@ihatediabetes - We took your questions to a Mayo Clinic pharmacist. Here is what she wrote:

"Red yeast rice has been shown to lower cholesterol. As you said, it contains a substance called monacolin K which is the active cholesterol-lowering substance in lovastatin. Most red yeast rice products contain a small percentage of monacolin K that is much lower than the normal daily dose of lovastatin, so researchers believe there are other substances in the red yeast rice that also help to lower cholesterol. The downside of using this is that there is not standardization across all red yeast rice products. Some brands may contain 0.1 mg of lovastatin per capsule while others may contain 10.09 mg per capsule. Studies have shown this to be a safe product when used for up to four months, but no long-term studies have been done."