A case of erectile dysfunction induced by red yeast rice in lipid‐lowering therapy

Liu, Zhigang; Chen, Peijie

doi:10.1002/ptr.6025

Cited by 13 publications

(6 citation statements)

References 8 publications

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“…However, RYR does have adverse effects because MK and citrinin associate with an increased risk of myopathy (Lapi et al, 2008; Polsani et al, 2008; Dobremez et al, 2018), symptomatic hepatitis (Roselle et al, 2008), peripheral neuropathy (Kumari et al, 2013), erectile dysfunction (Liu and Chen, 2018), and anaphylactic reactions (Hipler et al, 2002). Among these, the prevalence rates of myopathy and hepatitis are the highest.…”

Section: Safety and Adverse Effectsmentioning

confidence: 99%

Red Yeast Rice: A Systematic Review of the Traditional Uses, Chemistry, Pharmacology, and Quality Control of an Important Chinese Folk Medicine

Zhu

Fang-yuan

et al. 2019

Front. Pharmacol.

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Red yeast rice (RYR), a Chinese traditional folk medicine produced by the fermentation of cooked rice kernels with a Monascaceae mold, Monascus purpureus, has long been used to treat blood circulation stasis, indigestion, diarrhea, and limb weakness in East Asian countries. This article provides a systematic review of the traditional uses, chemistry, biological activities, and toxicology of RYR to highlight its future prospects in the field of medicine. The literature reviewed for this article was obtained from the Web of Science, Elsevier, SciFinder, PubMed, CNKI, ScienceDirect, and Google Scholar, as well as Ph.D. and M.Sc. dissertations, published prior to July 2019. More than 101 chemical constituents have been isolated from RYR, mainly consisting of monacolins, pigments, organic acids, sterols, decalin derivatives, flavonoids, polysaccharides, and other compounds. Crude extracts of RYR, as well as its isolated compounds, possess broad pharmacological properties with hypolipidemic, anti-atherosclerotic, anti-cancer, neurocytoprotective, anti-osteoporotic, anti-fatigue, anti-diabetic, and anti-hypertensive activities. However, further studies are needed to characterize its diverse chemical constituents and the toxicological actions of the main bioactive compounds. New pharmacological trials addressing the overlooked traditional uses of RYR, such as in the treatment of indigestion and diarrhea, are required.

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Section: Safety and Adverse Effectsmentioning

confidence: 99%

Red Yeast Rice: A Systematic Review of the Traditional Uses, Chemistry, Pharmacology, and Quality Control of an Important Chinese Folk Medicine

Zhu

Fang-yuan

et al. 2019

Front. Pharmacol.

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“…A case of erectile dysfunction was described in a 39‐year‐old subject, who self‐prescribed a RYR preparation to reduce his hyperlipidaemia (Liu and Chen, ). Symptoms disappeared after 5 weeks of wash out from RYR.…”

Section: Biological and Toxicological Datamentioning

confidence: 99%

Scientific opinion on the safety of monacolins in red yeast rice

Younes¹,

Aggett²,

Aguilar³

et al. 2018

EFS2

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The Panel on Food Additives and Nutrient Sources added to Food (ANS) was asked to deliver a scientific opinion on the safety of monacolins in red yeast rice (RYR) and to provide advice on a dietary intake of monacolins that does not give rise to concerns about harmful effects to health. The Panel reviewed the scientific evidences available as well as the information provided by interested parties in response of a public 'Call for data' launched by EFSA. The Panel considered that monacolin K in lactone form is identical to lovastatin, the active ingredient of several medicinal products authorised for the treatment of hypercholesterolaemia in the EU. On the basis of the information available, the Panel concluded that intake of monacolins from RYR via food supplements, could lead to estimated exposure to monacolin K within the range of the therapeutic doses of lovastatin. The Panel considered that the available information on the adverse effects reported in humans were judged to be sufficient to conclude that monacolins from RYR when used as food supplements were of significant safety concern at the use level of 10 mg/day. The Panel further considered that individual cases of severe adverse reactions have been reported for monacolins from RYR at intake levels as low as 3 mg/day. The Panel concluded that exposure to monacolin K from RYR could lead to severe adverse effects on musculoskeletal system, including rhabdomyolysis, and on the liver. In the reported cases, the product contained other ingredients in addition to RYR. However, these reported effects in particular musculoskeletal effects, have both occurred after ingestion of monacolin K and lovastatin independently. On the basis of the information available and several uncertainties highlighted in this opinion, the Panel was unable to identify a dietary intake of monacolins from RYR that does not give rise to concerns about harmful effects to health, for the general population, and as appropriate, for vulnerable subgroups of the population.

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“…Despite the beneficial effects of RYR on hypercholesterol, as well as the fact that some studies have suggested that RYR is relatively safe [ 7 , 11 , 12 , 15 ], the potential side effects of RYR should be considered, such as muscle symptoms, central nervous system complaints, and diabetes, with these effects being partially similar to the effects of statins [ 27 ]. Some studies and case reports have indicated that dietary supplements containing red yeast rice may be related to hepatotoxicity [ 28 – 30 ], symptomatic myopathy [ 28 , 30 , 31 ], and erectile dysfunction [ 32 ]. Therefore, the uncertain safety of the dietary intake of RYR was indicated by the European Food Safety Authority (EFSA) and other studies [ 9 , 10 , 33 ].…”

Section: Discussionmentioning

confidence: 99%

Decreased Risk of Stroke in People Using Red Yeast Rice Prescriptions (LipoCol Forte®): a Total Population-Based Retrospective Cohort Study

Chang

Sun

Chou

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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The influence of red yeast rice (RYR) on the risk of incident stroke remains underexplored. We aimed to compare the risk of stroke between people with and without use of RYR prescriptions. We used research data from the National Health Insurance Program in Taiwan and identified 34,723 adults (aged ≥20 years) who first received the RYR prescription from 2010 to 2014. To select the appropriate control group, we used frequency matching by age and sex (case-control ratio = 1 : 1) and identified a non-RYR cohort that included 34,723 adults who first received lovastatin. Events of an incident stroke that occurred during the follow-up period of 2010–2017 were identified from medical claims. The adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of stroke risk associated with RYR prescription were calculated in the multiple Cox proportional hazard model. Compared with the non-RYR cohort, patients who received RYR prescriptions had a decreased risk of stroke (HR 0.65, 95% CI 0.59–0.71), including hemorrhagic stroke (HR 0.60, 95% CI 0.44–0.83), ischemic stroke (HR 0.49, 95% CI 0.43–0.57), and other types of strokes (HR 0.53, 95% CI 0.42–0.67). The association between RYR prescription and stroke risk was significant in both sexes and in people aged more than 40 years, as well as in those individuals with various medical conditions. The frequency of RYR prescription (HR 0.57, 95% CI 0.50–0.64) was associated with a decreased risk of stroke with a dose-response relationship (p for trend<0.0001). This study showed a potentially positive effect of RYR on the risk of stroke. However, compliance with medication use should be cautioned. The findings of this study require future studies to validate the beneficial effects of RYR prescription on stroke risk.

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A case of erectile dysfunction induced by red yeast rice in lipid‐lowering therapy

Cited by 13 publications

References 8 publications

Red Yeast Rice: A Systematic Review of the Traditional Uses, Chemistry, Pharmacology, and Quality Control of an Important Chinese Folk Medicine

Red Yeast Rice: A Systematic Review of the Traditional Uses, Chemistry, Pharmacology, and Quality Control of an Important Chinese Folk Medicine

Scientific opinion on the safety of monacolins in red yeast rice

Decreased Risk of Stroke in People Using Red Yeast Rice Prescriptions (LipoCol Forte®): a Total Population-Based Retrospective Cohort Study

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