Drug interactions
Darunavir + Red yeast rice
Severity: Major
Darunavir 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, identical to lovastatin, a sensitive CYP3A4 substrate. Darunavir, usually given with ritonavir or cobicistat, strongly inhibits CYP3A4, so monacolin K exposure may rise and cause myopathy or rhabdomyolysis.
What this interaction means in plain words
Darunavir 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.
Darunavir belongs to Anti Virals; Red yeast rice belongs to Gastrointestinal Tract.
Why it happens
Boosted darunavir inhibits CYP3A4, reducing monacolin K metabolism.
What to do
Avoid the combination and use a statin less dependent on CYP3A4 such as pravastatin or rosuvastatin. Advise patients to report unexplained muscle pain or weakness.
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 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
Other interactions of Darunavir
- Alfuzosin + Darunavir Contraindicated
- Avanafil + Darunavir Contraindicated
- Darunavir + Dronedarone Contraindicated
- Darunavir + Eletriptan Contraindicated
- Darunavir + Ergotamine Contraindicated
- Darunavir + Flibanserin Contraindicated
Frequently asked questions
Can I take Darunavir with Red yeast rice?
MediHelp rates the interaction as major. Darunavir 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, identical to lovastatin, a sensitive CYP3A4 substrate. Darunavir, usually given with ritonavir or cobicistat, strongly inhibits CYP3A4, so monacolin K exposure may rise and cause myopathy or rhabdomyolysis.
How serious is the interaction between Darunavir 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 use a statin less dependent on CYP3A4 such as pravastatin or rosuvastatin. Advise patients to report unexplained muscle pain or weakness.
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.
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