Patients with high cholesterol are frequently started on a statin medication to lower their levels when a low-fat diet is not enough. Drugs like Lovastatin help to decrease cholesterol, which decreases the risk of heart disease and stroke. Some people prefer a natural alternative or do not tolerate prescription medications. Red yeast rice has been used in Chinese medicine for centuries, and is often promoted for lowering cholesterol levels. There are some differences and some similarities between red yeast rice and Lovastatin.
Differences in Origin
Red yeast rice develops when the yeast, Monascus purpureus, is fermented with rice. The yeast produces chemical compounds called monacolins which are the active ingredients in red yeast rice that lower cholesterol. Monacolin K has the same chemical structure as lovastatin which was originally isolated from a bacterium known as Aspergillus. Since both have the same structure, they work identically in the body.
Red Yeast Rice Composition and Dosing
Since red yeast rice is a dietary supplement, the medication is not standardized. This means each bottle from each manufacturer could have a different amount of monacolin. Some batches may contain too little active ingredient, while some may have too much. According to the website Natural Standard, when batches of red yeast rice were analyzed, the amount of monacolin in each capsule varied from 0.15 to 3.37 mg per capsule. Average dosing ranges from 1,200 to 2,400 mg of red yeast rice daily.
Lovastatin Composition and Dosing
Because Lovastatin is a prescription product, the dosing is standardized and regulated by the FDA so each batch has a similar amount of medication. Standard dosing for Lovastatin is 20 mg daily with a maximum daily dose of 80 mg. According to Natural Standard, a 2,400 mg dose of red yeast rice showed a smaller concentration in the body than a 20 mg dose of Lovastatin.
Both Lovastatin and red yeast rice are considered to be safe for use in humans. However, Natural Standard reports that a toxin known as citrinin found in red yeast rice can cause birth defects and miscarriage, while Lovastatin has been shown to cause birth defects in animal studies. Chemicals in the Monascus yeast may be able to cause cancer, though this has not been seen in human studies. Neither medication should be used during pregnancy.
Differences in Efficacy
A 2005 study in the "European Journal of Endocrinology" showed that taking 600 mg of red yeast rice twice daily caused an average decrease in LDL cholesterol of 26 percent after eight weeks. Additionally, total cholesterol decreased an average of 20 percent after eight weeks. Lovastatin is more potent than red yeast rice. According to the prescribing information for Mevacor, Lovastatin lowers total cholesterol by 16 to 24 percent and LDL cholesterol by 21 to 32 percent, depending on the daily dose.
- Natural Standard: Red Yeast Rice
- Merck and Co, Inc: Mevacor
- National Heart, Lung and Blood Institute: Detection, Evaluation and Treatment of High Blood Cholesterol in Adults
- "European Journal of Endocrinology"; Efficacy and Safety of Monascus Purpureus Went Rice in Subjects with Hyperlipidemia; Cheng-Chieh Lin, et al.; 2005