Red Yeast Rice for Hypercholesterolemia

Methodist Debakey Cardiovasc J. 2019 Jul-Sep;15(3):192-199. doi: 10.14797/mdcj-15-3-192.


The extract of red yeast rice (RYR) is the most effective cholesterol-lowering nutraceutical on the market. In particular, its effectiveness is directly related to the amount of monacolin K within the extract (up to 10 mg/day). Consuming monacolin K on a daily basis reduces low-density lipoprotein (LDL) cholesterol plasma levels between 15% and 25% within 6 to 8 weeks. Certainly, the decrease in LDL-cholesterol is accompanied by a similar reduction in total cholesterol, non-high-density lipoprotein cholesterol, plasma apolipoprotein B, matrix metalloproteinases 2 and 9, and high-sensitivity C-reactive protein. Furthermore, the RYR lipid-lowering effect is associated with significant improvements in pulse wave velocity and endothelial function, which are validated and reliable biomarker tools able to detect vascular aging. Although it has a mechanism of action similar to statins, a daily consumption of between 3 and 10 mg monacolin K has only minimal associated risks, and mild myalgias are seen only in the frailest patients (those who also cannot tolerate minimal dosages of statin). The monacolin K found in RYR is a safe and effective supplement for managing mild to moderate hypercholesterolemia in people with no additional cardiovascular risk factors.

Keywords: lipid-lowering supplement; monacolin k; nutraceutical; red yeast rice.

Publication types

  • Review

MeSH terms

  • Animals
  • Biological Products / adverse effects
  • Biological Products / therapeutic use*
  • Biomarkers / blood
  • Cholesterol / blood*
  • Dietary Supplements* / adverse effects
  • Down-Regulation
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / adverse effects
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
  • Hypercholesterolemia / blood
  • Hypercholesterolemia / diagnosis
  • Hypercholesterolemia / drug therapy*
  • Lovastatin / adverse effects
  • Lovastatin / therapeutic use*
  • Treatment Outcome


  • Biological Products
  • Biomarkers
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • red yeast rice
  • Cholesterol
  • Lovastatin