Drug & supplement interaction

Sulforaphane + Atazanavir, Cobicistat

Atazanavir, Cobicistat brand name: Evotaz.

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

Sulforaphane has a moderate interaction with Atazanavir, Cobicistat. Theoretically, sulforaphane might increase the levels and effects of CYP3A4 substrates.

Read the full interaction report
SeverityModerate
LikelihoodPossible
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Sulforaphane and Atazanavir, Cobicistat

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

Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

Why this applies to Atazanavir, Cobicistat

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

Theoretically, sulforaphane might increase the levels and effects of CYP3A4 substrates.
Animal and in vitro research shows that sulforaphane inhibits CYP3A4 enzyme activity and downregulates its expression. This interaction has not been reported in humans.
Severity Moderate 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 quick picture with your Evotaz (atazanavir plus cobicistat) and sulforaphane. Atazanavir is cleared partly by a liver enzyme called CYP3A4, and cobicistat is actually in there on purpose to slow that enzyme down and keep your atazanavir levels high. In lab and animal studies, sulforaphane also appears to block CYP3A4. If that held true in people, your atazanavir levels could drift a bit higher, which in theory might mean more of its usual effects, like nausea, headache, or the yellowing of skin or eyes (a known atazanavir effect from raised bilirubin).

The honest part: this is only seen in test tubes and animals, never reported in real patients. Eating broccoli is not a concern. Before starting a concentrated sulforaphane supplement, just run it by your pharmacist or HIV provider.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Fimognari C, Lenzi M, Hrelia P. Interaction of the isothiocyanate sulforaphane with drug disposition and metabolism: pharmacological and toxicological implications. Curr Drug Metab. 2008;9(7):668-78. PubMed
  2. Mahéo K, Morel F, Langouët S, et al. Inhibition of cytochromes P-450 and induction of glutathione S-transferases by sulforaphane in primary human and rat hepatocytes. Cancer Res. 1997;57(17):3649-52.
  3. Yoxall V, Kentish P, Coldham N, Kuhnert N, Sauer MJ, Ioannides C. Modulation of hepatic cytochromes P450 and phase II enzymes by dietary doses of sulforaphane in rats: Implications for its chemopreventive activity. Int J Cancer. 2005;117(3):356-62. 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

Sulforaphane Also Interacts With Other Medications

Sulforaphane has 721 moderate 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 721 No known interaction 2,109 (incl. Atazanavir, Cobicistat)
Taking anything else?

Check Another of Your Medications Against Sulforaphane

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

Everything else you take

See Every Supplement That Interacts With Atazanavir, Cobicistat

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

We hold 167 real supplement products containing Sulforaphane, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Sulforaphane. Your product may carry other ingredients that interact with Atazanavir, Cobicistat too, on top of Sulforaphane — 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 Sulforaphane 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 Sulforaphane
Top half

#565 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 Sulforaphane

What is Sulforaphane?

  • Antioxidant support
  • General cellular health
  • Detoxification support
  • Inflammation
  • Skin and aging concerns

Sulforaphane is a natural compound found in broccoli and other cruciferous vegetables that has shown promising antioxidant and anti-inflammatory effects in lab studies, but strong human evidence for most specific health claims is still limited. It is generally well tolerated as part of a vegetable-rich diet, but if you take a concentrated supplement, talk to your pharmacist or doctor first.

Read the full Sulforaphane 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 & Sulforaphane

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

0Major
721Moderate
0Minor
2,108No known interaction
721 Moderate 2,108 No interaction
Moderate

721 interactions

Showing 60 of 721 moderate interactions — see all 721 on the Sulforaphane page.

No interaction 2,108 drugs checked — show the list

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

Showing the 60 most looked-up of 2,108 medications checked with no known interaction — see the full Sulforaphane list.

See the full Sulforaphane 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
Sulforaphane 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 Sulforaphane and Atazanavir, Cobicistat Together: Common Questions

Can you take Sulforaphane with Atazanavir, Cobicistat?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Sulforaphane and Atazanavir, Cobicistat interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

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

Still Have a Question About Atazanavir, Cobicistat and Sulforaphane?

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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.