Drug interactions
Red yeast rice + Rosuvastatin
Severity: Major
Red yeast rice and Rosuvastatin: 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 identical to lovastatin, so taking it with rosuvastatin duplicates HMG-CoA reductase inhibition. This increases the risk of myopathy and rhabdomyolysis and adds no proven benefit.
What this interaction means in plain words
Red yeast rice and Rosuvastatin 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 belongs to Gastrointestinal Tract; Rosuvastatin belongs to Cardiovascular.
Why it happens
Therapeutic duplication of statin activity producing additive dose-related muscle toxicity.
What to do
Avoid the combination and stop the red yeast rice. Ask patients about supplement use and monitor for muscle symptoms and CK.
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 Rosuvastatin
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 Red yeast rice with Rosuvastatin?
MediHelp rates the interaction as major. Red yeast rice and Rosuvastatin 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 identical to lovastatin, so taking it with rosuvastatin duplicates HMG-CoA reductase inhibition. This increases the risk of myopathy and rhabdomyolysis and adds no proven benefit.
How serious is the interaction between Red yeast rice and Rosuvastatin?
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 stop the red yeast rice. Ask patients about supplement use and monitor for muscle symptoms and CK.
What other medicines interact with Rosuvastatin?
MediHelp also lists interactions of Rosuvastatin with, for example, Atazanavir, Cyclosporine, Cyclosporin. The full list is on the Rosuvastatin page.
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