Drug & supplement interaction

Germanium + Atazanavir

Atazanavir brand name: Reyataz.

No Known Interaction
Medically reviewed by · Updated July 2026 · Pair last verified Sep 20, 2026
The bottom line No known interaction

We found no known interaction between Germanium and Atazanavir in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the label for Atazanavir states a food rule worth keeping to, and the two are separately associated with some of the same side effects, which would make a new symptom harder to attribute to one or the other.

Know someone taking this? Share
Facebook Post Reddit Email
On this page
Interaction report

Germanium and Atazanavir

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Atazanavir and Germanium in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

Worth understanding: our licensed dataset holds no drug-interaction record for Germanium at all — not against Atazanavir, and not against any other medication we track. This verdict therefore rests on the absence of any recorded data, not on research that looked at this combination and found nothing. We cannot rule an interaction out.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Germanium safety at a glance

Germanium overall Avoid Germanium supplements have caused serious kidney damage and deaths and should be avoided.
Pregnancy Likely Unsafe When used orally due to reported toxicity; avoid using. Read the full pregnancy detail
Breastfeeding Likely Unsafe When used orally due to reported toxicity; avoid using. Read the full breastfeeding detail

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center) — the full detail is in the Special populations card below. Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Atazanavir and Germanium? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
What to actually watch for

No Interaction Found — But Data Suggests Germanium and Atazanavir May Share Several of the Same Side Effects

This is not an interaction. Neither one changes how your body handles the other, and nothing here says they react together. What our sources do show is that each has separately been linked to the effects below — so taking both can make those effects more likely to turn up, and harder to pin on one or the other if they do. 2 of them are worth acting on rather than waiting out — marked below.

  • Low mood Worth acting on reported in 13.3% of FDA reports for Atazanavir Additional detail

    Germanium

    “Orally, depression occurred in two patients receiving an organometallic preparation of germanium called propagermanium 30 mg daily.”

    Germanium · Natural Medicines adverse-effect record, reported in depression.

    1 source cited
    1. 51746. Tsutsumi, Y., Tanaka, J., Kanamori, H., Musashi, M., Minami, H., Fukushima, A., Yamato, H., Ehira, N., Kawamura, T., Obara, S., Ogura, N., Asaka, M., Imamura, M., and Masauzi, N. Effectiveness of propagermanium treatment in multiple myeloma patients. Eur. PubMed

    Atazanavir

    Listed in the ADVERSE REACTIONS section of the FDA label for Atazanavir, and in voluntary FDA adverse-event reports. Read the label on DailyMed ›

  • Kidney problems Worth acting on Additional detail

    Germanium

    “Orally, germanium is well tolerated in amounts typically found in the diet, 0.4-3.4 mg daily. However, there have been more than 30 reports of renal tubular cell damage with renal failure, hepatic steatosis, lactic acidosis, myopathy, peripheral neuropathy, cerebellar ataxia, and degeneration of the dorsal column of the spinal cord, in some cases leading to death, when organic or inorganic germanium compounds are tak…”

    Germanium · Natural Medicines adverse-effect record, reported in alcohol-related liver disease.

    6 sources cited
    1. 557. Tao SH, Bolger, PM. Hazard assessment of germanium supplements. Regul Toxicol Pharmacol 1997;25:211-9.
    2. 51753. Schauss, A. G. Nephrotoxicity in humans by the ultratrace element germanium. Ren Fail. 1991;13(1):1-4. PubMed
    3. 10040. Higuchi I, Izumo S, Kuriyama M, et al. Germanium myopathy: clinical and experimental pathological studies. Acta Neuropathol (Berl) 1989;79:300-4.. PubMed
    4. 10041. Matsusaka T, Fujii M, Nakano T, et al. Germanium-induced nephropathy: report of two cases and review of the literature. Clin Nephrol 1988;30:341-5..
    5. 10042. Hess B, Raisin J, Zimmermann A, et al. Tubulointerstitial nephropathy persisting 20 months after discontinuation of chronic intake of germanium lactate citrate. Am J Kidney Dis 1993;21:548-52.. PubMed
    6. 10043. Luck BE, Mann H, Melzer H, et al. Renal and other organ failure caused by germanium intoxication. Nephrol Dial Transplant 1999;14:2464-8. PubMed

    “Orally, germanium can cause renal tubular degeneration and renal failure. In one case report, a 38-year-old woman presented with renal failure eventually leading to death after taking 600 mg of a germanium preparation daily for 18 months as an elixir. The preparation was found to be mainly germanium dioxide with some organic compound present.”

