Tipranavir (Oral)

Tipranivir is used to treat an infection caused by the human immunodeficiency virus (HIV), the virus that causes acquired immunodeficiency syndrome (AIDS).

Overview

Tipranavir is used in combination with Norvir (ritonavir) to treat the human immunodeficiency virus (HIV). This medication prevents HIV cells from multiplying inside your body and slows down the destruction of the immune system. It may also help delay the development of problems typically related to AIDS or HIV from occurring. While this medication is used to treat HIV, it does not cure the disease, and it is not meant to prevent the spread of HIV from one person to another, which is why safe sex is recommended, whether patients are on this medication or not. Tipranavir is for patients who have received treatment for HIV in the past, and for some reason the medication didn't work.

Also called Aptivus, tipranavir destroys CD4 T cells - a type of white blood cell that protects your body from infection. By reducing the amount of the HIV virus in your body, this medication stops the production of protein that the virus needs to replicate itself. This medication can only be prescribed by a licensed healthcare professional.

Condition(s) Treated

  • Human immunodeficiency syndrome (HIV)

Type of Medicine

  • Non-peptidic protease inhibitor (PI)

Side Effects

Tipranavir can cause some unwanted side effects, some more common than others, and some more serious than others. In order for some drugs to be effective, they must be combined with other medications. In some cases, side effects are the result of this combination, but may be necessary for treatment. If you notice side effects, you may need to contact your doctor. Other side effects, however, do not require medical attention. Contact your doctor immediately if you see any of the following (less common) side effects:

  • Bleeding gums
  • Confusion
  • Fever
  • Paralysis
  • Cough producing mucus
  • Coughing up blood
  • Difficulty breathing or swallowing
  • Dizziness
  • Headache
  • Nosebleeds
  • General feeling of weakness or tiredness
  • Nausea or vomiting
  • Increased vaginal bleeding or menstrual flow
  • Tightness in the chest
  • Loss of appetite
  • Prolonged bleeding from cuts
  • Yellow skin and eyes
  • Sudden severe weakness
  • Upper right stomach or abdominal pain
  • Black or red, tarry, or light-colored stools
  • Unusual bleeding
  • Red or dark brown urine

Some more common side effects that don't usually require medical attention typically go away during the course of treatment. Your body usually just needs time to adjust to the medication. Your doctor can help you identify ways to reduce or prevent some of these side effects. Talk to your doctor if you notice any of the following common side effects (especially if they become troublesome):

  • Diarrhea

Less common side effects include:

  • Abdominal pain
  • Loss of interest or pleasure
  • Cough
  • Loss or lack of strength
  • Trouble sleeping
  • Discouragement
  • Trouble concentrating
  • Fat redistribution
  • Feeling empty or sad
  • Irritability
  • Lack of appetite
  • Rash

You may experience side effects not listed above. Inform your doctor of any side effects you experience.

Dosage

Dosage varies from patient to patient. Your doctor will determine your dosage. The following information includes the typical doses of this medication. The dosage you're prescribed will depend on the strength of the medication and the number of doses you take per day.

Take this medication exactly as prescribed by your doctor. Do not take more or less than your doctor directed you to take, and do not stop taking this medication without consulting your doctor. Doing so could make your condition more difficult to treat. When your medication is running low, contact your pharmacist or your doctor ahead of time to inquire about refills. Do not forget to refill, as it is imperative that you do not run out.

Read the patient information leaflet that comes with your medication so that you're fully aware of all risks and side effects of taking tipranavir.

Take tipranavir with ritonavir; they're always supposed to be taken together. Take them both at the same time, unless your doctor instructs you to do it differently.

If you're using the tipranavir with ritonavir oral liquid or capsules, the medication can be taken with or without food. If you're using the ritonavir tablets, however, it should be taken with food.

Avoid crushing, breaking or chewing the capsules; swallow them whole.

Measure out the liquid using the provided measuring spoon, medicine cup, or oral syringe. Do not use a household spoon to measure out your medication; always use the medicine cup that comes with the medication, or one provided by your pharmacist.

