Red yeast rice is a natural compound with the same effects as statin drugs to treat high cholesterol. However, some studies show its promising benefits when combined with CoQ10, a natural antioxidant essential for muscle and heart health and energy production in the body.
Learn more about red yeast rice and CoQ10 in this article as we cover why combining these two naturally occurring supplements is beneficial, their dosage, and their side effects.
Table of Contents
What is Red Yeast Rice?

Red yeast rice, known as “Went Yeast” in China, is a type of fermented yeast called Monascus purpureus grown over rice. This yeast rice mixture is a staple in Chinese medicine as it helps to lower bad cholesterol and improve digestion and blood circulation.
In today’s health, red yeast rice is also available as an oral supplement. It contains similar compounds called monacolin K, an ingredient used in a cholesterol-lowering drug. Doctors prescribe red yeast rice supplements to patients with high cholesterol as it can help reduce the risk of heart disease and lower LDL or bad cholesterol.
What is CoQ10?

One of the natural ways that our bodies fight off illnesses is with the help of antioxidants. One of these antioxidants is called Coenzyme 10 or CoQ10. Our body produces CoQ10, but we can also get them through diet.
As we grow old, CoQ10 production decreases in the body. It means that obtaining them from either diet or supplements may be recommended. Some conditions associated with reduced levels of CoQ10 in the body include diabetes, cancer, and neurodegenerative disorders like Alzheimer’s or Parkinson’s.
But more studies are still necessary to support this claim as it is unclear whether CoQ10 deficiency causes the diseases or results from them [1].
CoQ10 is present in higher levels in the heart, kidney, pancreas, and liver as these organs demand more energy to perform their tasks in our body [2]. It helps to produce energy in the cells to create ATP or adenosine triphosphate. This compound provides energy to support and drive many functions in living cells.

Aside from its ability to produce energy in our cells, CoQ10 could also improve outcomes for patients with heart failure, according to some studies [3]. A study stated that 1 out of 7 reviews found that CoQ10 could help manage heart failure, especially for those opposed to other treatment options [4].
Therefore, treatments with CoQ10 may help regenerate energy level production, improve heart health, and reduce stress levels, all of which can be essential for treating heart failure.
Combining Red Yeast Rice and CoQ10
Doctors use a group of medications called statins to reduce bad cholesterol in the blood. However, the main side effect of this medication is myopathy or muscle disease. This condition may impair a patient from performing daily activities like combing their hair, bathing, or even standing up from a chair.
This is why a study suggests that a safe alternative for treating high cholesterol is by combining red yeast rice and CoQ10.
During the study, rats were treated with either statin (atorvastatin), red yeast rice, CoQ10, or combined treatments [5]. The results were analyzed after 15 and 30 days of the treatment. The result showed that red yeast rice and CoQ10 were beneficial over atorvastatin in lowering blood cholesterol without increasing the production of creatine kinase, which indicates myopathy.
This study proved that combining red yeast rice and CoQ10 may be an alternative treatment to reduce the chance of getting atorvastatin-associated myopathy.
Red Yeast Rice and CoQ10 Dosage
Taking red yeast rice with CoQ10 can be available either in capsule or tablet with doses ranging from 200-4,800 mg based on clinical trials with 10 mg of monacolin [6]. However, further scientific studies are necessary to determine the amount needed to maximize the promising benefits. This means proper caution is still critical to lowering the risk of serious side effects.

It is highly recommended to speak with your healthcare provider first to determine the appropriate dosage for you.
Red Yeast Rice and CoQ10 Benefits

Although red yeast rice is a natural remedy for years, it is mostly used as an alternative medication to lower bad cholesterol levels and promote heart health [7]. Meanwhile, CoQ10 is a critical component to improve congestive heart failure symptoms and may help lower blood pressure.
Some studies have shown the promising benefits of red yeast rice in treating the risk of factors of developing metabolic syndromes like heart disease, diabetes, and stroke. An 18-week study found that red yeast rice-containing supplements can lower blood sugar, systolic blood pressure, and insulin levels in the blood [8].
On the other hand, CoQ10 has reportedly reduced bad cholesterol in diabetes patients, reducing the risk of heart disease [9].
Red Yeast Rice and CoQ10 Side Effects
Red yeast rice may contain a compound called monacolin K which is the same compound used to treat high cholesterol. The side effects may include liver damage and muscle disorders or myopathy. Some mild side effects like heartburn, headache, dizziness, abdominal discomfort, or gas may also be experienced by some patients.

