Food supplements (FSs) are widely used by the general population and are commonly available in community pharmacies. As highly accessible healthcare professionals, pharmacists are well positioned to provide evidence-based information and guidance regarding their safe and appropriate use. Adequate knowledge of FSs is essential for pharmacists to prevent adverse effects, identify potential interactions with other medications, and ensure rational use. The objective of this study was to assess community pharmacists’ knowledge regarding FSs and their attitudes towards dispensing and patient counseling practices. A literature review was carried out using the scientific databases PubMed, Scopus, and Web of Science. The following keywords were used: (“food supplements” OR “dietary supplements”) AND (“pharmacists’ knowledge”) AND (“pharmacists’ attitudes”). A total of 789 articles were identified from the electronic databases, of which 31 met the inclusion criteria. The majority of studies were conducted in Asia, with fewer in Europe, North America, and Australia. Cross-sectional survey-based studies represented the predominant research design. The analyzed studies showed that community pharmacists generally demonstrate insufficient knowledge regarding FSs. Nonetheless, they tend to hold a positive attitude toward the use of FSs and recognize their responsibility to counsel patients on safe consumption. Several barriers affecting pharmacists’ ability to deliver evidence-based guidance were identified, including limited training, lack of basic nutrition education, and insufficient access to reliable information sources. The findings indicate the need for targeted strategies to enhance pharmacists’ competencies and improve the quality of patient counseling in this domain.

Red yeast rice (RYR) food supplements are widely used for cholesterol management owing to their content of monacolin K (MK), which, in its lactone form, is chemically identical to the prescription statin lovastatin. Despite their popularity, RYR products raise significant quality and safety concerns related to pronounced variability in MK content, frequent labeling non-compliance, contaminations with undeclared pharmaceutical statins, etc. The analytical differentiation between naturally produced MK and added synthetic lovastatin remains particularly challenging due to their identical chemical structures. This review provides a comprehensive overview of the chemical composition of RYR, with emphasis on monacolins, pigments, and relevant secondary metabolites, and critically summarizes current regulatory, safety, and quality issues associated with RYR-based food supplements. Furthermore, a practical, multi-level analytical strategy for product authentication is proposed. The approach integrates targeted quantification of MK and accompanying monacolins, identification of characteristic Monascus pigments as authenticity markers, gas chromatography–mass spectrometry for the detection of undeclared statins and other non-declared constituents, and proton nuclear magnetic resonance for global compositional fingerprinting. By combining complementary targeted and non-targeted techniques, this workflow enables more reliable authentication, detection of adulteration, and comprehensive quality assessment. The implementation of standardized analytical protocols is essential to improve transparency and enhance consumer safety in the rapidly expanding RYR supplement market.

Introduction : Food supplements (FSs) containing monacolins derived from red yeast rice (RYR) have become increasingly prevalent on the European Union (EU) market and are classified under Regulation (EC) No 1925/2006 as “Restricted substances” and “Substances under Community scrutiny”. Aim : This study aims to assess EU regulatory requirements for FSs containing monacolins from RYR, evaluate labeling compliance of selected FSs on the Bulgarian market, and identify common ingredient combinations in registered products. Materials and methods : A documentary analysis of the regulatory requirements applicable to FSs containing monacolins from RYR was conducted, alongside a review of the Bulgarian register of FSs. In addition, 18 FSs containing these ingredients available on the Bulgarian market were selected, and the information provided on their packaging was compared with the relevant EU labeling requirements. Results and discussion : RYR is most frequently combined with plant extracts, coenzyme Q10, and B vitamins. Labelling of FSs containing monacolins from RYR is required to include specific mandatory warnings, including recommendations to avoid a daily intake of 3 mg or more of monacolins. Non-compliance with labeling requirements was identified in 11 of the 18 FSs examined due to the absence of mandatory information required by national legislation or warnings mandated by EU regulations for FSs containing monacolins from RYR. Conclusion : The results indicate that some FSs on the Bulgarian market do not comply with EU labeling requirements, highlighting the need for strengthened regulatory control.

