Alfredo Vannacci, MD, PhD; Francesco Lapi, PharmD, PhD; Eugenia Gallo, MS; Francesca Menniti-Ippolito, MS, PhD; Alessandro Mugelli, PhD, MD; Fabio Firenzuoli, MD
Potential Conflicts of Interest: None disclosed.
Vannacci A, Lapi F, Gallo E, Menniti-Ippolito F, Mugelli A, Firenzuoli F. Red Yeast Rice for Dyslipidemia in Statin-Intolerant Patients. Ann Intern Med. 2010;152:135. doi: 10.7326/0003-4819-152-2-201001190-00025
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Published: Ann Intern Med. 2010;152(2):135.
TO THE EDITOR:
We read with interest the article by Becker and colleagues (1) on the effects of red yeast rice in statin-intolerant patients. The results are certainly interesting, but the safety profile of red yeast rice when used in the “real world” should not be underestimated.
We recently conducted an analysis (2) in the Italian adverse drug reactions database of natural health products (including herbal drugs and food supplements) and found 4 cases of myopathy associated with red yeast rice (dose range, 200 to 1200 mg/d; data were not available on monacolin content). Each patient reported muscle pain, and creatinine phosphokinase levels were increased, ranging from 288 to 401 IU/L. The time to onset was 2 to 6 months (6 months in 1 statin-intolerant person). After product withdrawal, 3 persons achieved complete recovery, whereas 1 statin-intolerant patient had persistently increased creatinine phosphokinase levels for several months.
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