CoQ10 supplements are generally safe and produce fewer side effects than red yeast rice. But some patients may also experience mild side effects like loss of appetite, diarrhea, nausea, vomiting, or upper abdominal pain. Sometimes, patients may also experience insomnia, fatigue, skin rashes, headaches and dizziness, and irritability or agitation.
However, it is still unclear if there are serious side effects of combined red yeast rice and CoQ10.
Bottomline: Should Red Yeast Rice and CoQ10 be Combined?
Red yeast rice is a fermented yeast grown over rice and is a natural remedy used in Chinese medicine to treat high cholesterol and improve digestion and blood circulation. It has a compound called monacolin K which is also present in statin medications used in treating high cholesterol.
CoQ10, a natural antioxidant produced in the body, is essential in producing energy, especially in the heart, liver, pancreas, and kidney, where more energy is needed to perform their tasks.
Some studies pointed out the benefits of combining red yeast rice and CoQ10 in reducing the adverse side effects of statin-related myopathy or muscle disorder. This proved that red yeast rice with CoQ10 can be an alternative treatment for patients with high cholesterol who may suffer serious side effects [10].
Although these two compounds are natural and generally safe, the recommended dosage should only range from 200-4,800 mg with supervision from your healthcare provider.
FAQs
Red yeast rice may contain monacolin K, which causes liver damage in some people. If you take red yeast rice with these types of drugs, herbs, and supplements, it could increase the risk of liver damage.
Disclaimer: This article is only a guide. It does not substitute the advice given by your healthcare professional. Before making any health-related decision, consult your healthcare professional.
Editorial References And Fact-Checking
- Sood B, Keenaghan M. Coenzyme Q10. [Updated 2022 Jan 19]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK531491/
- Saini R. Coenzyme Q10: The essential nutrient. J Pharm Bioallied Sci. 2011 Jul;3(3):466-7. doi: 10.4103/0975-7406.84471. PMID: 21966175; PMCID: PMC3178961.
- Di Lorenzo A, Iannuzzo G, Parlato A, Cuomo G, Testa C, Coppola M, D’Ambrosio G, Oliviero DA, Sarullo S, Vitale G, Nugara C, Sarullo FM, Giallauria F. Clinical Evidence for Q10 Coenzyme Supplementation in Heart Failure: From Energetics to Functional Improvement. J Clin Med. 2020 Apr 27;9(5):1266. doi: 10.3390/jcm9051266. PMID: 32349341; PMCID: PMC7287951.
- Jafari M, Mousavi SM, Asgharzadeh A, Yazdani N. Coenzyme Q10 in the treatment of heart failure: A systematic review of systematic reviews. Indian Heart J. 2018 Jul;70 Suppl 1(Suppl 1):S111-S117. doi: 10.1016/j.ihj.2018.01.031. Epub 2018 Jan 31. PMID: 30122240; PMCID: PMC6097169.
- Abdelbaset M, Safar MM, Mahmoud SS, Negm SA, Agha AM. Red yeast rice and coenzyme Q10 as safe alternatives to surmount atorvastatin-induced myopathy in hyperlipidemic rats. Can J Physiol Pharmacol. 2014 Jun;92(6):481-9. doi: 10.1139/cjpp-2013-0430. Epub 2014 Apr 28. PMID: 24896301.
- Gerards MC, Terlou RJ, Yu H, Koks CH, Gerdes VE. Traditional Chinese lipid-lowering agent red yeast rice results in significant LDL reduction but safety is uncertain – a systematic review and meta-analysis. Atherosclerosis. 2015 Jun;240(2):415-23. doi: 10.1016/j.atherosclerosis.2015.04.004. Epub 2015 Apr 12. PMID: 25897793.
- Xue Y, Tao L, Wu S, Wang G, Qian L, Li J, Liao L, Tang J, Ji K. Red yeast rice induces less muscle fatigue symptom than simvastatin in dyslipidemic patients: a single center randomized pilot trial. BMC Cardiovasc Disord. 2017 May 18;17(1):127. doi: 10.1186/s12872-017-0560-z. PMID: 28521773; PMCID: PMC5437665.
- Affuso F, Mercurio V, Ruvolo A, Pirozzi C, Micillo F, Carlomagno G, Grieco F, Fazio S. A nutraceutical combination improves insulin sensitivity in patients with metabolic syndrome. World J Cardiol. 2012 Mar 26;4(3):77-83. doi: 10.4330/wjc.v4.i3.77. PMID: 22451856; PMCID: PMC3312235.
- Dludla PV, Nyambuya TM, Orlando P, Silvestri S, Mxinwa V, Mokgalaboni K, Nkambule BB, Louw J, Muller CJF, Tiano L. The impact of coenzyme Q10 on metabolic and cardiovascular disease profiles in diabetic patients: A systematic review and meta-analysis of randomized controlled trials. Endocrinol Diabetes Metab. 2020 Mar 14;3(2):e00118. doi: 10.1002/edm2.118. PMID: 32318636; PMCID: PMC7170462.
- Abdelbaset, M., Safar, M. M., Mahmoud, S. S., Negm, S. A., & Agha, A. M. (2014). Red yeast rice and coenzyme Q10 as safe alternatives to surmount atorvastatin-induced myopathy in hyperlipidemic rats. Canadian journal of physiology and pharmacology, 92(6), 481–489. https://doi.org/10.1139/cjpp-2013-0430