The Medical Letter on Drugs and Therapeutics
Red Yeast Rice
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Red yeast rice is a food product that has been used in Chinese cooking and medicine for centuries. It is available in the US in a capsule formulation and is often used by patients who want a “natural” product to lower cholesterol.

THE PRODUCT — Red yeast rice is formed when rice is fermented with the yeast Monascus purpureus. The fermented product usually contains numerous monacolins, which are naturally occurring HMG-CoA reductase inhibitors. One of these, monacolin K, also known as mevinolin, became lovastatin (Mevacor, and others), the first statin approved in the US.

In one report analyzing the contents of 9 red yeast rice products on the market in the US, the total monacolin content varied by weight from 0% to 0.58%.1 In another, among 10 such products, monacolin K content varied 100-fold.2

CLINICAL STUDIES — In one ... more      

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