Adults should take 500 milligrams (two 250 mg capsules or 5 mL oral solution) co-administered with 200 mg or ritonavir, twice per day.

Patients between the ages of 2 and 18 years old must have their dosage determined by their doctor based on weight (kg), or body surface area (BSA).

Interactions

Certain medications should not be used in combination. However, in some cases, two different medications may be used in conjunction, despite whether an interaction might occur. Your doctor might change the dosage of one of your medications, or other precautions might be taken. Let your doctor know if you're currently taking any of the following medications:

  • Alfuzosin
  • Amiodarone
  • Astemizole
  • Bedpridil
  • Cisapride
  • Colchicine
  • Dihydroergotamine
  • Ergonovine
  • Ergotamine
  • Flecainide
  • Grazoprevir
  • Isavuconazonium Sulfate
  • Lovastatin
  • Lurasidone
  • Methylergonovine
  • Midazolam
  • Naloxegol
  • Pazopanib
  • Pimozide
  • Primidone
  • Propafenone
  • Quinidine
  • Rifampin
  • Romidepsin
  • Sildenafil
  • Simvastatin
  • St John's Wort
  • Terfenadine
  • Tolvaptan
  • Triazolam

Using tipranavir with any of the following medications is typically not recommended, but might be required in special circumstances. If both medications are prescribed together, your dosage will most likely be adjusted on one or both of the medications.

  • Ado-Trastuzumab Emtansine
  • Irinotecan Liposome
  • Afatinib
  • Saquinavir
  • Nelfinavir
  • Dolutegravir
  • Amprenavir
  • Olaparib
  • Doxorubicin
  • Salmeterol
  • Apixaban
  • Irinotecan
  • Artemether
  • Orlistat
  • Ketoconazole
  • Doxorubicin Hydrochloride Liposome
  • Atazanavir
  • Macitentan
  • Eluxadoline
  • Palbociclib
  • Atorvastatin
  • Bedaquiline
  • Simeprevir
  • Vilazodone
  • Ruxolitinib
  • Ledipasvir
  • Darunavir
  • Boceprevir
  • Etravirine
  • Bosentan
  • Panobinostat
  • Sofosbuvir
  • Levomilnacipran
  • Rilpivirine
  • Brentuximab Vedotin
  • Cabazitaxel
  • Linagliptin
  • Delamanid
  • Tadalafil
  • Piperaquine
  • Carbamazepine
  • Fluticasone
  • Lumefantrine
  • Ceritinib
  • Fosamprenavir
  • Pixantrone
  • Telaprevir
  • Cilostazol
  • Idelalisib
  • Clozapine
  • Garlic
  • Cobicistat
  • Rifapentine
  • Tenofovir Alafenamide
  • Ifosfamide
  • Ponatinib
  • Lopinavir
  • Conivaptan
  • Retapamulin
  • Cyclophosphamide
  • Dabigatran Etexilate
  • Velpatasvir
  • Indinavir
  • Lumacaftor
  • Rifabutin
  • Vilanterol

Using tipranavir with the following medications can cause an increased risk of some side effects, but using both medications could be the best treatment for you. If both medications are prescribed together, one or both dosages may need to be adjusted.

  • Abacavir
  • Aluminum Carbonate, Basic
  • Aluminum Hydroxide
  • Aluminum Phosphate
  • Bupropion
  • Calcium Carbonate
  • Clarithromycin
  • Conjugated Estrogens
  • Dihydroxyaluminum Aminoacetate
  • Dihydroxyaluminum Sodium Carbonate
  • Enfuvirtide
  • Esterified Estrogens
  • Estradiol
  • Estriol
  • Estrone
  • Estropipate
  • Ethinyl Estradiol
  • Fluconazole
  • Magaldrate
  • Magnesium Carbonate
  • Magnesium Hydroxide
  • Magnesium Trisilicate
  • Methadone
  • Omeprazole
  • Rosuvastatin
  • Tenofovir Disoproxil Fumarate
  • Trazodone
  • Zidovudine

Certain medical conditions can also interact with this medication. If you have any of the following medical conditions:

  • Sulfa allergy, known or suspected
  • Bleeding problems (like hemophilia)
  • Liver disease (moderate or severe)
  • Diabetes mellitus
  • Liver problems (like hepatitis B or C)
  • Hyperglycemia (high blood sugar)

If you have any of these conditions, use this medication with caution and inform your doctor of any side effects you experience.

