From the Guidelines
If you accidentally took an extra red yeast rice supplement, there's generally no need for immediate concern, but you should return to your regular dosing schedule for the next dose. Red yeast rice contains monacolin K (similar to lovastatin) and taking one extra dose is unlikely to cause serious problems, as supported by the lack of data on severe adverse effects in the available studies 1. However, don't take any more supplements today to "make up" for the extra dose. Some key points to consider:
- Side effects from a single extra dose are uncommon but could include stomach upset, headache, or muscle pain.
- If you experience severe muscle pain, weakness, or dark urine, contact a healthcare provider as these could indicate a rare but serious reaction.
- To prevent future overdoses, consider using a pill organizer, setting reminders, or keeping a medication log.
- The long-term safety and efficacy of red yeast rice supplements are still not well established, and more research is needed to fully understand their effects 1.
- Other studies have explored the use of different cholesterol-lowering medications, but the focus on red yeast rice is limited, with some information available on its potential benefits and risks 1.
From the Research
Effects of Red Yeast Rice Supplements
The effects of taking an extra Red Yeast Rice (RYR) supplement can be understood by examining the properties and components of RYR. RYR contains a fungus (Monascus purpureus) that is chemically identical to lovastatin, a pharmaceutical statin, and its primary active ingredient is monacolin K, which blocks cholesterol production 2.
Therapeutic Effects
- RYR has been shown to decrease low-density lipoprotein (LDL) cholesterol levels, with studies indicating a significant reduction in LDL cholesterol compared to placebo 3, 4.
- The lipid-regulating potency of RYR varies according to the concentration of monacolin K it possesses, making it challenging to predict dose-related efficacy and side-effect risks 2.
- RYR may be a treatment option for dyslipidemic patients who cannot tolerate statin therapy, as it has been found to decrease LDL cholesterol levels without increasing creatinine phosphokinase (CPK) or pain levels 3.
Safety Concerns
- The US Food and Drug Administration has issued warnings against taking RYR products due to the lack of assurance about its efficacy, safety, and standardized preparation methods 2.
- RYR has been associated with adverse reactions, including liver and kidney injury, with reported cases of acute hepatitis and acute kidney injury 5, 6.
- The risk of liver and kidney injury with RYR is uncertain, with some studies suggesting a low incidence of adverse reactions, while others report more severe cases 4, 6.
- RYR may also cause Fanconi syndrome, a rare disorder of the kidneys, as reported in cases of AKI with renal tubular acidosis following consumption of RYR-containing supplements 6.