1 interaction related to efficacy
St. John's wort is a strong inducer of the CYP3A4 enzyme system that clears the statin-like compound (monacolin K, chemically identical to lovastatin) in red yeast rice. Taking them together speeds up how the body breaks down that compound, lowering its levels and weakening red yeast rice's cholesterol-lowering effect. The concern here is loss of benefit rather than toxicity, and the direction is the opposite of CYP3A4-inhibitor interactions, so it does not raise muscle-injury risk.