Warnings

Before taking tipranavir, you and your doctor must decide whether the risks are worth the good the medication will do for you. Consider the following information before taking tipranavir and talk to your doctor about the risks of taking this medication.

Children younger than 2 years old should not take this medication.

Elderly patients should take this medication with caution, as it may have an increased risk of age-related heart, kidney, or liver problems. A dosage adjustment may be necessary.

When taken with ritonavir (Norvir), tipranavir may cause bleeding in the brain, a condition that could be life-threatening. If you have had surgery recently, or if you've sustained any injuries recently, tell your doctor before taking tipranavir.

If you have a bleeding disorder, like hemophilia - a condition in which the blood clots abnormally - tell your doctor about it.

This medication does not prevent you from giving HIV to your partner during sex. It is only meant to treat the infection. Be sure you fully understand how to practice safe sex living with HIV, even if your partner has HIV. Never share needles and always inform your sexual partners that you have HIV so that they can make an informed decision after they know about the risks of sleeping with someone with HIV.

Tell your doctor if you have ever had hepatitis (swelling of the liver caused by a virus), or any other liver disease.

If you drink alcohol, let your doctor know.

You should also inform your doctor and pharmacist if you're taking any of the following medications: anticoagulants (blood thinners) like aspirin (or products containing aspirin), warfarin (Coudamin, Jantoven), clopidogrel (Plavix), cilostazol, eptifibatide (Integrilin), dipyridamole (Persantine, in Aggrenox), heparin, prasugrel (Effient), nonsteroidal anti-inflammatory drugs (naproxen, ibuprofen), tirofiban, or ticlopidine. Also, inform your doctor if you're taking vitamin E (especially if it's more than the daily recommended amount). This is especially important if you're taking the liquid form of tipranavir.

Do not use tipranavir with propafenone (Rythmol), alfuzosin (Uroxatral), amiodarone (Cordarone, Pacenone), rifampin (Rifadin, Rimactane), bepridil (Vascor), sildenafil (Revatio), cisapride (Propulside), triazolam (Halcion), midazolam (versed), pimozide (Orap), ergot medicines (such as dihydroergotamine, ergonovine, ergotamine, methylergonovine, Cafergot, Methergine, Migranal), simvastatin (Simcor, Vytorin, Zocor), quinidine (Cardioquin, Quinaglute Dura), and oral lurasidone (Latuda).

Keep a list of all of the medications you're currently taking with you when you go to the doctor or when you go to the pharmacy. You can also carry it with you in case of an emergency and those treating you will be able to prevent any possible interactions.

Tell your doctor if you're taking any vitamins, nutritional supplements, or herbal products, or if you're planning on taking them. Then, you can decide together whether you can safely take certain supplements and natural products.

If you need to get emergency treatment for an unrelated injury or illness, tell any doctors or nurses treating you that you're taking tipranavir.

Call your doctor right away if you experience unusual bleeding or bruising while you're taking tipranavir.

If you're taking antacids, take them one hour before or two hours after taking tipranavir.

If you're taking didanosine (Videx), take it two hours before or two hours after taking tipranavir.

Autoimmune disorders such as Guillain-Barre syndrome, polymyositis, and Graves' disease, have been reported while using these medications.

This medication may make you more sensitive to sunlight; therefore, it's important that you wear sunscreen when you leave the house. Wearing hats or protective clothing is also recommended. Avoid tanning beds and sunlamps.

Do not take tipranavir if you have moderate to severe liver disease (cirrhosis). Tipranavir can cause liver damage, a condition that can be life threatening.

