Anna L. Kolpakchi, MD; Ikedieze I. Chukwu, MD; Maria T. Vlachaki, MD, MBA
Potential Conflicts of Interest: None disclosed.
Kolpakchi A., Chukwu I., Vlachaki M.; Red Yeast Rice for Dyslipidemia in Statin-Intolerant Patients. Ann Intern Med. 2010;152:133-134. doi: 10.7326/0003-4819-152-2-201001190-00023
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Published: Ann Intern Med. 2010;152(2):133-134.
TO THE EDITOR:
We read with interest the article by Becker and colleagues (1). The emergence of red yeast rice as a dietary supplement and cholesterol-lowering agent shows why such supplements are currently classified as unapproved drugs under the Dietary Supplement Health and Education Act (2).
Red yeast rice as a supplement did not exist until 1993. However, it has been used as a food coloring and flavoring agent throughout the Orient for centuries, and its medicinal use for indigestion, diarrhea, and blood circulation is mentioned in ancient Chinese pharmacopoeia. Originally, it was made by fermenting cooked white rice with Monascus purpureus in the open air. In November 1978, Dr. Alberts (Merck, Whitehouse Station, New Jersey) isolated lovastatin from Aspergillus terreus. In February 1979, Professor Endo (Tokyo Noko University, Tokyo, Japan) also isolated monacolin K, a lovastatin analogue, from a certain strain of M. purpureus. In 1987, the U.S. Food and Drug Administration (FDA) approved lovastatin as the first cholesterol-lowering drug (3). The first red yeast rice supplement, Cholestin, was made by Pharmanex (Provo, Utah) in 1993. It was advertised as a natural, ancient Chinese remedy that lowered cholesterol levels. Trials (4, 5) showed short-term effectiveness and safety.
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