Interactions

Interactions with Drugs

Red yeast rice (RYR) may increase the risk of bleeding when taken with drugs that increase the risk of bleeding. Some examples include aspirin, anticoagulants (blood thinners) such as warfarin (Coumadin®) or heparin, antiplatelet drugs such as clopidogrel (Plavix®), and nonsteroidal anti-inflammatory drugs such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®, Aleve®).

RYR may affect blood sugar levels. Caution is advised when using medications that may also affect blood sugar. People taking drugs for diabetes by mouth or insulin should be monitored closely by a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.

RYR may cause low blood pressure. Caution is advised in people taking drugs that lower blood pressure.

RYR may interfere with the way the body processes certain drugs using the liver's cytochrome P450 enzyme system. As a result, the levels of these drugs may be increased in the blood and may cause increased effects or potentially serious adverse reactions. People using any medications should check the package insert and speak with a qualified healthcare professional, including a pharmacist, about possible interactions.

RYR may also interact with agents that may affect the immune system, agents that may affect the nervous system, agents that may harm the liver, agents that may increase the risk of muscle fiber breakdown, agents that may treat heart disorders, agents that may treat retrovirus infections (HIV), alcohol, antibiotics, anticancer agents, antifungals, anti-inflammatory agents, antiobesity agents, cardiac glycosides, cholesterol-lowering agents, cyclosporine, digoxin, fibric acid derivatives, levothyroxine, macrolides, protease inhibitors, ranitidine, skin agents, statins, stomach agents, and thyroid hormones.

Interactions with Herbs and Dietary Supplements

RYR may increase the risk of bleeding when taken with herbs and supplements that are believed to increase the risk of bleeding. Multiple cases of bleeding have been reported with the use of Ginkgo biloba, and fewer cases with garlic and saw palmetto. Numerous other agents may theoretically increase the risk of bleeding, although this has not been proven in most cases.

RYR may affect blood sugar levels. Caution is advised when using herbs or supplements that may also affect blood sugar. Blood glucose levels may require monitoring, and doses may need adjustment.

RYR may cause low blood pressure. Caution is advised in people taking herbs or supplements that lower blood pressure.

RYR may interfere with the way the body processes certain herbs or supplements using the liver's cytochrome P450 enzyme system. As a result, the levels of other herbs or supplements may become too high in the blood. It may also alter the effects that other herbs or supplements possibly have on the P450 system.

RYR may also interact with antibacterials, anticancer herbs and supplements, antifungal herbs and supplements, anti-inflammatory herbs and supplements, antioxidants, astaxanthin, cardiac glycosides, cholesterol-lowering herbs and supplements, coenzyme Q10, grapefruit, herbs and supplements that may affect the immune system, herbs and supplements that may affect the nervous system, herbs and supplements that may harm the liver, herbs and supplements that may treat heart disorders, herbs and supplements that may treat stomach disorders, iron, milk thistle, niacin, octacosanol, St. John's wort, tannin-containing herbs and supplements, thyroid herbs and supplements, vitamin A, and zinc.

This evidence-based monograph was prepared by The Natural Standard Research Collaboration

www.naturalstandard.com