Drug interactions
Conivaptan + Red yeast rice
Severity: Major
Conivaptan and Red yeast rice: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Red yeast rice supplies monacolin K, identical to lovastatin, which relies on CYP3A4 for clearance. Conivaptan is a potent CYP3A4 inhibitor, so monacolin K levels may rise and increase the risk of myopathy.
What this interaction means in plain words
Conivaptan and Red yeast rice can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
Conivaptan inhibits CYP3A4, decreasing monacolin K metabolism.
What to do
Avoid the combination and withhold red yeast rice during conivaptan therapy. Monitor for muscle symptoms and creatine kinase if exposure occurs.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Conivaptan and Red yeast rice, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 14 days on the web. No card needed.
Other interactions of Red yeast rice
- Red yeast rice + Ritonavir Contraindicated
- Red yeast rice + Saquinavir Contraindicated
- Red yeast rice + Tipranavir Contraindicated
- Atazanavir + Red yeast rice Major
- Atorvastatin + Red yeast rice Major
- Cyclosporine + Red yeast rice Major
Frequently asked questions
Can I take Conivaptan with Red yeast rice?
MediHelp rates the interaction as major. Conivaptan and Red yeast rice can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Red yeast rice supplies monacolin K, identical to lovastatin, which relies on CYP3A4 for clearance. Conivaptan is a potent CYP3A4 inhibitor, so monacolin K levels may rise and increase the risk of myopathy.
How serious is the interaction between Conivaptan and Red yeast rice?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination and withhold red yeast rice during conivaptan therapy. Monitor for muscle symptoms and creatine kinase if exposure occurs.
What other medicines interact with Red yeast rice?
MediHelp also lists interactions of Red yeast rice with, for example, Ritonavir, Saquinavir, Tipranavir. The full list is on the Red yeast rice page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
