Drug & supplement interaction

Zinc + Ritonavir

Ritonavir brand name: Norvir.

Moderate Interaction
The bottom line Moderate

Zinc has a moderate interaction with Ritonavir. Zinc modestly reduces levels of ritonavir.

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

Zinc and Ritonavir

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

Moderate

RITONAVIR (Norvir)

Zinc modestly reduces levels of ritonavir.
Clinical research shows that zinc might reduce serum ritonavir levels by chelating with ritonavir in the gut and preventing its absorption. In patients with HIV, ritonavir is taken with atazanavir to prevent the metabolism and increase the effects of atazanavir. A pharmacokinetic study shows that, in patients being treated with atazanavir/ritonavir, co-administration of zinc sulfate (Solvazinc tablets) 125 mg as a single dose or as multiple daily doses for 2 weeks reduces plasma levels of ritonavir by about 16%. However, atazanavir levels still remains high enough to prevent HIV virus replication. Therefore, the decrease in ritonavir levels is not likely to be clinically significant.
Severity Moderate 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 for ritonavir (Norvir): zinc can grab onto ritonavir in your gut, a process called chelation, and slightly cut how much gets absorbed. In one study, daily zinc dropped ritonavir blood levels by about 16%, which is a fairly small dip.

The good news is this didn't hurt the bigger picture. Ritonavir is usually given as a 'booster' to keep another HIV drug like atazanavir working, and those levels stayed plenty high to keep the virus suppressed. So this interaction is probable but mild, and most likely not something you'd notice. Still, since staying on track with HIV therapy matters so much, run any zinc supplement past your pharmacist or HIV doctor first.

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 62 moderate, 4 minor known drug interactions in our database — the Ritonavir 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 Zinc

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

From our Q&A

Questions About Zinc or Ritonavir

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Zinc or Ritonavir, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Ritonavir

This page covers Zinc only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Ritonavir page lists 178 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Beer (major), Grapefruit (major), Siberian Cocklebur (major) and St. John's Wort (major).

By severity: 6 major · 136 moderate · 36 minor.

From our pharmacist’s overview on the Ritonavir page

“If you take ritonavir (Norvir), slow down before adding any supplement from this page. Six of the 178 ingredients here carry a major rating, and St.”

Reviewed by 2 · Jul 18, 2026

Open the Ritonavir 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 Ritonavir 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 Ritonavir 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

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

29 days ago today
Medication Ritonavir
Steady interest

#2,784 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 Ritonavir

What Is Ritonavir Used For?

Brand name: Norvir

Ritonavir (brand name Norvir) is used together with other HIV medicines to treat HIV-1 infection in adults and children older than one month of age. It is always taken as part of a combination regimen — never on its own.

Norvir oral powder is specifically indicated for pediatric patients with HIV-1 infection. Norvir tablets and oral solution are indicated for both adults and pediatric patients with HIV-1 infection. Ritonavir tablets (generic) are also indicated for the treatment of HIV-1 infection in combination with other antiretroviral agents.

See full Ritonavir 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
62Moderate
4Minor
2,763No known interaction
Moderate

62 interactions

Showing 60 of 62 moderate interactions — see all 62 on the Zinc page.

Minor

4 interactions

No interaction 2,763 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

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Pharmacist Counseling Corner

Taking Zinc and Ritonavir Together: Common Questions

Can you take Zinc with Ritonavir?
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 Zinc and Ritonavir 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 Ritonavir 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.