Coadministration has not been studied. Red yeast rice contains monacolin K (a natural component with the same chemical structure as lovastatin) which is metabolised by CYP3A4. Emtricitabine and tenofovir alafenamide do not interfere with monacolin K metabolism. Elvitegravir/cobicistat could significantly increase the exposure of monacolin K due to inhibition of CYP3A4. There are two case reports of rhabdomyolysis resulting from drug-drug interactions with red yeast rice (one with ciclosporin; one with sertraline and rosuvastatin). Since coadministration with lovastatin is contraindicated due to the potential for serious reactions such as myopathy including rhabdomyolysis, red yeast rice should not be coadministered with elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide.