Red yeast rice is the fermentation product of the mould Monascus ruber and is traditionally used in East Asia to dye and conserve food. Its main pharmacologically active compound, monakolin K, was isolated from red yeast rice and is used as an inhibitor of cholesterol synthesis under the INN lovastatin. Lovastatin and several other statins are marketed as drugs whereas red yeast rice is offered as a food supplement. As statins can cause severe side effects, such as muscle damage and kidney failure, the dosing and information about interactions with drugs and food is essential for the use of these products. Furthermore, red yeast rice can contain the mycotoxin citrinin and several other substances that are not yet toxicologically evaluated.