Drug interactions
Red yeast rice + Saquinavir
Severity: Contraindicated
Red yeast rice and Saquinavir: contraindicated 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, whose clearance depends on CYP3A4. Saquinavir, usually boosted with ritonavir, strongly inhibits CYP3A4 and can raise levels enough to cause myopathy or rhabdomyolysis.
What this interaction means in plain words
Red yeast rice and Saquinavir are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Why it happens
Saquinavir (with ritonavir boosting) inhibits CYP3A4, increasing monacolin K (lovastatin) exposure.
What to do
Avoid the combination and stop red yeast rice. Use a statin less dependent on CYP3A4 if lipid lowering is required.
What to ask your pharmacist
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
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Other interactions of Red yeast rice
- Red yeast rice + Ritonavir Contraindicated
- Red yeast rice + Tipranavir Contraindicated
- Atazanavir + Red yeast rice Major
- Atorvastatin + Red yeast rice Major
- Conivaptan + Red yeast rice Major
- Cyclosporine + Red yeast rice Major
Frequently asked questions
Can I take Red yeast rice with Saquinavir?
MediHelp rates the interaction as contraindicated. Red yeast rice and Saquinavir are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Red yeast rice contains monacolin K, identical to lovastatin, whose clearance depends on CYP3A4. Saquinavir, usually boosted with ritonavir, strongly inhibits CYP3A4 and can raise levels enough to cause myopathy or rhabdomyolysis.
How serious is the interaction between Red yeast rice and Saquinavir?
MediHelp rates it contraindicated, 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 red yeast rice. Use a statin less dependent on CYP3A4 if lipid lowering is required.
What other medicines interact with Red yeast rice?
MediHelp also lists interactions of Red yeast rice with, for example, Ritonavir, Tipranavir, Atazanavir. The full list is on the Red yeast rice page.
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