<p>Mini-review: medication safety of red yeast rice products</p>

Abstract

High lipid levels in the blood together with high blood pressure and diabetes are among the highest risks for coronary heart disease. In particular, elevated cholesterol levels promote the progression of atherosclerosis. Red yeast rice, also called red fermented rice or red mold rice, is used as a dietary supplement to lower cholesterol levels. It contains varying amounts of natural monacolin K, which is a structural homolog to lovastatin, and shows hypocholesterolemic properties comparable to synthetic statins. Despite being portrayed as a natural alternative, the potential of red yeast rice for side effects and interactions is comparable to statin drugs. Consumers need to be made aware of the varying monacolin K content in red yeast rice products and the insufficient long-term safety data regarding the potential risks of red yeast rice.

Perspectives on Functional Red Mold Rice: Functional Ingredients, Production, and Application

“…It may be useful to specify a total MLs content in the form of monacolin equivalents. This hypothesis suggests that FRMR can be considered an unregistered medicine (Farkouh and Baumgärtel, 2019).…”

“…Moreover, three important points need to be taken into consideration: (1) Recognizing that FRMR contains a statin-like compound; (2) carefully recommending FRMR to statin-intolerant patients with a history of myositis or myopathy; (3) Documenting all alternative medicines, such as FRMR, taken by patients, in order to weigh the benefit-to-risk of co-administration of other drugs (Polsani et al, 2008). Overall, the real-world vigilance should be strengthened at different levels, including consumers, clinicians and policy-makers to promote the proper use and harmonize the regulatory status of FRMR (Raschi et al, 2018;Farkouh and Baumgärtel, 2019).…”

“…Red mold rice (RMR), also called red koji or red yeast rice is the fermentation product of Monascus spp. (Farkouh and Baumgärtel, 2019). It is widely used as a colorant, supplement, and starters in the food industry in Asian countries.…”

“…The functions of the beneficial metabolites such as Monascus pigments and γ-aminobutyric acid should be understood and evaluated, while using FRMR as a food supplement or as an alternative drug to the chemical statins. Meanwhile, the toxic metabolite produced by some Monascus strains, citrinin, should not only be studied but should also be carefully controlled (Farkouh and Baumgärtel, 2019). Furthermore, the side effects of MLs such as myopathies and liver injury need to be evaluated (Mazzanti et al, 2017).…”

Monacolin K – a natural statin

“…Dane te zaobserwowano zarówno u zdrowych pacjentów z hipercholesterolemią, jak i u pacjentów z chorobą wieńcową. Biorąc pod uwagę, że minimalna (1%) poprawa funkcji śródbłonka wydaje się być związana z wyraźnym zmniejszeniem ryzyka sercowo-naczyniowego (-12%), dane te wydają się mieć duże znaczenie prognostyczne [18,19].…”