    Germanium · Natural Medicines adverse-effect record, reported in myasthenia gravis.

    6 sources cited
    1. 557. Tao SH, Bolger, PM. Hazard assessment of germanium supplements. Regul Toxicol Pharmacol 1997;25:211-9.
    2. 10041. Matsusaka T, Fujii M, Nakano T, et al. Germanium-induced nephropathy: report of two cases and review of the literature. Clin Nephrol 1988;30:341-5..
    3. 10042. Hess B, Raisin J, Zimmermann A, et al. Tubulointerstitial nephropathy persisting 20 months after discontinuation of chronic intake of germanium lactate citrate. Am J Kidney Dis 1993;21:548-52.. PubMed
    4. 10044. Schauss AG. Nephrotoxicity and neurotoxicity in humans from organogermanium compounds and germanium dioxide. Biol Trace Elem Res 1991;29:267-80.. PubMed
    5. 10073. Krapf R, Schaffner T, Iten PX. Abuse of germanium associated with fatal lactic acidosis. Nephron 1992;62:351-6.. PubMed
    6. 10074. Takeuchi A, Yoshizawa N, Oshima S, et al. Nephrotoxicity of germanium compounds: report of a case and review of the literature. Nephron 1992;60:436-42.. PubMed

    Atazanavir

    Listed in the ADVERSE REACTIONS section of the FDA label for Atazanavir. Read the label on DailyMed ›

  • Dizziness Additional detail

    Germanium

    “Orally, germanium has caused peripheral neuropathy. Intravenously, transient lethargy, dizziness, visual blurring, and ataxia were the main adverse effects to the organic compound, spirogermanium. Less common adverse effects were persistent loss of taste and weakness, and a seizure. At doses above 250 mg/m2 daily tremors and mental confusion are more severe.”

    Germanium · Natural Medicines adverse-effect record, reported in epilepsy.

    4 sources cited
    1. 557. Tao SH, Bolger, PM. Hazard assessment of germanium supplements. Regul Toxicol Pharmacol 1997;25:211-9.
    2. 10038. Vogelzang NJ, Gesme DH, Kennedy BJ. A phase II study of spirogermanium in advanced human malignancy. Am J Clin Oncol 1985;8:341-4.. PubMed
    3. 10049. Schein PS, Slavik M, Smythe T, et al. Phase I clinical trial of spirogermanium. Cancer Treat Rep 1980;64:1051-6..
    4. 51770. Woolley, P. V., Ahlgren, J. D., Byrne, P. J., Priego, V. M., and Schein, P. S. A Phase I trial of spirogermanium administered on a continuous infusion schedule. Invest New Drugs 1984;2(3):305-309. PubMed

    Atazanavir

    Listed in the ADVERSE REACTIONS section of the FDA label for Atazanavir. Read the label on DailyMed ›

  • A skin rash Additional detail

    Germanium

    “Orally, one case of skin rash has been reported for a 38-year-old woman who had taken 600 mg of a germanium preparation as an elixir daily for 18 months. The preparation was found to be mainly germanium dioxide with some organic compound present.”

    Germanium · Natural Medicines adverse-effect record, reported in myasthenia gravis.

    1 source cited
    1. 51762. Nagata, N., Yoneyama, T., Yanagida, K., Ushio, K., Yanagihara, S., Matsubara, O., and Eishi, Y. Accumulation of germanium in the tissues of a long-term user of germanium preparation died of acute renal failure. J.Toxicol.Sci. 1985;10(4):333-341. PubMed

    Atazanavir

    Listed in the ADVERSE REACTIONS section of the FDA label for Atazanavir. Read the label on DailyMed ›

Reported for Germanium but not commonly for Atazanavir: numbness or tingling, liver problems, confusion and muscle weakness.

