.
Cardiovascular diseases ✪✪✪✪✪
The intake of 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 with placebo.
Posologie
Oral administration
1.2 g
5 - years
dry extract
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).
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).
Properties
Cholesterol-lowering
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 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 can inhibit cholesterol absorption or increase cholesterol clearance from circulation.nn
Usages associés
Cardiovascular
Some evidence suggests that red yeast rice may increase the number and improve the function of circulating endothelial progenitor cells (EPCs). EPCs are thought to help protect and repair the vascular endothelium.nnRed yeast rice may also improve cardiovascular status by improving left ventricular mass index and left ventricular diastolic function. These effects have been attributed to the anti-fibrotic and anti-inflammatory effects of red yeast rice.nn
Usages associés
Anti-inflammatory
Red yeast rice lowers C-reactive protein levels and inhibits certain markers of inflammation such as TNF and interleukins.nn
Antioxidant
The tannins of 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.nn
Safe dosage
Adults 18 years and older: 1200 mg - 2400 mg (standardized extract)
Red yeast rice products have been used safely in clinical studies for periods of 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 that drug. It is recommended that people taking red yeast rice products be monitored for the same hepatic and muscular adverse effects as those observed with lovastatin. Doses range from 1200 mg to 2400 mg per day, providing between 7 and 10 mg of Monacoline K.
Interactions
Médicaments
Gemfibrozil: moderate interaction
Red yeast rice contains lovastatin, a statin medication, and has been associated with cases of myopathy. In theory, taking red yeast rice together with gemfibrozil could increase the risk of myopathy.
Statins: moderate interaction
Red yeast rice contains lovastatin, a statin 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 people taking prescription statins (HMG-CoA reductase inhibitors).
Plantes ou autres actifs
Red yeast rice: low interaction
St. John's wort induces the cytochrome P450 3A4 enzyme and can lower serum levels of lovastatin, a drug from the statin family. Red yeast rice contains statin-type substances such as lovastatin. Theoretically, St. John's wort could reduce the serum levels of lovastatin from red yeast rice.
Red yeast rice: moderate interaction
Red yeast rice may lower coenzyme Q10 levels.
Precautions
Breastfeeding: avoid
Avoid due to lack of data.
Hepatic impairment: avoid
Red yeast rice contains lovastatin, a statin drug. Lovastatin can cause liver injury in some people. Some clinical research suggests that supplements containing red yeast rice may 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. Because of inconsistent results, red yeast rice should be used with caution or avoided in people with liver dysfunction, at risk of liver dysfunction, or with abnormal liver function test results.
Contraindications
Pregnancy: contraindicated
Lovastatin, a component of red yeast rice, caused fetal skeletal malformations in animals; contraindicated in pregnant women.
