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Red Yeast Rice for High Cholesterol (Hyperlipidemia)

A

CCSPS trial (4,870 post-MI): 45% MI reduction, 33% mortality reduction. Contains monacolin K (lovastatin). Strong efficacy for LDL reduction but significant regulatory and quality control concerns.

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The Bottom Line

            
            
CCSPS trial (4,870 post-MI): 45% MI reduction, 33% mortality reduction. Contains monacolin K (lovastatin). Strong efficacy for LDL reduction but significant regulatory and quality control concerns.

            
            
        

    











    
    

        
        

            

  
Key Statistics





            


    

        
22

        
Studies

    

    

        
8000

        
Participants

    

    

        
            
            ↑
            
        
        
Positive

    

    

        A

        
Grade

    




        


        
        

        
        
        

            

  
Dosage & Usage





            
mg = milligrams · mcg = micrograms (1,000× smaller) · IU = International Units


            
            

                
Commonly Used Dosages

                

                    
                    

                        
general:

                        
1,200-2,400 mg/day providing 10 mg monacolin K

                    

                    
                    

                        
lipidsupport:

                        
600 mg BID

                    

                    
                

                
                

                    Upper limit: EU-regulated maximum: 10 mg monacolin K/day; quality varies dramatically between products
                

                
            

            

            

            
            

                Best taken: With dinner (cholesterol synthesis peaks overnight)
            

            
        

        

        
        
        

            

  
Safety & Side Effects





            

                
                

                    
Reported Side Effects

                    
    
                        
                        
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                            Myalgia (muscle pain — same mechanism as statins)
                        
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                            Gastrointestinal discomfort
                        
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                            Elevated liver enzymes (rare)
                        
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                            Citrinin contamination risk in poorly manufactured products
                        
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                            Rhabdomyolysis (rare, at high doses)
                        
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Known Interactions

                    
    
                        
                        
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                            ●
                            Statins (contraindicated — same mechanism, additive myopathy risk)
                        
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                            CYP3A4 inhibitors (grapefruit juice, certain antibiotics — increased monacolin K levels)
                        
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                            Fibrates (increased myopathy risk)
                        
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                            Cyclosporine (increased myopathy risk)
                        
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                            Niacin (increased myopathy risk at high doses)
                        
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                        Tolerable upper intake: EU-regulated maximum: 10 mg monacolin K/day; quality varies dramatically between products
                    

                

                
            

            

                Always consult your healthcare provider before starting any supplement.
            

        

        

        
        
        

            

  
Frequently Asked Questions





            




    
    

        
            Does Red Yeast Rice help with High Cholesterol (Hyperlipidemia)?
            
        
        

            Based on 22 studies with 8,000 participants, there is strong evidence from multiple clinical trials that Red Yeast Rice may support High Cholesterol (Hyperlipidemia) management. Our evidence grade is A (Strong Evidence).
        

    

    
    

        
            How much Red Yeast Rice should I take for High Cholesterol (Hyperlipidemia)?
            
        
        

            Studies have used various dosages. A commonly studied range is 1,200-2,400 mg/day providing 10 mg monacolin K. Always consult your healthcare provider before starting any supplement regimen.
        

    

    
    

        
            Are there side effects of Red Yeast Rice?
            
        
        

            Reported side effects may include Myalgia (muscle pain — same mechanism as statins), Gastrointestinal discomfort, Elevated liver enzymes (rare), Citrinin contamination risk in poorly manufactured products. Most side effects are mild and dose-dependent. Consult your doctor if you experience any adverse reactions.
        

    

    
    

        
            How strong is the evidence for Red Yeast Rice and High Cholesterol (Hyperlipidemia)?
            
        
        

            We rate the evidence as Grade A (Strong Evidence). This rating is based on 22 peer-reviewed studies with 8,000 total participants. The overall direction of effect is positive.
        

    

    




        

        

        
        
        

            

  
Related Evidence





            

                
                
                

                
            

        

        

    


    
    












    

        FDA Disclaimer:
        These statements have not been evaluated by the Food and Drug Administration. The products and information on this website are not intended to diagnose, treat, cure, or prevent any disease. The evidence grades presented are based on our analysis of published peer-reviewed research and do not constitute medical advice. Always consult your healthcare provider before starting any supplement regimen.