Red yeast rice
Content by: OpenSupplement Editorial Team | Medical review: pending | Last updated: April 13, 2026
TL;DR
Fermented rice containing Monacolin K — a natural statin
High evidence for lowering LDL cholesterol
Acts exactly like the drug Lovastatin; carries similar risks
Variable quality; some products contain 'citrinin' (a kidney toxin)
Cost: ~$10-20/month
Best for: High cholesterol in those who prefer 'natural' statins
What it is
Red Yeast Rice (RYR) is made by fermenting white rice with the yeast Monascus purpureus. The fermentation produces Monacolin K, which is chemically identical to the pharmaceutical drug Lovastatin.
Because it contains a natural statin, it works by inhibiting the HMG-CoA reductase enzyme in the liver, which is the 'factory' that produces cholesterol. It is highly effective, but because it is a 'natural' product, the amount of Monacolin K can vary wildly from bottle to bottle.
What the research says
RYR is the most powerful 'natural' cholesterol lowerer. Evidence. Clinical trials have shown that RYR can reduce LDL cholesterol by 20-30%. Alternative to Statins. In studies of patients who were 'statin intolerant,' many were able to tolerate RYR and achieve significant cholesterol reductions. Note. Because it is a statin, it will also lower your CoQ10 levels, so they should be taken together. [1][2][3]
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Red yeast rice on Amazon
Safety
Shares the same side effects as statins: muscle pain (myopathy), liver enzyme elevation, and CoQ10 depletion. A major concern is the presence of citrinin, a toxic byproduct of the fermentation process that can cause kidney failure. Only buy from major brands that test for citrinin.
Interactions
- Statins: Never combine with prescription statins (Lipitor, Crestor); risk of severe muscle damage.
- CYP3A4 Inhibitors: Drugs like Erythromycin or Grapefruit Juice can dangerously increase RYR levels.
Dosing
Standard Dose: 600-1,200 mg twice daily. Form: Look for products that state they are 'Citrinin-free.' Recommendation: Always take with 100-200mg of CoQ10.
Cost
Affordable. $10-20 per month.
The bottom line
Red Yeast Rice is 'Nature's Statin.' It is highly effective, but don't be fooled by the 'natural' label—it is a potent medicine and should be treated with the same respect and caution as a prescription drug.
References
- Xiong X, Wang P, Li S, et al. The effects of red yeast rice dietary supplement on blood lipid concentrations: A systematic review and meta-analysis of randomized controlled trials. Crit Rev Food Sci Nutr. 2017;57(8):1770-1777.
- Lu Z, Kou W, Du B, et al. Effect of Xuezhikang, an extract from red yeast Chinese rice, on coronary events in a Chinese population with previous myocardial infarction. Am J Cardiol. 2008;101(12):1689-1693.
- Cicero AFG, Fogacci F, Banach M. Red Yeast Rice for Hypercholesterolemia: JACC Focus Seminar. J Am Coll Cardiol. 2021;77(5):620-628.
Sources for this page include published meta-analyses, systematic reviews, and NIH dietary supplement fact sheets. All claims reflect the evidence as of early 2026.
This is not medical advice. Consult your healthcare provider before starting any supplement, especially if you take medications.