Drug interactions
Red yeast rice + Voriconazole
Severity: Major
Red yeast rice and Voriconazole: 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, and voriconazole can raise its exposure. This increases the risk of myopathy and rhabdomyolysis.
What this interaction means in plain words
Red yeast rice and Voriconazole 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; Voriconazole belongs to Anti Fungals.
Why it happens
Voriconazole inhibits CYP3A4 metabolism of monacolin K (lovastatin).
What to do
Avoid red yeast rice during voriconazole therapy and counsel patients to report muscle pain or weakness; check creatine kinase if symptoms occur.
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 Voriconazole
- Avanafil + Voriconazole Contraindicated
- Butabarbital + Voriconazole Contraindicated
- Carbamazepine + Voriconazole Contraindicated
- Conivaptan + Voriconazole Contraindicated
- Dihydroergotamine intranasal + Voriconazole Contraindicated
- Dihydroergotamine + Voriconazole 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 Red yeast rice with Voriconazole?
MediHelp rates the interaction as major. Red yeast rice and Voriconazole 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, and voriconazole can raise its exposure. This increases the risk of myopathy and rhabdomyolysis.
How serious is the interaction between Red yeast rice and Voriconazole?
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 voriconazole therapy and counsel patients to report muscle pain or weakness; check creatine kinase if symptoms occur.
What other medicines interact with Voriconazole?
MediHelp also lists interactions of Voriconazole with, for example, Avanafil, Butabarbital, Carbamazepine. The full list is on the Voriconazole page.
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