Table 10.

Case reports of liver function alteration associated with intake of food supplements containing monacolin K from RYR preparations, published in the scientific literature

Patient data	Daily intake of monacolin Ka	Period of intake	Adverse effects	Reference
Female, 63 years old	15–30 mg	6 months	Severe lobular necroinflammatory changes at liver biopsy; previous mild hepatotoxicity during therapy with lovastatin	Grieco et al. (2009)
Female, 53 years old	3 mg	60 days	Increased level of ALT and AST, GGT	Lapi et al. (2008)
Male, 49 years old	5 mg	60 days	Increased level of ALT and AST	Lapi et al. (2008)
Female, 42 years old	3 mg	30 days	Acute hepatitis with hospitalisation	Mazzanti et al. (2017)
Female, 46 years old	3 mg	50 days	Acute hepatitis with hospitalisation	Mazzanti et al. (2017)
Female, 58 years old	3 mg	60 days	Increased level of AST (2x normal level)	Mazzanti et al. (2017)
Female, 68 years old	3 mg	15 days	Increased level of pancreas and hepatic enzymes	Mazzanti et al. (2017)
Female, 68 years old	3 mg	1 year	Increased level of transaminases; previous statin intolerance	Mazzanti et al. (2017)
Male, 35 years old	3 mg	60 days	Toxic acute hepatitis with hospitalisation	Mazzanti et al. (2017)
Male, 36 years old	3 mg	76 days	Acute hepatitis with hospitalisation	Mazzanti et al. (2017)

ALT: alanine aminotransferase; AST: aspartate aminotransferase; GGT: gamma‐glutamyl transpeptidase.

^aIngredients other than monacolin K may be present in the products.