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This nutraceutical combination consists of red yeast rice, policosanol, and berberine, designed as a lipid-lowering alternative for patients who are intolerant to statins. Red yeast rice contains monacolin K, which acts as a natural HMG-CoA reductase inhibitor, similar to lovastatin. Berberine lowers cholesterol by upregulating the low-density lipoprotein receptor (LDLR) through the inhibition of PCSK9 and stabilization of LDLR mRNA. Policosanol is a mixture of long-chain aliphatic alcohols that may further inhibit cholesterol synthesis. This specific combination was evaluated by the University of Roma La Sapienza in the ECLIPSE trial, comparing its efficacy to ezetimibe in patients with coronary artery disease and hypercholesterolemia who had undergone percutaneous coronary intervention (PCI).
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