Interactions

Possible interactions include:

• Alcohol. Don't drink alcohol if you are taking red yeast rice. The combination might increase the risk of liver damage.
• Cyclosporine (Neoral, Sandimmune). Taking this immunosuppressive drug with red yeast rice might increase the risk of myopathy.
• Cytochrome P450 3A4 (CYP3A4) inhibitors. Taking red yeast rice with drugs, such as erythromycin, that inhibit this enzyme might increase the risk of harmful red yeast rice side effects.
• Grapefruit. Drinking grapefruit juice and taking red yeast rice might increase the risk of the supplement's harmful side effects.
• Gemfibrozil (Lopid). Taking this cholesterol drug with red yeast rice might increase the risk of myopathy.
• Hepatotoxic drugs, herbs and supplements. Red yeast rice might contain monacolin K, which can cause liver damage in some people. Taking red yeast rice with these types of drugs, herbs and supplements could increase the risk of liver damage.
• Niacin. Taking red yeast rice with high-dose niacin might increase the risk of myopathy.
• St. John's wort. Taking this supplement with red yeast rice might reduce the effectiveness of red yeast rice.
• Statin. Taking red yeast rice with other statins might increase the risk of harmful side effects.