Effects for Atazanavir come from the ADVERSE REACTIONS section of its FDA label; effects for Germanium come from the Natural Medicines adverse-effect record, quoted above. Where a percentage is shown, it is the share of 14,470 voluntary FDA FAERS reports for Atazanavir that mention that effect — a reporting proportion, not an incidence rate and not evidence the drug caused it. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

Special populations

Germanium in Pregnancy & Breastfeeding

Pregnancy And Lactation Likely Unsafe

When used orally due to reported toxicity; avoid using.

DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.© 2026 Therapeutic Research Center

How to take them

Some Atazanavir Products Have a Food Rule — Germanium Should Not Break It

At least one FDA label for a product containing Atazanavir says to take it with food. If you take Germanium on an empty stomach out of habit, keep them separate — and take Atazanavir with a meal where the label says to.

This may not be true of your version. Food instructions belong to the product, not the ingredient: two Atazanavir products can carry different directions, and extended-release forms often differ from immediate-release ones. The label we read is quoted below — check the directions on your own box or bottle, or ask your pharmacist, for how to take the exact product you were given.

b For adult patients who cannot swallow the capsules, REYATAZ oral powder is taken once daily with food at the same recommended adult dosage as the capsules along with ritonavir.

From the Dosage and Administration section of the FDA label we read for Atazanavir — where that label names a specific product, the instruction is that product's. Read the label on DailyMed ›

A food rule is not an interaction — it is about how much of the medicine you absorb. The directions that came with your own product, and your pharmacist, outrank anything on this page.

Overlapping uses

What Atazanavir Is Prescribed For, and What Germanium Has Been Studied For

These two come up together because they touch the same health topic — not because they do the same job. Atazanavir is a prescription medicine with approved uses on its FDA label. Germanium is a supplement: what follows is what researchers have looked at it for, and how strong that evidence is.

Atazanavir is prescribed for: Atazanavir capsules are used together with other antiretroviral medicines to treat HIV-1 infection in adults and in children 6 years and older who weigh at least 15 kg (about 33 lbs). Reyataz — available as capsules and as an oral powder — is also approved for HIV-1 treatment in adults and in children as young as 3 months who weigh at least 5 kg (about 11 lbs). Reyataz oral powder must always be taken with ritonavir and food, and is not for use in children weighing less than 5 kg.

Germanium has been studied for:

  • Cancer studied, not established Germanium has been studied for this. Natural Medicines rates the evidence: Insufficient Reliable Evidence To Rate Read what the research shows

    Germanium for cancer

    Researchers have been interested in spirogermanium, an organometallic form of germanium, as an alternative or palliative treatment for various kinds of cancer including breast cancer, colon cancer, prostate cancer, ovarian cancer, head and neck cancer, and lung cancer. However, response rates in phase I and II trials have generally been low, with only a few reports of partial responses or stable disease.

    6 sources cited
    1. 10035. Budman DR, Schulman P, Vinciguerra V, Degnan TJ. Phase I trial of spirogermanium given by infusion in a multiple-dose schedule. Cancer Treat Rep 1982;66:173-5..
    2. 10037. Mainwaring MG, Poor C, Zander DS, Harman E. Complete remission of pulmonary spindle cell carcinoma after treatment with oral germanium sesquioxide. Chest 2000;117:591-3.. PubMed
    3. 10038. Vogelzang NJ, Gesme DH, Kennedy BJ. A phase II study of spirogermanium in advanced human malignancy. Am J Clin Oncol 1985;8:341-4.. PubMed
    4. 10039. Ettinger DS, Finkelstein DM, Donehower RC, et al. Phase II study of N-methylformamide, spirogermanium, and 4-demethoxydaunorubicin in the treatment of non-small cell lung cancer (EST 3583): an Eastern Cooperative Oncology Group study. Med Pediatr Oncol 1 PubMed
    5. 10049. Schein PS, Slavik M, Smythe T, et al. Phase I clinical trial of spirogermanium. Cancer Treat Rep 1980;64:1051-6..
    6. 10050. Trope C, Mattsson W, Gynning I, et al. Phase II study of spirogermanium in advanced ovarian malignancy. Cancer Treat Rep 1981;65:119-20..

