Red Yeast Rice
Red yeast rice contains monacolin K (lovastatin-like). It can lower LDL but carries statin-like risks and product variability.
Overview
What is red yeast rice?
Red yeast rice is a fermented rice produced using the mold Monascus purpureus or Monascus ruber. The active ingredient found in red yeast rice, monacolin K, is the same compound found in prescription drugs including lovastatin.
Dosage
A typical dose of red yeast rice is 600 mg twice per day.
Effect graph
Effect heatmap
SupplementDEX Database
11 conditions for , , and rated at least stars. All purchase bands. No minimum star filter.
Database Snapshot
Most red yeast rice research is concentrated in a handful of conditions.
- Hyperlipidemia accounts for 36 of 54 studies (67%).
- High blood pressure accounts for 4 of 54 studies (7%).
- Myocardial infarction (MI) accounts for 4 of 54 studies (7%).
- Sparse coverage remains for Cancer, Metabolic syndrome, All-cause mortality.
Safety
Dose windows
Long-term
Red yeast rice is possibly safe at doses of up to 1.2 grams per day in the long term. Red yeast rice products contain the same HMG-CoA reductase inhibitor found in lovastatin and should be monitored for the same effects seen with lovastatin.
Frequently Asked Questions
References
Sources50 references
SupplementDEX uses only high-quality sources to determine supplement effectiveness.
SupplementDEX Database · Hyperlipidemia
36 references1.SupplementDEX Database: Hyperlipidemia — Red Yeast Rice and Statin Therapy in Patients with Hypercholesterolemia and the Comorbidities: A Retrospective Cohort Study on Lipid-Lowering Effects and Cardiovascular Outcomes2024
In a propensity-matched cohort of 5,984 hyperlipidemic adults, red yeast rice lowered cholesterol comparably to statins over 1 year, with similar cardiovascular outcomes in comorbid subgroups.
2.SupplementDEX Database: Hyperlipidemia — Safety and Efficacy of the Consumption of the Nutraceutical "Red Yeast Rice Extract" for the Reduction of Hypercholesterolemia in Humans: A Systematic Review and Meta-Analysis2024
A meta-analysis of 14 RCTs (4–24 weeks) found red yeast rice extract significantly lowered total cholesterol and LDL-C without increasing serious adverse events in hypercholesterolemia.
3.SupplementDEX Database: Hyperlipidemia — Impact of red yeast rice supplementation on lipid profile: a systematic review and meta-analysis of randomized-controlled trials2023
A meta-analysis of 24 RCT treatment arms found red yeast rice significantly lowered total cholesterol, LDL-C, and triglycerides and raised HDL-C in adults with dyslipidemia.
4.SupplementDEX Database: Hyperlipidemia — Evaluation of the effect of a dietary supplementation with a red yeast rice and fish oil-containing nutraceutical on lipid pattern, high sensitivity C-reactive protein, and endothelial function in moderately hypercholesterolaemic subjects: a double-blind, placebo-controlled, randomized clinical trial2023
In moderately hypercholesterolemic adults over 8 weeks, combined red yeast rice (2.8 mg monacolins) plus fish oil lowered LDL-C 17%, total cholesterol 12%, apoB 22%, and hsCRP 15% versus placebo.
5.SupplementDEX Database: Hyperlipidemia — The antihyperlipidemic effect of a combined supplement of standardized dry extracts of amla (Emblica officinalis), walnut (Juglans regia), olive (Olea europaea) and red yeast rice (Monascus purpureus) powder: Reduction in circulatory low-density lipoprotein-cholesterol (LDL-C) and remnant cholesterol (RC) levels in patients with hypercholesterolemia2023
In 208 hypercholesterolemic adults over 2 months, a combined amla, walnut, olive, and red yeast rice supplement lowered total cholesterol 15%, LDL-C 19%, and remnant cholesterol 12% with good tolerability.
6.SupplementDEX Database: Hyperlipidemia — Red Yeast Rice for Hyperlipidemia: A Meta-Analysis of 15 High-Quality Randomized Controlled Trials2022
A meta-analysis of 15 RCTs (1,012 adults) found red yeast rice at 200–4800 mg/day effectively improved lipids, with a notable triglyceride-lowering effect versus statins or other nutraceuticals.
7.SupplementDEX Database: Hyperlipidemia — Red yeast rice for dyslipidaemias and cardiovascular risk reduction: A position paper of the International Lipid Expert Panel2022
An International Lipid Expert Panel position paper reviewed evidence that red yeast rice lowers LDL-C and may reduce cardiovascular events, advising use mainly when statins are unsuitable.
8.SupplementDEX Database: Hyperlipidemia — 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice2021
The 2021 ESC cardiovascular prevention guidelines provide clinical recommendations on lipid management and prevention; no specific red yeast rice trial data are summarized in the available abstract.
9.SupplementDEX Database: Hyperlipidemia — Low dose red yeast rice with monacolin K lowers LDL cholesterol and blood pressure in Japanese with mild dyslipidemia: A multicenter, randomized trial2021
In 18 Japanese adults with mild dyslipidemia over 8 weeks, low-dose red yeast rice (200 mg/day, 2 mg monacolin K) lowered LDL-C, total cholesterol, apoB, and blood pressure versus diet alone.
10.SupplementDEX Database: Hyperlipidemia — Efficacy and Safety of Armolipid Plus®: An Updated PRISMA Compliant Systematic Review and Meta-Analysis of Randomized Controlled Clinical Trials2021
A meta-analysis of 12 RCTs (1,050 adults) found Armolipid Plus (including red yeast rice) significantly improved total cholesterol, LDL-C, triglycerides, hsCRP, and fasting glucose versus control.
11.SupplementDEX Database: Hyperlipidemia — Comparison of the Reductions in LDL-C and Non-HDL-C Induced by the Red Yeast Rice Extract Xuezhikang Between Fasting and Non-fasting States in Patients With Coronary Heart Disease2021
In 50 coronary heart disease patients over 6 weeks, 1,200 mg/day Xuezhikang lowered LDL-C and non-HDL-C similarly in fasting and non-fasting states after meals.
12.SupplementDEX Database: Hyperlipidemia — Effect of combined lipid-lowering and antioxidant nutraceutical on plasma lipids, endothelial function, and estimated cardiovascular disease risk in moderately hypercholesterolemic patients: a double-blind, placebo-controlled randomized clinical trial2021
In 40 moderately hypercholesterolemic adults over 8 weeks, a red-yeast-rice-based nutraceutical lowered total cholesterol 12% and LDL-C 17% and improved endothelial reactivity versus placebo.
13.SupplementDEX Database: Hyperlipidemia — Efficacy of red yeast rice extract on myocardial infarction patients with borderline hypercholesterolemia: A meta-analysis of randomized controlled trials2020
A meta-analysis of 7 trials (10,699 post-MI patients) found red yeast rice at 1,200 mg/day reduced nonfatal MI, revascularization, sudden death, and improved lipid profiles.
14.SupplementDEX Database: Hyperlipidemia — A Randomized, Double-Blinded, Placebo-Controlled, Clinical Study of the Effects of a Nutraceutical Combination (LEVELIP DUO®) on LDL Cholesterol Levels and Lipid Pattern in Subjects with Sub-Optimal Blood Cholesterol Levels (NATCOL Study)2020
In 88 moderately hypercholesterolemic adults over 8 weeks, combined phytosterols and red yeast rice lowered LDL-C 32.5 mg/dL (−19.8%) versus a 2.5 mg/dL rise on placebo.
15.SupplementDEX Database: Hyperlipidemia — 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines2019
The 2019 ACC/AHA primary prevention guideline provides recommendations on cardiovascular risk management; no specific red yeast rice trial outcomes are summarized in the available abstract.
16.SupplementDEX Database: Hyperlipidemia — Adverse Events to Food Supplements Containing Red Yeast Rice: Comparative Analysis of FAERS and CAERS Reporting Systems2018
A comparative analysis of FDA and Canadian adverse event reports found red yeast rice supplements were associated with statin-like liver and muscle adverse events in real-world reporting systems.
17.SupplementDEX Database: Hyperlipidemia — Comparison of Low-Dose Statin Versus Low-Dose Statin + Armolipid Plus in High-Intensity Statin-Intolerant Patients With a Previous Coronary Event and Percutaneous Coronary Intervention (ADHERENCE Trial)2017
An RCT of 100 statin-intolerant post-PCI coronary patients found low-dose statin plus Armolipid Plus (berberine-containing nutraceutical) achieved LDL <70 mg/dL in 70% versus none on statin alone.
18.SupplementDEX Database: Hyperlipidemia — Effects of a nutraceutical combination containing berberine (BRB), policosanol, and red yeast rice (RYR), on lipid profile in hypercholesterolemic patients: A meta-analysis of randomised controlled trials2016
A meta-analysis of 11 RCTs in 3,924 patients found the berberine-containing nutraceutical Armolipid Plus reduced total cholesterol 9.9% and LDL 13.7% versus control.
19.SupplementDEX Database: Hyperlipidemia — ESSENS dyslipidemia: A placebo-controlled, randomized study of a nutritional supplement containing red yeast rice in subjects with newly diagnosed dyslipidemia2016
In a multicenter RCT of statin-free adults with newly diagnosed dyslipidemia over 12 weeks, a red yeast rice nutritional supplement improved LDL-C versus placebo.
20.SupplementDEX Database: Hyperlipidemia — Pharmacologically effective red yeast rice preparations marketed as dietary supplements illustrated by a case report2016
A case report described statin-like myopathy from a red yeast rice supplement and analyzed monacolin content, highlighting regulatory gaps for pharmacologically active dietary supplements.
21.SupplementDEX Database: Hyperlipidemia — Xuezhikang Capsule for Type 2 Diabetes with Hyperlipemia: A Systematic Review and Meta-Analysis of Randomized Clinical Trails2015
A meta-analysis of 21 RCTs (1,548 type 2 diabetics with hyperlipidemia) found Xuezhikang improved lipids and was generally safe over at least 8 weeks of treatment.
22.SupplementDEX Database: Hyperlipidemia — Usefulness of Nutraceuticals (Armolipid Plus) Versus Ezetimibe and Combination in Statin-Intolerant Patients With Dyslipidemia With Coronary Heart Disease2015
An RCT of 100 statin-intolerant dyslipidemic CHD patients found Armolipid Plus alone or with ezetimibe improved LDL-C over 3–12 months with good tolerability versus ezetimibe monotherapy.
23.SupplementDEX Database: Hyperlipidemia — Traditional Chinese lipid-lowering agent red yeast rice results in significant LDL reduction but safety is uncertain - a systematic review and meta-analysis2015
A meta-analysis of 20 RCTs found red yeast rice significantly lowered LDL cholesterol, but safety reporting was inconsistent and long-term harm signals could not be fully excluded.
24.SupplementDEX Database: Hyperlipidemia — Nutraceutical approach to moderate cardiometabolic risk: results of a randomized, double-blind and crossover study with Armolipid Plus2014
An 8-week crossover RCT of 30 moderate-risk adults found Armolipid Plus lowered LDL-C 21.1%, comparable to pravastatin 10 mg/day, and improved leptin-to-adiponectin ratio.
25.SupplementDEX Database: Hyperlipidemia — Effect on LDL-cholesterol of a large dose of a dietary supplement with plant extracts in subjects with untreated moderate hypercholesterolaemia: a randomised, double-blind, placebo-controlled study2013
In 45 hypercholesterolemic adults, 4 weeks of a red yeast rice, policosanol, and artichoke supplement at standard or double dose lowered LDL versus placebo, with no extra benefit from doubling the dose.
26.SupplementDEX Database: Hyperlipidemia — A combined natural supplement lowers LDL cholesterol in subjects with moderate untreated hypercholesterolemia: a randomized placebo-controlled trial2013
In 100 adults with moderate hypercholesterolemia over 16 weeks, a supplement with red yeast rice, policosanol, and artichoke lowered LDL cholesterol 14% versus placebo without safety concerns.
27.SupplementDEX Database: Hyperlipidemia — LDL-cholesterol-lowering effect of a dietary supplement with plant extracts in subjects with moderate hypercholesterolemia2013
In 39 adults with moderate hypercholesterolemia over 16 weeks, a supplement with red yeast rice, policosanol, and artichoke extract reduced LDL cholesterol 21% and total cholesterol 14% versus baseline.
28.SupplementDEX Database: Hyperlipidemia — A multicenter study of nutraceutical drinks for cholesterol (evaluating effectiveness and tolerability)2012
In 79 adults in a multicenter trial, nutraceutical drinks containing red yeast rice lowered LDL and total cholesterol more than placebo drinks without red yeast rice.
29.SupplementDEX Database: Hyperlipidemia — Long-term effects of nutraceuticals (berberine, red yeast rice, policosanol) in elderly hypercholesterolemic patients2011
A 12-month RCT of 80 statin-intolerant elderly hypercholesterolemic patients found a berberine-containing nutraceutical reduced total cholesterol 20% and LDL 31% with good tolerability.
30.SupplementDEX Database: Hyperlipidemia — Tolerability of red yeast rice (2,400 mg twice daily) versus pravastatin (20 mg twice daily) in patients with previous statin intolerance2010
In 43 statin-intolerant adults over 12 weeks, red yeast rice 2,400 mg twice daily was tolerated similarly to pravastatin 20 mg twice daily for lipid lowering.
31.SupplementDEX Database: Hyperlipidemia — Effects of a nutraceutical combination (berberine, red yeast rice and policosanols) on lipid levels and endothelial function randomized, double-blind, placebo-controlled study2010
A 6-week RCT of 50 hypercholesterolemic adults found berberine-red yeast rice-policosanol lowered total cholesterol 1.14 mmol/L and LDL 1.06 mmol/L and improved endothelial function versus placebo.
32.SupplementDEX Database: Hyperlipidemia — Red yeast rice for dyslipidemia in statin-intolerant patients: a randomized trial2009
In 62 statin-intolerant adults over 24 weeks, red yeast rice 1,800 mg twice daily lowered LDL-C 27% versus 6% on placebo alongside lifestyle counseling.
33.SupplementDEX Database: Hyperlipidemia — Efficacy of Monascus purpureus Went rice on lowering lipid ratios in hypercholesterolemic patients2007
In 79 hypercholesterolemic adults over 8 weeks, red yeast rice 600 mg twice daily significantly improved LDL-C and multiple lipid ratios versus placebo.
34.SupplementDEX Database: Hyperlipidemia — Efficacy and safety of Monascus purpureus Went rice in subjects with hyperlipidemia2005
In 79 hypercholesterolemic adults over 8 weeks, Monascus purpureus red yeast rice 600 mg twice daily lowered LDL-C about 27% with no serious adverse events reported.
35.SupplementDEX Database: Hyperlipidemia — Cholesterol-lowering effects of a proprietary Chinese red-yeast-rice dietary supplement1999
In 46 hyperlipidemic US adults on a Step I diet, a proprietary red yeast rice supplement 2.4 g/day significantly lowered total and LDL cholesterol versus placebo.
36.Multicenter clinical trial of the serum lipid-lowering effects of a Monascus purpureus (red yeast) rice preparation from traditional Chinese medicine. See external sourceExternal source
37.SupplementDEX Database: Myocardial infarction (MI) — 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)2009
In 772 elderly hypertensive post-MI patients over 4.5 years, Xuezhikang reduced coronary events by 38% and coronary death by 29% versus placebo.
38.SupplementDEX Database: Myocardial infarction (MI) — Effect of Xuezhikang, an extract from red yeast Chinese rice, on coronary events in a Chinese population with previous myocardial infarction2008
In ~5000 post-MI Chinese patients over 4.5 years, Xuezhikang cut major coronary events from 10.4% to 5.7%, reduced CV and total mortality ~30%, and improved lipids.
39.SupplementDEX Database: Myocardial infarction (MI) — 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)2007
In 591 type 2 diabetics with coronary heart disease followed ~4 years, Xuezhikang reduced coronary events from 18.6% to 9.2% versus placebo.
SupplementDEX Database · High blood pressure
4 references40.SupplementDEX Database: High blood pressure — Effects of combined therapy of Xuezhikang Capsule and Valsartan on hypertensive left ventricular hypertrophy and heart rate turbulence2010
In 32 hypertensive patients with LVH over 24 months, combined Xuezhikang (1200 mg/day) and valsartan improved heart rate turbulence and LV mass index more than valsartan alone.
41.SupplementDEX Database: High blood pressure — Long-term effects of Xuezhikang on blood pressure in hypertensive patients with previous myocardial infarction: data from the Chinese Coronary Secondary Prevention Study (CCSPS)2010
In 1363 hypertensive post-MI patients over 4.5 years, Xuezhikang did not significantly change blood pressure versus placebo in this CCSPS subgroup analysis.
42.SupplementDEX Database: High blood pressure — Potential protective effect of long-term therapy with Xuezhikang on left ventricular diastolic function in patients with essential hypertension2009
In 28 hypertensive patients over 72 weeks, 1200 mg/day Xuezhikang with nifedipine improved left ventricular diastolic function versus placebo plus nifedipine.
43.SupplementDEX Database: High blood pressure — Effects of Xuezhikang and pravastatin on circulating endothelial progenitor cells in patients with essential hypertension2009
In 88 hypertensive patients over 8 weeks, Xuezhikang or pravastatin with antihypertensive drugs increased circulating endothelial progenitor cell count and function similarly.
SupplementDEX Database · All-cause mortality
1 reference44.SupplementDEX Database: All-cause mortality — Red Yeast Rice Preparations Reduce Mortality, Major Cardiovascular Adverse Events, and Risk Factors for Metabolic Syndrome: A Systematic Review and Meta-analysis2022
A meta-analysis of 30 RCTs found red yeast rice reduced mortality, major cardiovascular events, fasting glucose, HbA1c, and blood pressure in metabolic syndrome.
SupplementDEX Database · Atherosclerosis
1 reference45.SupplementDEX Database: Atherosclerosis — Effectiveness of red yeast rice on carotid atherosclerosis: A systematic review and meta-analysis2022
A meta-analysis of 20 RCTs (2217 patients) found red yeast rice reduced carotid plaque area, plaque score, intima-media thickness, and LDL cholesterol.
SupplementDEX Database · Liver cancer
1 reference46.SupplementDEX Database: Liver cancer — LipoCol Forte capsules reduce the risk of liver cancer: A propensity score-matched, nationwide, population-based cohort study2023
In a propensity-matched Taiwanese cohort, LipoCol Forte red yeast rice prescription was associated with lower liver cancer risk compared with matched non-users.
SupplementDEX Database · Metabolic syndrome
2 references47.SupplementDEX Database: Metabolic syndrome — A nutraceutical combination reduces left ventricular mass in subjects with metabolic syndrome and left ventricular hypertrophy: A multicenter, randomized, double-blind, placebo-controlled trial2020
In 74 metabolic syndrome patients with left ventricular hypertrophy over 24 weeks, Armolipid Plus (berberine, red yeast rice, policosanol) reduced left ventricular mass versus placebo.
48.SupplementDEX Database: Metabolic syndrome — Effect of Monacolin K and COQ10 supplementation in hypertensive and hypercholesterolemic subjects with metabolic syndrome2018
In 104 hypertensive hypercholesterolemic metabolic syndrome patients over 2 months, monacolin K plus coenzyme Q10 with lifestyle management improved blood pressure and lipids versus diet alone.
49.SupplementDEX Database: Postoperative recovery — Effects of red yeast rice prescription (LipoCol Forte) on adverse outcomes of surgery2019
In 2,581 surgical patients matched to 25,810 controls, preoperative red yeast rice (LipoCol Forte) prescription showed no significant difference in postoperative complications or mortality.
SupplementDEX Database · Stroke
1 reference50.SupplementDEX Database: Stroke — Decreased Risk of Stroke in People Using Red Yeast Rice Prescriptions (LipoCol Forte®): a Total Population-Based Retrospective Cohort Study2022
In 34,723 Taiwanese adults matched to lovastatin users, red yeast rice prescription (LipoCol Forte) was associated with lower incident stroke risk over follow-up.