Niacin and Red Yeast Rice: Can You Take Them Together?

Notable interaction — adjust timing

Niacin and Red Yeast Rice can interact. Increased risk of myopathy — muscle pain and weakness, and rarely rhabdomyolysis — plus additive liver-enzyme elevation. In a 25,000-patient randomised trial, adding extended-release niacin to statin therapy produced an excess of myopathy and other serious adverse events without reducing cardiovascular events. This combination has been tested at drug doses and did not pay off, so there is little reason to assemble it from supplements. If both are being taken, watch for muscle pain, tenderness or weakness and stop and seek review if it appears — particularly in the first months. Anyone whose cholesterol needs treating is better served by a prescribed regimen with liver and CK monitoring.

What the evidence says

moderateconflict· moderate evidence

Red yeast rice supplies monacolin K, which is chemically identical to lovastatin. Adding niacin to a statin raises the risk of muscle injury, and both agents can also raise liver enzymes.

What to do: This combination has been tested at drug doses and did not pay off, so there is little reason to assemble it from supplements. If both are being taken, watch for muscle pain, tenderness or weakness and stop and seek review if it appears — particularly in the first months. Anyone whose cholesterol needs treating is better served by a prescribed regimen with liver and CK monitoring.

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Multivitamin & Niacin

Frequently asked questions

Can you take Niacin and Red Yeast Rice together?: Niacin and Red Yeast Rice can interact. Increased risk of myopathy — muscle pain and weakness, and rarely rhabdomyolysis — plus additive liver-enzyme elevation. In a 25,000-patient randomised trial, adding extended-release niacin to statin therapy produced an excess of myopathy and other serious adverse events without reducing cardiovascular events. This combination has been tested at drug doses and did not pay off, so there is little reason to assemble it from supplements. If both are being taken, watch for muscle pain, tenderness or weakness and stop and seek review if it appears — particularly in the first months. Anyone whose cholesterol needs treating is better served by a prescribed regimen with liver and CK monitoring.
Do Niacin and Red Yeast Rice interact?: Increased risk of myopathy — muscle pain and weakness, and rarely rhabdomyolysis — plus additive liver-enzyme elevation. In a 25,000-patient randomised trial, adding extended-release niacin to statin therapy produced an excess of myopathy and other serious adverse events without reducing cardiovascular events. Red yeast rice supplies monacolin K, which is chemically identical to lovastatin. Adding niacin to a statin raises the risk of muscle injury, and both agents can also raise liver enzymes.
Should you separate Niacin and Red Yeast Rice?: This combination has been tested at drug doses and did not pay off, so there is little reason to assemble it from supplements. If both are being taken, watch for muscle pain, tenderness or weakness and stop and seek review if it appears — particularly in the first months. Anyone whose cholesterol needs treating is better served by a prescribed regimen with liver and CK monitoring.

This information is for educational purposes only. It is not a substitute for professional medical advice. Always consult a qualified healthcare provider before starting, stopping, or changing any supplement or medication.

What the evidence says

moderateconflict· moderate evidence

Red yeast rice supplies monacolin K, which is chemically identical to lovastatin. Adding niacin to a statin raises the risk of muscle injury, and both agents can also raise liver enzymes.

Frequently asked questions

Can you take Niacin and Red Yeast Rice together?

Do Niacin and Red Yeast Rice interact?

Increased risk of myopathy — muscle pain and weakness, and rarely rhabdomyolysis — plus additive liver-enzyme elevation. In a 25,000-patient randomised trial, adding extended-release niacin to statin therapy produced an excess of myopathy and other serious adverse events without reducing cardiovascular events. Red yeast rice supplies monacolin K, which is chemically identical to lovastatin. Adding niacin to a statin raises the risk of muscle injury, and both agents can also raise liver enzymes.

Should you separate Niacin and Red Yeast Rice?

This combination has been tested at drug doses and did not pay off, so there is little reason to assemble it from supplements. If both are being taken, watch for muscle pain, tenderness or weakness and stop and seek review if it appears — particularly in the first months. Anyone whose cholesterol needs treating is better served by a prescribed regimen with liver and CK monitoring.