Effectiveness ratings and the research summaries above are the verbatim record from the Natural Medicines database, which grades evidence from “Effective” down to “Insufficient Reliable Evidence To Rate”. A rating below the top of that scale means researchers have looked at it — not that it works, and never that it can stand in for a prescribed medicine. Do not stop or replace Atazanavir on your own; if you are taking Germanium for the same health topic, tell your prescriber, especially if the medicine is being adjusted to a target.

Everything else you take

See Every Supplement That Interacts With Atazanavir

This page covers Germanium only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Atazanavir 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 page

“Atazanavir (Reyataz) treats HIV, and keeping its blood level steady is what stands between viral control and drug resistance, so I read this list with genuine care. Of the 152 supplement and herbal ingredients on file, three carry a major rating: St.”

Reviewed by 2 · Jul 18, 2026

Open the Atazanavir interaction page

One more smart check

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

We hold 41 real supplement products containing Germanium, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Germanium. Even though Germanium itself has no known interaction with Atazanavir, another ingredient on your label might. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Germanium and Atazanavir 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 Germanium
Steady interest

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

29 days ago today
Medication Atazanavir
Top half

#725 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.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Germanium reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 20, 2026. The Germanium and Atazanavir records this page draws on were last updated July 10, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
Supplement

About Germanium

What is Germanium?

  • Immune support
  • Cancer (unproven, alternative therapy)
  • Antioxidant claims
  • Pain relief
  • General wellness/anti-aging

Germanium is a chemical element sometimes sold as a dietary supplement, but there is no reliable evidence it treats any disease. More importantly, germanium supplements have been linked to serious and sometimes fatal kidney damage, so health authorities have warned against their use. We do not recommend taking germanium supplements.

Not a plant; germanium is a chemical element (mineral) · Capsules, tablets, powders (often as germanium-132 / organic germanium or inorganic germanium salts)

An interaction check asks whether these two react with each other — it does not ask whether Germanium is a good idea for someone in your situation. Here is what our Germanium record says about it on its own.

Germanium: dosing

There is no safe or established dose of germanium as a dietary supplement, and we do not recommend taking it at all.

From our Germanium monograph — the full record covers uses, side effects and every documented interaction.

Read the full Germanium monograph & all interactions
Medication

About Atazanavir

What Is Atazanavir Used For?

Brand name: Reyataz

Atazanavir capsules are used together with other antiretroviral medicines to treat HIV-1 infection in adults and in children 6 years and older who weigh at least 15 kg (about 33 lbs).

Reyataz — available as capsules and as an oral powder — is also approved for HIV-1 treatment in adults and in children as young as 3 months who weigh at least 5 kg (about 11 lbs). Reyataz oral powder must always be taken with ritonavir and food, and is not for use in children weighing less than 5 kg.

Most-Reported Side Effects for Atazanavir

From FAERS, the FDA’s public side-effect reporting system (14,470 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Depression 1,318 reports
Foetal exposure during pregnancy 1,048 reports
Anxiety 878 reports
Emotional distress 660 reports
Anhedonia 601 reports
See full Atazanavir drug information
Keep checking

Other Drugs & Germanium

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

0Major
0Moderate
0Minor
2,829No known interaction
2,829 No interaction
No interaction 2,829 drugs checked — show the list

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

Showing the 60 most looked-up of 2,829 medications checked with no known interaction — see the full Germanium list.

See the full Germanium interactions page
See every supplement checked against Atazanavir, ranked by severity
Evidence & sources

