Is Red Yeast Rice Safe with Niacin high dose?
Free · No account · based on published sources including NIH ODS, FDA drug labels, and peer-reviewed literature
Never combine high-dose niacin with red yeast rice supplements. This combination significantly increases risk of severe muscle damage. Discontinue red yeast rice and consult prescriber immediately.
Why this interaction occurs
Red yeast rice acts as a natural HMG-CoA reductase inhibitor. Combined with high-dose niacin, the interaction mimics statin-niacin combination therapy, markedly increasing risk of myopathy, myositis, and life-threatening rhabdomyolysis with acute renal failure.
Evidence
Evidence level: strong.
Reported safety data
The FDA’s adverse event reporting system (FAERS) has received 2,519,437 reports mentioning Niacin high dose. This reflects reported cases involving the medication in general — not confirmed causation, and not specific to the Niacin high dose + supplement combination on this page.
FAERS reports are voluntary and cannot prove that a drug caused an event. Do not use report counts to assess the safety of this specific drug-supplement pair.
Frequently asked questions
Related interactions
All Red Yeast Rice interactions → · All Niacin high dose interactions →
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Educational only — not medical advice.
Always confirm with your doctor or pharmacist.