Is Red Yeast Rice an alternative to statins?

Dr Iqbal Malik investigates.

Dr Malik was recently asked by a patient whether Red Yeast Rice (RYR) can be used as an alternative to statins, so he undertook some research and found the below results.

After consulting this medical journal, published in 2018, Dr Malik surmised that Red Yeast Rice contains Monacolin K, which in some forms (lactone) is nearly identical to Lovastatin (at statin). RYR is made by fermentation of rice with yeasts, mainly Monascus Purpureus. RYR is traditionally used in China for culinary purposes as a food colouring or as a traditional remedy to promote digestion and blood circulation.

The main points to note are:

  • RYR will lower cholesterol as it acts as a statin
  • It may cause similar side effects to statins and have similar drug interactions
  • It is not regulated as a medicine and therefore does not go through all the checks that statins have to go through
  • It is hard to calculate what the correct dose is. Some formulations have 10mg of Monacolin K, which is probably equivalent to a pharmacological dose of Lovastatin, but the ratio between Monacolin K lactone and Monacolin K HA is variable in food supplements containing RYR. For example, a range of supplements showed Monacolin K levels of 0.05mg to 2.74mg per 600mg of RYR.

So to summarise: Is Red Yeast Rice safer than a statin? Dr Malik says probably not.

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Written by Dr Iqbal Malik

Dr Iqbal Malik is a consultant cardiologist and Medical Director of OneWelbeck Heart Health, specialising in coronary artery disease and structural heart disease including PFO, ASD and the TAVI procedure.