Germanium References

The 30 references that drive our Germanium monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. Tao SH, Bolger, PM. Hazard assessment of germanium supplements. Regul Toxicol Pharmacol 1997;25:211-9.
  2. Budman DR, Schulman P, Vinciguerra V, Degnan TJ. Phase I trial of spirogermanium given by infusion in a multiple-dose schedule. Cancer Treat Rep 1982;66:173-5..
  3. Mainwaring MG, Poor C, Zander DS, Harman E. Complete remission of pulmonary spindle cell carcinoma after treatment with oral germanium sesquioxide. Chest 2000;117:591-3.. PubMed
  4. Vogelzang NJ, Gesme DH, Kennedy BJ. A phase II study of spirogermanium in advanced human malignancy. Am J Clin Oncol 1985;8:341-4.. PubMed
  5. Ettinger DS, Finkelstein DM, Donehower RC, et al. Phase II study of N-methylformamide, spirogermanium, and 4-demethoxydaunorubicin in the treatment of non-small cell lung cancer (EST 3583): an Eastern Cooperative Oncology Group study. Med Pediatr Oncol 1 PubMed
  6. Higuchi I, Izumo S, Kuriyama M, et al. Germanium myopathy: clinical and experimental pathological studies. Acta Neuropathol (Berl) 1989;79:300-4.. PubMed
  7. Matsusaka T, Fujii M, Nakano T, et al. Germanium-induced nephropathy: report of two cases and review of the literature. Clin Nephrol 1988;30:341-5..
  8. Hess B, Raisin J, Zimmermann A, et al. Tubulointerstitial nephropathy persisting 20 months after discontinuation of chronic intake of germanium lactate citrate. Am J Kidney Dis 1993;21:548-52.. PubMed
  9. Luck BE, Mann H, Melzer H, et al. Renal and other organ failure caused by germanium intoxication. Nephrol Dial Transplant 1999;14:2464-8. PubMed
  10. Schauss AG. Nephrotoxicity and neurotoxicity in humans from organogermanium compounds and germanium dioxide. Biol Trace Elem Res 1991;29:267-80.. PubMed
  11. Schein PS, Slavik M, Smythe T, et al. Phase I clinical trial of spirogermanium. Cancer Treat Rep 1980;64:1051-6..
  12. Trope C, Mattsson W, Gynning I, et al. Phase II study of spirogermanium in advanced ovarian malignancy. Cancer Treat Rep 1981;65:119-20..
  13. Gerber GB, Leonard A. Mutagenicity, carcinogenicity and teratogenicity of germanium compounds. Mutat Res 1997;387:141-6.. PubMed
  14. Asaka T, Nitta E, Makifuchi T, et al. Germanium intoxication with sensory ataxia. J Neurol Sci 1995;130:220-3.. PubMed
  15. Sanai T, Okuda S, Onoyama K, et al. Germanium dioxide-induced nephropathy: a new type of renal disease. Nephron. 1990;54:53-60.. PubMed

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking Germanium and Atazanavir Together: Common Questions

Is it safe to take Germanium with Atazanavir?
We do not list a known interaction between Germanium and Atazanavir. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
Do Germanium and Atazanavir have any of the same side effects?
Yes — our sources link each of them separately to 4 of the same effects. That is not an interaction: neither changes how your body handles the other. It does mean that if one of those effects turns up, it can be harder to tell which one is behind it. They are listed on this page with the source behind each.
Should I take Germanium and Atazanavir at the same time of day?
At least one FDA label for a product containing Atazanavir says to take it with food. If you take Germanium on an empty stomach out of habit, keep them separate and take Atazanavir with a meal where the label says to. Food instructions belong to the product rather than the ingredient — two Atazanavir products can differ — so check the directions on your own box. This is about absorption, not an interaction.
Are Germanium and Atazanavir used for the same thing?
They overlap in purpose, which usually means the real question is whether you need both rather than whether they are safe together. This page lists the shared uses and how strong the evidence is for Germanium in each. That is a conversation for your prescriber, especially if Atazanavir is being adjusted to a target.
Does Atazanavir interact with any supplements?
Yes. Atazanavir has documented interactions with 152 supplements in our database — Germanium is not one of them. The Atazanavir interaction page linked on this page lists every one, ranked by severity.

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

Where next

Keep Exploring

Germanium monograph Uses, safety profile, and every drug interaction in one place Atazanavir drug information The full plain-English guide to this medication Atazanavir supplement interactions Every supplement checked against Atazanavir, ranked by severity Supplement interaction checker Check any supplement or product against your medications Browse medications A–Z Every drug we’ve checked against herbs & supplements References The 30 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Atazanavir and Germanium?

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.