Drug & supplement interaction

Thunder God Vine + Atazanavir

Atazanavir brand name: Reyataz.

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

Atazanavir falls into 2 drug categories that Thunder God Vine can interact with; the most serious is rated moderate. Theoretically, CYP3A4 inhibitors might increase the levels and adverse effects of thunder god vine constituents.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions2
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Thunder God Vine and Atazanavir

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

Thunder God Vine interacts with whole categories of medication. Atazanavir falls into 2 of those categories, so it can interact with Thunder God Vine in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

CYTOCHROME P450 3A4 (CYP3A4) INHIBITORS

1 of 2

Why this applies to Atazanavir

Atazanavir falls under CYTOCHROME P450 3A4 (CYP3A4) INHIBITORS — the group Thunder God Vine interacts with.

Theoretically, CYP3A4 inhibitors might increase the levels and adverse effects of thunder god vine constituents.
Inhibitors of CYP3A4 can increase the concentration of triptolide, a thunder god vine constituent, and its derivative (5R)-5-hydroxytriptolide. In vitro research shows that triptolide and (5R)-5-hydroxytriptolide are about 94% and 64% metabolized by CYP3A4, respectively.
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 thing to keep in mind with this pairing: it's the Thunder God Vine we worry about, not your atazanavir. Atazanavir (Reyataz) is a strong blocker of an enzyme called CYP3A4, and that same enzyme is what your body uses to break down triptolide, one of the main active compounds in Thunder God Vine.

So when atazanavir slows that enzyme down, the herb can build up in your system and hit harder than expected. Thunder God Vine can already be tough on the body (think stomach upset, diarrhea, and in some cases liver or other serious harm), so a buildup could make those problems more likely. This is a theoretical concern based on how the drugs behave, not something proven in people. Still, please check with your pharmacist or doctor before combining them.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Xu Y, Zhang YF, Chen XY, Zhong DF. CYP3A4 inducer and inhibitor strongly affect the pharmacokinetics of triptolide and its derivative in rats. Acta Pharmacol Sin. 2018;39(8):1386-1392. PubMed
Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

2 of 2

Atazanavir also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.

Theoretically, thunder god vine might increase the levels and clinical effects of CYP3A4 substrates.
In vitro research shows that triptolide, a constituent of thunder god vine, inhibits CYP3A4 enzymes in human microsomes. 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 gist for your HIV medicine. Atazanavir is cleared from your body largely by a liver enzyme called CYP3A4. In test-tube studies, a compound in Thunder God Vine (triptolide) appears to slow that enzyme down. If that held true in people, your atazanavir could build up higher than expected, which might mean more side effects like nausea, headache, or the yellowing of skin and eyes (jaundice) that this drug is known for. It could also affect your heart's rhythm in rare cases.

The important thing to know is that this is theoretical, based only on lab work, and has never actually been reported in a person. Still, since Thunder God Vine itself can be toxic and your HIV treatment matters, please don't combine them without checking with your doctor or pharmacist first.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Song W, Liu M, Wu J, Zhai H, Chen Y, Peng Z. Preclinical Pharmacokinetics of Triptolide: A Potential Antitumor Drug. Curr Drug Metab. 2019;20(2):147-154. 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

Thunder God Vine Also Interacts With Other Medications

Thunder God Vine has 848 moderate known drug interactions in our database — the Atazanavir one above is among them. If you take anything else, check it against the full list below.

Moderate 848 No known interaction 1,982 (incl. Atazanavir)
Taking anything else?

Check Another of Your Medications Against Thunder God Vine

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

Everything else you take

See Every Supplement That Interacts With Atazanavir

This page covers Thunder God Vine 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

How much people look this up

Where Thunder God Vine 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 Thunder God Vine
Steady interest

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

29 days ago today
Medication Atazanavir
Steady interest

#1,457 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 Thunder God Vine

What is Thunder God Vine?

Thunder God Vine
  • Rheumatoid arthritis
  • Lupus and autoimmune conditions
  • Inflammation
  • Skin conditions like psoriasis
  • Immune-related disorders

Thunder God Vine is a Chinese herb studied mainly for rheumatoid arthritis and other autoimmune conditions, with some promising but limited evidence. It can be toxic if prepared or dosed improperly, and may cause serious side effects, so it should only be used under medical supervision. Avoid it during pregnancy and breastfeeding.

Read the full Thunder God Vine 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 & Thunder God Vine

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

0Major
848Moderate
0Minor
1,981No known interaction
848 Moderate 1,981 No interaction
Moderate

848 interactions

Showing 60 of 848 moderate interactions — see all 848 on the Thunder God Vine page.

No interaction 1,981 drugs checked — show the list

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

Showing the 60 most looked-up of 1,981 medications checked with no known interaction — see the full Thunder God Vine list.

See the full Thunder God Vine interactions page
See every supplement checked against Atazanavir, 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
Thunder God Vine monograph › Uses, safety, and every drug interaction in one place Atazanavir supplement interactions › Every supplement checked against Atazanavir, ranked by severity Atazanavir 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 Thunder God Vine and Atazanavir Together: Common Questions

Can you take Thunder God Vine with Atazanavir?
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.
Why are there 2 interactions listed for Thunder God Vine and Atazanavir?
Atazanavir belongs to more than one drug category, and Thunder God Vine interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Thunder God Vine and Atazanavir 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 and Thunder God Vine?

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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.