Virtual patients (VPs) and artificial intelligence (AI) are being implemented in pharmacy education across various countries in order to learn different techniques to improve communication skills, identify drug-related problems, assess the pharmacist’s role in the self-medication process or assess students’ knowledge acquisition. The objective of this study was to assess the benefits of integrating VPs and AI in pharmacy education, particularly their impact on pharmacy students’ knowledge and skills in self-medication counselling. A literature search was conducted across PubMed, Scopus and Web of Science databases. Studies focused on the integration of VPs and AI tools in pharmacy education and their impact on students’ knowledge, counselling and communication skills related to self-medication, were evaluated. Eligible studies were full-text, peer-reviewed research articles published in English. No restrictions were applied regarding publication year. A total of 857 articles were identified through electronic databases and 9 met the inclusion criteria. Six studies were conducted in the USA and one each in Portugal, Sweden and Indonesia. Most studies employed a pre–post-study design. Six studies utilized VP simulations, while the remaining three implemented AI-based tools. Key outcomes covered in analyzed articles included improvements in knowledge score, communication, and consultation skills, along with positive perceptions, including increased student satisfaction and confidence levels. Using VP simulations and AI tools in pharmacy education could positively impact students by enhancing their knowledge as well as their confidence and counselling skills.

Red yeast rice (RYR) food supplements show substantial variability in monacolin composition, raising concerns regarding product quality, labelling accuracy, and regulatory compliance. This study evaluated 14 RYR-containing food supplements purchased from the Bulgarian market using complementary HPLC-PDA, LC-MS, and GC-MS/MS approaches. A validated HPLC-PDA method was applied for quantitative determination of the lactone form of monacolin K (MK) and monascorubrin, while LC-MS was used for identity confirmation and GC-MS/MS for targeted screening of undeclared simvastatin and rosuvastatin. The measured lactone MK intake at the maximum manufacturer-recommended daily dose ranged from 0.06 to 14.11 mg/day, demonstrating substantial product-to-product variability and discrepancies between measured MK concentrations and label declarations. Three products contained lactone MK at levels of ≥3 mg/day. However, because the hydroxy acid form and other monacolins were not quantified, these results cannot be directly interpreted as total RYR-derived monacolin intake for regulatory assessment. Neither simvastatin nor rosuvastatin was detected under the applied analytical conditions. Monascorubrin was not detected in any of the analysed products under the applied analytical conditions; consequently, its non-detection cannot substantiate product authenticity, and the present findings do not support its use as a standalone authenticity marker for finished RYR supplements. Overall, the results demonstrate substantial variability in measured MK-lactone content among RYR food supplements purchased from the Bulgarian market and highlight the importance of improved analytical characterisation and product standardisation.

Introduction : Red yeast rice (RYR)-containing food supplements (FSs) are widely used. However, considerable variability in their pharmaceutical-technological quality has been reported, highlighting the need for systematic evaluation. Aim : This study aimed to evaluate the pharmaceutical-technological characteristics of RYR-containing FSs and explore possible differences according to the declared formulation composition and dosage form. Materials and methods : A total of 15 commercially available FSs containing RYR were evaluated, including coated and uncoated tablets, as well as hard and soft gelatin capsules. Mass uniformity, mechanical strength, resistance to crushing, friability of uncoated tablets, and disintegration were evaluated according to the requirements of the European Pharmacopoeia (Ph. Eur.), 12 ^th edition. Results : The friability of all uncoated tablets was below 1%, with the lowest value being 0.12%. Mechanical strength ranged from 58.6 to 280 N. The sample with the highest mechanical strength also exhibited the lowest friability and the longest disintegration time. Disintegration times varied from 5 to 40 min and were generally shorter for capsules than for tablets. Two hard gelatin capsule samples failed the mass uniformity test, whereas all four uncoated tablet samples exceeded the pharmacopeial disintegration limits. Discussion : The observed differences may reflect variations in formulation composition and excipient content. Microcrystalline cellulose, polyvinylpyrrolidone, and hypromellose may contribute to mechanical resistance, whereas starch and croscarmellose may promote disintegration. Lipophilic components and plant extracts may also affect dosage-form properties. Conclusion : Some RYR-containing FSs complied with all applicable Ph. Eur. requirements, whereas others showed deviations in mass uniformity or disintegration. The findings demonstrate variability among commercially available products and support the need for systematic pharmaceutical-technological quality assessment.