Published: May 2009

Complementary Medicine Corner - Risk of myalgia with red yeast rice extract

Prescriber Update 30(2): 14
May 2009

Prescribers are reminded that complementary medicines can contain pharmacologically active ingredients that may cause adverse reactions or interact with conventional medicines.

CARM has received a report of chest pain, myalgia, elevated creatine kinase levels, and abnormal liver function tests in an individual who had taken a combination of red yeast rice extract, saw palmetto (Serenoa repens), coenzyme Q10 and multivitamins. Red yeast rice extract is an extract of red yeast (Monascus pupureas) grown on rice. It contains the constituent lovastatin, a naturally-occurring statin with a similar adverse reaction profile to other statins that are approved medicines in New Zealand. Lovastatin can cause severe muscle problems (myalgia) leading to kidney impairment.1 The risk of myalgia is increased in patients taking other medicines such as itraconazole, ketoconazole, and other statins.

Prescribers are reminded to ask their patients about their use of complementary medicines, and report any suspected adverse reactions to CARM.

  1. FDA – MedWatch (2007) FDA Warns Consumers to Avoid Using Red Yeast Rice Products.