Drug interactions
Pravastatin + Red yeast rice
Severity: Major
Pravastatin 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, which is chemically the same as lovastatin, so taking it with pravastatin amounts to using two statins at once. This duplication raises the risk of myopathy and rhabdomyolysis, and the monacolin content of supplements is unstandardized and unpredictable.
What this interaction means in plain words
Pravastatin 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.
Pravastatin belongs to Cardiovascular; Red yeast rice belongs to Gastrointestinal Tract.
Why it happens
Additive pharmacodynamic HMG-CoA reductase inhibition from duplicate statin therapy, increasing dose-related muscle toxicity.
What to do
Avoid combining the supplement with pravastatin; stop red yeast rice and keep the prescribed statin. Ask patients about muscle pain or weakness and check creatine kinase if symptoms appear.
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 Pravastatin
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 Pravastatin with Red yeast rice?
MediHelp rates the interaction as major. Pravastatin 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, which is chemically the same as lovastatin, so taking it with pravastatin amounts to using two statins at once. This duplication raises the risk of myopathy and rhabdomyolysis, and the monacolin content of supplements is unstandardized and unpredictable.
How serious is the interaction between Pravastatin 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 combining the supplement with pravastatin; stop red yeast rice and keep the prescribed statin. Ask patients about muscle pain or weakness and check creatine kinase if symptoms appear.
What other medicines interact with Pravastatin?
MediHelp also lists interactions of Pravastatin with, for example, Cyclosporine, Cyclosporin, Gemfibrozil. The full list is on the Pravastatin page.
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