Drug interactions
Posaconazole + Red yeast rice
Severity: Major
Posaconazole 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 posaconazole can raise its levels. This increases the risk of myopathy and rhabdomyolysis.
What this interaction means in plain words
Posaconazole 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.
Posaconazole belongs to Anti Fungals; Red yeast rice belongs to Gastrointestinal Tract.
Why it happens
Posaconazole inhibits CYP3A4 metabolism of monacolin K (lovastatin).
What to do
Avoid red yeast rice during posaconazole therapy and stop it for the treatment period. Advise patients to report muscle pain, weakness or dark urine.
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 Posaconazole
- Artemether + Posaconazole Contraindicated
- Avanafil + Posaconazole Contraindicated
- Cobimetinib + Posaconazole Contraindicated
- Conivaptan + Posaconazole Contraindicated
- Dihydroergotamine intranasal + Posaconazole Contraindicated
- Dihydroergotamine + Posaconazole 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 Posaconazole with Red yeast rice?
MediHelp rates the interaction as major. Posaconazole 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 posaconazole can raise its levels. This increases the risk of myopathy and rhabdomyolysis.
How serious is the interaction between Posaconazole 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 during posaconazole therapy and stop it for the treatment period. Advise patients to report muscle pain, weakness or dark urine.
What other medicines interact with Posaconazole?
MediHelp also lists interactions of Posaconazole with, for example, Artemether, Avanafil, Cobimetinib. The full list is on the Posaconazole page.
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