Drug & supplement interaction

Zinc + Atazanavir, Cobicistat

Atazanavir, Cobicistat brand name: Evotaz.

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

Zinc has a minor interaction with Atazanavir, Cobicistat. Zinc modestly reduces levels of atazanavir, although this effect does not seem to be clinically significant.

Read the full interaction report
SeverityMinor
LikelihoodProbable
EvidenceB
What do Severity, Likelihood & Evidence mean?
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Interaction report

Zinc and Atazanavir, Cobicistat

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

Minor

ATAZANAVIR (Reyataz)

Zinc modestly reduces levels of atazanavir, although this effect does not seem to be clinically significant.
Clinical research shows that zinc might decrease serum atazanavir levels by chelating with atazanavir in the gut and preventing its absorption. Although a single dose of zinc sulfate (Solvazinc tablets) 125 mg orally does not affect atazanavir concentrations in patients being treated with atazanavir/ritonavir, co-administration of zinc sulfate 125 mg daily for 2 weeks reduces plasma levels of atazanavir by about 22% in these patients. However, despite this decrease, atazanavir levels still remain at high enough concentrations for the prevention of HIV virus replication.
Severity Minor Likelihood Probable Evidence B

Interaction 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..

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

Here's the gist with your Evotaz (atazanavir plus cobicistat) and zinc. Zinc can bind to atazanavir down in your gut, which slightly lowers how much gets absorbed. In one small study, taking 125 mg of zinc daily for two weeks dropped atazanavir blood levels by about 22 percent. That sounds like a lot, but the levels still stayed high enough to keep the HIV virus in check, so researchers didn't see it cause real-world problems.

So this is rated a minor interaction. The bigger worry would only be if your HIV treatment lost strength over time. I wouldn't lose sleep over the occasional zinc lozenge, but before starting a daily high-dose zinc supplement, run it past your pharmacist or doctor so they can keep an eye on things.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Moyle G, Else L, Jackson A, Back D, Yapa MH, Seymour N, Ringner-Nackter L, Karolia Z, Gazzard B, Boffito M. Coadministration of atazanavir-ritonavir and zinc sulfate: impact on hyperbilirubinemia and pharmacokinetics. Antimicrob Agents Chemother. 2013 Aug PubMed
  2. Jalloh MA, Gregory PJ, Hein D, et al. Dietary supplement interactions with antiretrovirals: a systematic review. Int J STD AIDS. 2017 Jan;28(1):4-15. 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

Zinc Also Interacts With Other Medications

Zinc has 63 moderate, 3 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 63 Minor 3 No known interaction 2,764 (incl. Atazanavir, Cobicistat)
Taking anything else?

Check Another of Your Medications Against Zinc

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

Everything else you take

See Every Supplement That Interacts With Atazanavir, Cobicistat

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

We hold 26,692 real supplement products containing Zinc, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Zinc. Your product may carry other ingredients that interact with Atazanavir, Cobicistat too, on top of Zinc — 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 Zinc 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 Zinc
Top 10

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

29 days ago today
Medication Atazanavir, Cobicistat
Top 10%

#228 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 Zinc

What is Zinc?

Zinc
  • Zinc deficiency
  • Immune support
  • Cold symptoms
  • Acne
  • Wound healing

Zinc is an essential mineral that your body needs for immune function, wound healing, taste, and smell. Most people get enough from food, but supplements can help correct or prevent a deficiency. Taking too much zinc for too long can cause harm, so check with a pharmacist or doctor before using high-dose supplements.

Read the full Zinc 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 & Zinc

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

0Major
63Moderate
3Minor
2,763No known interaction
63 Moderate 3 Minor 2,763 No interaction
Moderate

63 interactions

Showing 60 of 63 moderate interactions — see all 63 on the Zinc page.

Minor

3 interactions

No interaction 2,763 drugs checked — show the list

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

Showing the 60 most looked-up of 2,763 medications checked with no known interaction — see the full Zinc list.

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

Can you take Zinc 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 Zinc 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 Zinc?

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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.