Drug & supplement interaction

Hops + Atazanavir

Atazanavir brand name: Reyataz.

Minor Interaction
The bottom line Minor

Hops has a minor interaction with Atazanavir. Theoretically, hops extract might alter metabolism of CYP3A4 substrates; however, this effect may not be clinically significant.

Read the full interaction report
SeverityMinor
LikelihoodPossible
EvidenceD
What do Severity, Likelihood & Evidence mean?
Know someone taking this? Share
Interaction report

Hops and Atazanavir

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

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

Theoretically, hops extract might alter metabolism of CYP3A4 substrates; however, this effect may not be clinically significant.
Animal research suggests that specific constituents of hops, called lupulones, can induce hepatic CYP3A4 enzyme activity. However, a pharmacokinetic study in healthy postmenopausal patients with normal metabolism shows that taking a standardized extract of spent hops containing prenylated phenols, as 59.5 mg twice daily for 2 weeks, decreases the concentration of alprazolam, a CYP3A4 probe substrate, by 7.6%. This reduction is unlikely to be clinically relevant.
Severity Minor Likelihood Possible Evidence D

Interaction 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.

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

Here's the gist for atazanavir (Reyataz): your body uses an enzyme called CYP3A4 to help break it down, and hops might nudge that enzyme to work a little faster. In theory, that could lower your atazanavir levels slightly. Since atazanavir keeps HIV under control, anything that meaningfully drops its blood level is a concern, because weaker drug levels can lead to less viral suppression over time.

The good news is that this is mostly lab and animal data, and a human study showed only a tiny (under 8%) change with a similar drug, which is unlikely to matter in real life. Still, because keeping HIV medicine steady is so important, I'd run any hops supplement past your pharmacist or doctor before adding it.

References
  1. Mannering, G. J., Shoeman, J. A., and Deloria, L. B. Identification of the antibiotic hops component, colupulone, as an inducer of hepatic cytochrome P-4503A in the mouse. Drug Metab Dispos 1992;20(2):142-147. DOI
  2. van Breemen RB, Chen L, Tonsing-Carter A, et al. Pharmacokinetic Interactions of a Hop Dietary Supplement with Drug Metabolism in Perimenopausal and Postmenopausal Women. J Agric Food Chem. 2020;68(18):5212-5220. 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

Hops Also Interacts With Other Medications

Hops has 289 moderate, 573 minor known drug interactions in our database — the Atazanavir one above is one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Hops

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

Everything else you take

See Every Supplement That Interacts With Atazanavir

This page covers Hops 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 Hops as Part of a Dietary Supplement Product? Check It for Interactions

We hold 1,325 real supplement products containing Hops, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Hops. Your product may carry other ingredients that interact with Atazanavir too, on top of Hops — 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 Hops 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 Hops
Top 25%

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

29 days ago today
Medication Atazanavir
Top half

#1,237 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 Hops

What is Hops?

Hops
  • Sleep problems and insomnia
  • Anxiety and restlessness
  • Menopausal symptoms
  • Mild digestive complaints
  • Flavoring in beer and food

Hops are most often used for sleep and mild anxiety, frequently combined with valerian, but the human evidence is limited and not very strong. They are generally well tolerated when used short-term, though they may cause drowsiness, and should be avoided during pregnancy and breastfeeding because their safety is unknown.

Read the full Hops 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.

See full Atazanavir drug information
Keep checking

Other Drugs & Hops

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

0Major
289Moderate
573Minor
1,967No known interaction
Moderate

289 interactions

Showing 60 of 289 moderate interactions — see all 289 on the Hops page.

Minor

573 interactions

Showing 60 of 573 minor interactions — see all 573 on the Hops page.

No interaction 1,967 drugs checked — show the list
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
Pharmacist Counseling Corner

Taking Hops and Atazanavir Together: Common Questions

Can you take Hops with Atazanavir?
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 Hops and Atazanavir 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 and Hops?

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.