Cholesterol-Lowering Medications

Red yeast rice should not be taken with cholesterol-lowering (statin) medications known as HMG-CoA reductase inhibitors (such as atorvastatin, lovastatin, fluvastatin, simvastatin, pravastatin, cerivastatin), because it may enhance the effect of these medications, thereby increasing the risk of liver damage.

Grapefruit Juice

When grapefruit or grapefruit juice is taken with HMG-CoA reductase inhibitors such as atorvastatin, cerivastatin, fluvastatin, lovastatin, pravastatin, and simvastatin, they enhance the effects of the medications and cause a significant increase in blood levels of these synthetic drugs, leading to a greater chance of side effects and liver damage. Because red yeast rice appears to act in much the same way as these cholesterol-lowering drugs, it would be wise to avoid drinking grapefruit juice or eating grapefruit or grapefruit products such as marmalade while taking red yeast rice.