Hypolipaemic nutraceutics: red yeast rice and Armolipid, berberine and bergamot

Ann Agric Environ Med. 2021 Mar 18;28(1):81-88. doi: 10.26444/aaem/130629. Epub 2020 Dec 2.


Introduction: Increased serum cholesterol levels constitute one of the main risk factors for cardiovascular diseases. Statins are a major method for reducing the levels which also lower the risk of cardiovascular events. However, these valuable drugs cannot be used in all patients who need them due to contraindications and intolerance. In such cases, help can be sought from nutraceutics that reduce the serum cholesterol concentration. Since there are numerous products of this type available at drugstores, registered as supplements, there seems to be a need to demonstrate their effectiveness in preventing cardiovascular diseases induced by atherosclerosis. In literature, increasingly more attention is drawn to red yeast rice, Armolipid, berberine and bergamot.

Brief description: This article presents knowledge about these nutraceutics based on clinical studies and expert statements relating to their use. The results of clinical studies and metaanalyses have shown that nutraceutics with cholesterol lowering properties, red yeast rice and Armolipid are the most favourable for reducing cardiovascular events. However, the evidence of benefits of berberine and bergamot is not so conclusive.

Conclusions: Red yeast rice products and Armolipid may be used as an alternative treatment in statin intolerant patients, especially in combination with ezetimibe. These nutraceutics can be also considered, as an adjunct to diet therapy in primary prevention of cardiovascular diseases in patients with mild and moderate hypercholesterolaemia. The opinion of experts on berberine and bergamot is ambiguous.

Keywords: berberine; bergamot; hypolipaemic nutraceutics; indications; red yeast rice.

Publication types

  • Review

MeSH terms

  • Berberine / administration & dosage*
  • Biological Products / administration & dosage*
  • Cholesterol / metabolism
  • Citrus / chemistry
  • Clinical Trials as Topic
  • Dietary Supplements / analysis
  • Humans
  • Hypercholesterolemia / drug therapy*
  • Hypercholesterolemia / metabolism
  • Hypolipidemic Agents / administration & dosage*
  • Plant Extracts / administration & dosage*


  • Biological Products
  • Hypolipidemic Agents
  • Plant Extracts
  • red yeast rice
  • Berberine
  • Cholesterol