If you experience any of the following symptoms, contact your doctor right away: vomiting, weakness, loss of appetite, flu-like symptoms, tiredness, swelling, nausea, aches and pains, pale bowel movements, yellowing of the eyes or skin, sensitivity on your right side below your ribs, or dark (tea-colored) urine.

Be sure to keep any appointments you have with your doctor and the laboratory.

Some patients have seen elevated lipids (large increases in the concentration of triglycerides and total cholesterol) when administered this medication with 200 milligrams of ritonavir.

Some patients have reported experiencing hyperglycemia (blood sugar increase) while taking this medication, even if they do not have diabetes. If you experience hyperglycemia, call your doctor as soon as you can. Left untreated, high blood sugar can cause a serious condition called ketoacidosis. This condition can become life-threatening if not caught and treated at an early stage. Symptoms of ketoacidosis include shortness of breath, nausea and vomiting, dry mouth, decreased consciousness, and breath that smells fruity.

Tipranavir can reduce the effect of certain birth control pills (oral contraceptives), injections, rings, and patches. To prevent pregnancy while on this medication, use another form of birth control. You and your partner could try condoms, a diaphragm, or contraceptive foam.

If you or your child have a bleeding disorder, make sure your doctor knows prior to taking this medication. This includes any medical conditions that increase your chances of bleeding.

HIV medications can strengthen your immune system; therefore, if you have certain infections hidden in your body, like tuberculosis or pneumonia, you may get new symptoms when your body tries to fight them off. Tell your doctor right away if this happens.

If you plan on having dental surgery, tell your dentist or oral surgeon that you're taking this medication.

Never share toothbrushes or razors.

Tipranavir can cause weight gain, or excess body fat. If you or your child notice changes in your body shape, such as an increased amount of fat in the neck, upper back, or around the stomach and chest area, or a loss of fat from the face, legs, and arms, notify your doctor. You may also notice excess body fat on your shoulders or breasts and you could lose fat from your buttocks as well.

Do not breastfeed your baby while taking this medication, as the risks to an unborn baby are still unknown. Women with HIV or AIDS should not breastfeed a baby. Even if your baby is born without HIV, it can still be passed into your breast milk.

Tipranavir must be administered with ritonavir in order to exert the therapeutic effect of the medication. Failure to administer both simultaneously can result in an inability to achieve the desired antiviral effect and could end up causing drug interactions.

Storage

Store this medication in a safe place out of sight and reach of children.

Keep the capsules in the refrigerator until you're ready to begin using the medication. Once you've opened the bottle, you can store it at room temperature. Do not store this medication in the bathroom. Keep this medication away from excess heat, moisture or direct light.

This medication can be used for up to 60 days after you open the bottle. Make sure to mark the date you open it on the bottle.

Never keep outdated medication or unused medication. Throw away any unused capsules after 60 days and get a new bottle.

Store the liquid form of this medication at room temperature. Do not refrigerate it or put it in the freezer. Use the liquid within 60 days of opening the bottle.

Ask your doctor or pharmacist about safe ways to dispose of unused medication.

Summary

While tipranavir is a greatly beneficial drug for patients with human immunodeficiency syndrome (HIV), it can also pose a risk to patients who fail to communicate fully with their doctors. As a non-peptidic protease inhibitor, tipranavir works by preventing HIV from reproducing and slowing down the destruction of the immune system. This drug is a treatment for patients with HIV, but it does not cure the disease. It is also not a form of STD prevention; it will not prevent the spread of HIV from person to person. Therefore, understanding safe sex as well as what this drug actually does is important.

By decreasing the amount of HIV in the blood, tipranavir can help patients avoid developing AIDS and HIV-related illnesses, such as cancer or serious infections. Patients can decrease the risk of transmitting the HIV virus to people with a few lifestyle changes and by practicing safer sex. While the medication is safe to take in combination with ritonavir (Norvir), it can cause interactions when combined with certain other medications, or when the patient has an underlying medical condition. Failure to talk to your doctor about the medical conditions you have or the medications you're taking can result in serious injury, or even death.

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Last Reviewed:
December 23, 2017
Last Updated:
April 05, 2018
Content Source: