Adverse effect of red yeast rice

Townsend Letter for Doctors and Patients,  May, 2007  by Alan R. Gaby

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A 61-year-old woman with a history of myopathy due to simvastatin developed severe myalgia in association with markedly elevated serum creatine kinase concentrations while taking unspecified doses of red yeast rice (rice that has been fermented by the red yeast Monascus purpureus) for hyperlipidemia. After red yeast rice was discontinued, symptoms resolved, and the creatine kinase level became normal.

Comment: Red yeast rice contains a wide array of chemicals that are structurally similar to, and have the same mechanism of action as, prescription HMG CoA-reductase inhibitors (statin drugs) used to treat hypercholesterolemia. Myopathy and myalgia are common side effects of prescription statin drugs. While red yeast rice seems to be well-tolerated in most cases, it has the potential to cause the same adverse effects in susceptible people as statins do. People taking red yeast rice should therefore watch for the development of muscle symptoms and should discontinue treatment if this side effect occurs.

Myalgias associated with the use of HMG CoA-reductase inhibitors may be due in part to a deficiency of coenzyme Q10, the synthesis of which is inhibited by these compounds. However, other factors must be involved as well, because supplementation with coenzyme Q10 is not universally successful in preventing this side effect.

Mueller PS. Symptomatic myopathy due to red yeast rice. Ann Intern Med. 2006;145:474-475.

COPYRIGHT 2007 The Townsend Letter Group
COPYRIGHT 2007 Gale Group