Drug & supplement interaction

Eleuthero + Atazanavir, Cobicistat

Atazanavir, Cobicistat brand name: Evotaz.

Minor Interaction
Medically reviewed by · Updated September 2026
The bottom line Minor

Eleuthero has a minor interaction with Atazanavir, Cobicistat. Theoretically, eleuthero might increase levels of drugs metabolized by CYP3A4.

Read the full interaction report
SeverityMinor
LikelihoodUnlikely
EvidenceB
What do Severity, Likelihood & Evidence mean?
Know someone taking this? Share
Facebook Post Reddit Email
On this page
Interaction report

Eleuthero and Atazanavir, Cobicistat

Here is the interaction we found between these two, with the evidence behind it.

Minor

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

Why this applies to Atazanavir, Cobicistat

Atazanavir, Cobicistat falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES — the group Eleuthero interacts with.

Theoretically, eleuthero might increase levels of drugs metabolized by CYP3A4.
In vitro and animal research suggest that standardized extracts of eleuthero might inhibit CYP3A4. However, research in healthy human volunteers has found that taking eleuthero 485 mg twice daily for 14 days does not inhibit CYP3A4 drug metabolism.
Severity Minor Likelihood Unlikely Evidence B

Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the situation with Evotaz (atazanavir plus cobicistat) and eleuthero. Both of these drugs are processed by a liver enzyme called CYP3A4. On paper, eleuthero might slow that enzyme down, which could let atazanavir build up a bit and theoretically nudge up side effects like nausea, headache, or the yellowing of skin and eyes (jaundice) that this medicine is known for.

The reassuring part: this concern comes mostly from lab and animal studies. When eleuthero was actually tested in healthy people, it did not meaningfully block CYP3A4. So a real-world problem is unlikely. Still, HIV medicines need steady, reliable levels to keep working, so it's worth a quick word with your pharmacist or doctor before adding eleuthero.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Harkey MR, Henderson GL, Zhou L, et al. Effects of Siberian ginseng (Eleutherococcus senticosus) on c-DNA-expressed P450 drug metabolizing enzymes. Alt Ther 2001;7:S14.
  2. Donovan JL, DeVane CL, Chavin KD, et al. Siberian Ginseng (Eleutheroccus senticosus) Effects on CYP2D6 and CYP3A4 Activity in Normal Volunteers. Drug Metab Dispos 2003;31:519-22.. PubMed

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Eleuthero Also Interacts With Other Medications

Eleuthero has 679 moderate, 460 minor known drug interactions in our database — the Atazanavir, Cobicistat one above is one of them. If you take anything else, check it against the full list below.

Moderate 679 Minor 460 No known interaction 1,691 (incl. Atazanavir, Cobicistat)
Taking anything else?

Check Another of Your Medications Against Eleuthero

Covers the 2,830 medications we’ve checked against Eleuthero. Pick one to open its full report.

From our Q&A

Questions About Eleuthero or Atazanavir, Cobicistat

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Eleuthero or Atazanavir, Cobicistat, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Atazanavir, Cobicistat

This page covers Eleuthero only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Atazanavir, Cobicistat page lists 152 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Grapefruit (major), St. John's Wort (major), Acacia Rigidula (moderate) and Adrafinil (moderate).

By severity: 3 major · 107 moderate · 42 minor.

From our pharmacist’s overview on the Atazanavir, Cobicistat page

“Evotaz (atazanavir with cobicistat) treats HIV, and its effectiveness depends on steady blood levels, so I read this list of 152 supplements and herbs carefully rather than casually. Only three carry a major rating, but those three deserve your attention first: St.”

Reviewed by 2 · Jul 18, 2026

Open the Atazanavir, Cobicistat interaction page

One more smart check

Taking Eleuthero as Part of a Dietary Supplement Product? Check It for Interactions

We hold 3,795 real supplement products containing Eleuthero, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Eleuthero. Your product may carry other ingredients that interact with Atazanavir, Cobicistat too, on top of Eleuthero — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Eleuthero and Atazanavir, Cobicistat Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Eleuthero
Top 5%

#61 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Atazanavir, Cobicistat
Top 10%

#254 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Eleuthero

What is Eleuthero?

Eleuthero
  • Fatigue and low energy
  • Physical and athletic performance
  • Stress resistance (adaptogen)
  • Immune support
  • Mental focus and alertness

Eleuthero is an herb traditionally used as an 'adaptogen' to fight fatigue, boost energy, and help the body handle stress. The scientific evidence behind these uses is limited and mixed, so it should not replace proven treatments. It is generally well tolerated short-term, but pregnant and breastfeeding people and those with certain conditions should avoid it or check with a healthcare provider first.

Read the full Eleuthero monograph & all interactions
Medication

About Atazanavir and Cobicistat

What Is Atazanavir and Cobicistat Used For?

Brand name: Evotaz

Evotaz (atazanavir/cobicistat) is used to treat HIV-1 infection. It must always be taken together with other antiretroviral medicines — it is not a complete regimen on its own. It is approved for adults and for pediatric patients who weigh at least 35 kg.

In patients who have been on HIV treatment before (treatment-experienced), how well Evotaz works depends on how much resistance to protease inhibitors the virus has already developed. Your prescriber will review this before starting you on Evotaz.

See full Atazanavir and Cobicistat drug information
Keep checking

Other Drugs & Eleuthero

Browse every other medication we’ve checked against Eleuthero — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
679Moderate
460Minor
1,690No known interaction
679 Moderate 460 Minor 1,690 No interaction
Moderate

679 interactions

Showing 60 of 679 moderate interactions — see all 679 on the Eleuthero page.

Minor

460 interactions

Showing 60 of 460 minor interactions — see all 460 on the Eleuthero page.

No interaction 1,690 drugs checked — show the list

We also checked Eleuthero against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 1,690 medications checked with no known interaction — see the full Eleuthero list.

See the full Eleuthero interactions page
See every supplement checked against Atazanavir, Cobicistat, ranked by severity
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

Keep exploring
Eleuthero monograph › Uses, safety, and every drug interaction in one place Atazanavir, Cobicistat supplement interactions › Every supplement checked against Atazanavir, Cobicistat, ranked by severity Atazanavir and Cobicistat drug information › The full plain-English guide to this medication Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Eleuthero and Atazanavir, Cobicistat Together: Common Questions

Can you take Eleuthero with Atazanavir, Cobicistat?
There is only a minor interaction, which is usually not serious. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Eleuthero and Atazanavir, Cobicistat interaction?
We rate it Minor. This interaction is generally not clinically significant, but it remains worth noting and discussing with your pharmacist.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Atazanavir, Cobicistat and Eleuthero?

Our pharmacists answer your medication & supplement questions — free.

Ask a pharmacist

This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.