Drug interactions
Cyclosporin + Red yeast rice
Severity: Major
Cyclosporin 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 contains monacolin K, chemically identical to lovastatin, so cyclosporine can raise statin exposure and the risk of myopathy and rhabdomyolysis. Product content is variable and unregulated, which makes the exposure unpredictable.
What this interaction means in plain words
Cyclosporin 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.
Cyclosporin belongs to Miscellaneous; Red yeast rice belongs to Gastrointestinal Tract.
Why it happens
Cyclosporine inhibits CYP3A4 and OATP-mediated disposition of monacolin K (lovastatin), increasing its systemic levels.
What to do
Avoid red yeast rice in patients taking cyclosporine and use a prescribed statin with labeled dose limits if lipid lowering is needed. Report muscle pain or dark urine promptly.
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?
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Other interactions of Cyclosporin
- Adenovirus types 4 and 7 live + Cyclosporin Contraindicated
- Aliskiren + Cyclosporin Contraindicated
- Bcg vaccine live + Cyclosporin Contraindicated
- Bosentan + Cyclosporin Contraindicated
- Cidofovir + Cyclosporin Contraindicated
- Cyclosporin + Dengue vaccine Contraindicated
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
- Conivaptan + Red yeast rice Major
Frequently asked questions
Can I take Cyclosporin with Red yeast rice?
MediHelp rates the interaction as major. Cyclosporin 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 contains monacolin K, chemically identical to lovastatin, so cyclosporine can raise statin exposure and the risk of myopathy and rhabdomyolysis. Product content is variable and unregulated, which makes the exposure unpredictable.
How serious is the interaction between Cyclosporin 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 red yeast rice in patients taking cyclosporine and use a prescribed statin with labeled dose limits if lipid lowering is needed. Report muscle pain or dark urine promptly.
What other medicines interact with Cyclosporin?
MediHelp also lists interactions of Cyclosporin with, for example, Adenovirus types 4 and 7 live, Aliskiren, Bcg vaccine live. The full list is on the Cyclosporin page.
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