Can Red Yeast Rice and Nitric Oxide Supplements Be Safe with Blood Pressure Meds? - Internal Medicine

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Antihypertensive medications, red yeast rice, and nitric oxide?


My husband is 43 years old and has been taking blood pressure medication (Lisinopril and Amlodipine) for about six months.
Can he take red yeast rice or nitric oxide-related health supplements?

Ms. Wu, 40~49 year old female. Ask Date: 2022/02/23

Dr. Lin Wuxuan reply Internal Medicine


Hello: Since we are unable to ascertain the current health status of the gentleman, it is recommended to bring the dietary supplements he wishes to take to his regular outpatient physician for consultation.
Thank you for your inquiry.

Reply Date: 2022/02/23

More Info


When considering the use of Red Yeast Rice (RYR) and Nitric Oxide (NO) supplements for someone who is on blood pressure medications such as Lisinopril (力安穩) and Amlodipine (百適歐), it is crucial to understand the potential interactions and effects these supplements may have on blood pressure management.

Red Yeast Rice (RYR) is a fermented product that contains monacolin K, which is chemically identical to the active ingredient in the prescription drug lovastatin. RYR is primarily used for lowering cholesterol levels, but it can also have effects on blood pressure. While some studies suggest that RYR may help in reducing blood pressure, its effects can vary significantly among individuals. Importantly, RYR can also interact with other medications, particularly those that affect liver function or cholesterol levels. Given that your husband is already on blood pressure medications, introducing RYR could potentially lead to an additive effect on blood pressure lowering, which might not be safe without medical supervision.

Nitric Oxide (NO) supplements, often marketed for their vasodilating properties, can also influence blood pressure. NO is a molecule that helps relax blood vessels, leading to improved blood flow and potentially lower blood pressure. While this can be beneficial for some individuals, it can also pose risks for those already taking antihypertensive medications. The combination of NO supplements with blood pressure medications could lead to hypotension (abnormally low blood pressure), especially if not monitored closely.

Given these considerations, it is essential to consult with your husband's healthcare provider before introducing any new supplements. The provider can assess his overall health status, current medications, and specific blood pressure readings to determine if RYR or NO supplements are appropriate. They can also monitor for any adverse effects or interactions that may arise from combining these supplements with his existing medications.

Additional Considerations:
1. Monitoring Blood Pressure: If your husband does decide to take these supplements, it is vital to monitor his blood pressure regularly. This will help identify any significant drops in blood pressure that could lead to dizziness, fainting, or other complications.

2. Dietary Sources: Instead of supplements, consider discussing dietary sources of these compounds with his healthcare provider. Foods rich in omega-3 fatty acids, potassium, and antioxidants can support cardiovascular health without the risks associated with supplements.

3. Lifestyle Modifications: Encourage your husband to adopt lifestyle changes that can help manage blood pressure, such as regular exercise, a balanced diet low in sodium, and stress management techniques.

4. Potential Side Effects: Be aware of the potential side effects of both RYR and NO supplements. RYR can cause muscle pain, liver damage, and digestive issues, while NO supplements may lead to headaches, dizziness, or gastrointestinal discomfort.

In conclusion, while Red Yeast Rice and Nitric Oxide supplements may offer benefits, their use in conjunction with blood pressure medications should be approached with caution. A thorough discussion with a healthcare provider is essential to ensure safety and efficacy in managing blood pressure and overall health.

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