Hi Doc, I am currently on Atripla with undetectable viral load and cd4 between 700 and 800. All is well except my cholesterol and triglycerides which has been significantly increasing lately. My doc said she wanted to try some alternative natural remedies before putting me on some statines, so she prescribed me some capsules of fermented red rice. Each pill contains 3 mg of the active principle Monakoline K + 4 mg of q10 enzyme. I read that red rice yeast may be not appropriate for people taking efavirenz. Do you know anything more about it?

Use of red rice products for treatment of elevated lipids is not approved in the US and there has been concern about the quality/purity and safety of products that are available. There is also concern about possible interaction with HIV drugs metabolized in the liver including efavirenz. Besides statins and other prescription drugs, use of fish oil and niacin as well as diet and exercise are often individualized in HIV+ patients to adequately and safely manage elevated lipid levels. KH