Red yeast rice (RYR or red Koji) is an ingredient in dietary supplements often used for people with dyslipidemia or with statin-intolerance. These supplements contain monacolin K (lovastatin). This 2017 study published by NCBI made a case-by-case assessment highlighting myopathies and liver injury as potential safety issues, thus suggesting that the safety profile of RYR is similar to statins. RYR is used in Chinese medicine as a natural statin to improves blood circulation by decreasing cholesterol and triglyceride levels. Certain studies have shown that statin use and a higher risk of PD are related and that PD symptoms appear to be stronger following use of statins. These findings raise the hypothesis that the safety profile of RYR is highly similar to that of synthetic statins and warrants further investigation to finally characterize the safety profile of RYR. The conclusion of this report is that the safety profile of RYR is similar to that of statins and the risk profile of these supplements needs to be examined and regulated.
Is it Safe to Take CoQ10 While Taking Warfarin or Plavix (clopidogrel)?
Question: Does CoQ10 interact with blood thinners? Answer: There are studies with conflicting results on whether CoQ10 may interfere with warfarin treatment or decrease the effectiveness of warfarin (Coumadin). There are studies that suggest that CoQ10 may increase the risk of bleeding when on warfarin and other studies that suggest CoQ10 may decrease the risk of bleeding when on warfarin. Other studies indicate that there is no effect so long as your INR (bleeding time) is stable. It’s not clear whether CoQ10 affects Plavix treatment. Consult with your doctor before taking any supplement or medication.
Source: ConsumerLab Q&A
What you Should Know About your Diet and Warfarin
The blood-thinning medication, warfarin decreases the chance of harmful blood clots by blocking the effects of vitamin K which helps blood-clotting proteins form in the liver. Your warfarin dose is determined by your PT or INR measurements that show how long it takes for your blood to form clots.
A document published by ImpactTeam looks at how your diet affects warfarin and how the amount of vitamin K in your diet will determine the warfarin dose needed to prevent bleeding. Warfarin may have possible interaction with cranberry juice, mango juice, grapefruit juice, caffeine, charbroiled foods, alcohol, garlic, soy, ginger, and green tea. In addition, there is potential interaction of dietary supplements with warfarin.
Source: Warfarin and your Diet
How Does Fasting Affect INR and %TTR?
A report published in the Journal of Thrombosis and Haemostasis looked at the effects of fasting in Muslim patients taking warfarin. The anticoagulation medication warfarin is influenced by changes in the diet and fasting might influence the INR and the %TTR. During the month of Ramadan, when Muslims fast during daylight hours (about 13.5hrs/24), stable warfarinised Muslim patients had their INR level tested before, during, and after Ramadan. Unsurprisingly the INR measurement and %TTR changed. The study concluded that fasting significantly increases the mean INR of medically stable patients taking warfarin and the likelihood of having an INR above therapeutic targets.
Source: The effects of fasting in Muslim patients taking warfarin
The EU Parliament: The Disruption of Medical Supply Chains Under COVID-19
The EU parliament offers a Q&A page where you can get updates and ask questions regarding the disruption of medical supply chains during the COVID-19 pandemic and measures taken by all EU countries. Up to 90% of active ingredients in medicines are produced in China and India. This has made the EU national health systems vulnerable during the COVID pandemic. Not only is the EU reliant on receiving the active ingredients from abroad under coronavirus restrictions but the situation is exacerbated by some member states restricting the intra-community movement of pharmaceuticals. This may lead to shortages and disruption of the medical supply chain.
EU Parliamentary Q&A: Disruption of medical supply chains in the EU due to COVID-19 and unilateral national measures
The FDA is Monitoring the Supply of Drugs During the COVID-19 Pandemic
The FDA is constantly monitoring the availability of medical drugs with expectations that COVID-19 will disrupt the supply chain. The FDA is in touch with more than 180 manufacturers of human drugs so that they are informed of any up-coming shortages including shortages of active ingredients produced in China. The FDA is also aware of the possible disruption of the supply chain for medical devices. COVID-19 movement restrictions, quarantines, and travel restrictions have all impacted the supply of medical drugs. The FDA will continue to monitor and update about the supply chain of human drugs, medical devices, biologics and blood supply, food and animal drugs during the pandemic.
Nattokinase as a Possible Treatment for Cardiovascular Disease
A 2018 review in the NCBI Biomarker Insights journal looks at nattokinase as a possible alternative in the prevention and treatment of cardiovascular disease. Nattokinase (NK), the most active ingredient of natto (cheese-like food made from fermented soybeans), possesses a variety of favorable cardiovascular effects. The review looks at the pharmacological effects and mechanisms of NK in terms of fibrinolytic/antithrombotic effects, anti-atherosclerotic and lipid-lowering effects, antihypertensive effects, antiplatelet/anticoagulant effects, and neuroprotective actions. The review also lists the few clinical studies that have been done with NK. NK is registered as a nutritional supplement and not a drug. In summary, compared with traditional antithrombotic and antihypertensive drugs, NK is characterized by high safety, low cost, simple production process, oral availability, and long in vivo half-life. As such, it is expected to become a new-generation drug for thrombotic disorders or CVDs.
Source: Nattokinase: A Promising Alternative in Prevention and Treatment of Cardiovascular Diseases