Interactions

Some medicines, supplements, and substances may not work well with red yeast rice. These include:

• Alcohol. Don't drink alcohol if you are taking red yeast rice. The combination might increase the risk of liver damage.
• Cyclosporine (Neoral, Sandimmune). This medicine suppresses the immune system. Taking it with red yeast rice might raise the risk of muscle issues.
• Cytochrome P450 3A4 inhibitors. Taking red yeast rice with medicines that slow down or stop the CYP3A4 enzyme might raise the risk of harmful side effects from red yeast rice. These medicines include erythromycin.
• Grapefruit. Drinking grapefruit juice and taking red yeast rice might raise the risk of the supplement's harmful side effects.
• Gemfibrozil (Lopid). Taking this cholesterol medicine with red yeast rice might raise the risk of muscle issues.
• Hepatotoxic medicines, herbs and supplements. Red yeast rice may have monacolin K in it, which can cause liver damage in some people. Taking red yeast rice with these types of medicines, herbs, and supplements could raise the risk of liver damage.
• Niacin. Taking red yeast rice with high-dose niacin might raise the risk of muscle issues.
• St. John's wort. Taking this supplement with red yeast rice might lessen how well the red yeast rice works.
• Statins. Taking red yeast rice with statins might raise the risk of harmful side effects.