Tipranavir 250mg capsules,
List of Related Indications:
- HIV infection
List Of Drugs:
- Tipranavir - Anti- Viral agents
Indication Type Description:
Dosages/ Overdosage Etc
Pregnancy and lactation
Drug Interactions -summary-
Aluminium and magnesium based antacids-
aluminium and magnesium antacids may decrease tipranavir absorption .
consider separating tipranavir. ritonavir dosing from antacid administration
Azole antifungals ( fluconazole ) + tipranazole / tipranavir + azole antifungals ( fluconazole,
fluconazole may increase tipranazole concentrations. Dosage adjustments is not needed
High dose( > 200mg) of fluconazole, itraconazole and ketoconazole are not recommended
Clarithromycin+ Tipranavir /Tipranavir + clarithromycin
concurrent use may increase tipranavir and clarithromycin levels. Dosage adjustments
are not recommended in patients with healthy renal function
efranavir coadministered with tipranavir/ritonavir ( 500mg/100mg twice daily) may cause
tiprnavir concentrations to decrease
Loperamide+ tipranavir/Tipranavir + loperamide -
coadmin my decrease the concentration of both tipranavir and loperamide
Rifamycin ( rifampin ) + tipranavir/ Tipranavir + rifamycin-
coadmin of tipranavir with rifampin may lead to loss of virologic response and possible
resistence to tipranavir
St Johns wart-
coadmin may lead to loss of virologic response and posible resistence to tipranavir.
Cuncurrent use is not recommended
Tenovir + tiprnavir/Tipranavir+ tenovir-
coadmin may decrease concentrations of both tiprnavir and tenovir
coadministration is contraindicated because of life threatening cardiac arrhythmias
Antiarrhythmics agents - (amidarone,bepiridil, flecanide, propafenone, quinidine )
coadmin is contraindicated because of life threatening cardiac arrhythmias
Benzodiapines ( midazolam, triazolam ) -
coadmin is contraindicated because of risk of prolonged increased sedation or
Cardiovascular - intracranial hemorrhage
CNS- dizziness, insomnia, peripheral neuropathy, sleep disorder, somnolence
Dermatologic- acquired lipodystrophy, lipoatrophy pertrophy, pruritus
GI - abnormal distention, anorexia, dyspepsia, flatulence, gastrointrestinal reflux disease,
Hematologic/lymphatic - anemia, neutropenia, thrombocytopenia
Hepatic - hepatic failure, epatitis,
Metabolic /nutritional - decreased appetite, dehydration, diabetes melitus, facial wasting,
hypercholosterolemia, hyperrglucemia, weight decreased.
Musculoskeletal - muacle cramps, myalgia
Renal - renal function impairment
Respiratory - dyspnea
Miscellaneous- hypersensitivity, influenza,-like illness, malaise, pyrexia, reaction of herpes
simplex and vercella zoster.
Lab test abnormalities- hepatic enzymes increased, liapase increased , liver function test
Coadministration with retonovir - tipranavir must be coadministered with ritonavir 200mg
to exert its therapeutic effect. Failure to corectly administer tipranavir with ritonavir will result
in reduced plasma levels of tiprnavir that is isufficient to produce antiviral effect.
Hepatic toxicity - clinical hepatitis and hepatic decompensation including fatalities reported,
Therefore, perform liver function tests prior to initiating theraphy with tiprnavir/itonavir
and frequently throughout the duration of treatment.
Platelet aggregation inhibition- use tiprnavir/retonovir with caution who may be at risk of
increased bleeding from trauma and surgery.
Hepatic function impairment - tipranavir/ritonavir is contraindicated in patients with moderate to
severe hepatic impairment
Pregnancy- use tipranavir/retonivir during prgnancy only if required
Lactation- instruct mothers not to breast feed if they receiving tipranavir.
Children- safety and efficacy not established
Elderly- excercise caution while administering to elderly patients
Monitoring- perform liver functin tests prior to initiating and frequently througout the
duration of tipranavir/retonovir administration.
Perform triglyceride and cholsterol testing prior to initiating and at periodic intervals
Dosages/ Overdosage Etc:
Recommended dose of tiprnanvir is 500mg ( two 250mg capsules) coadministered with
ritonavir 200mg twice daily
1. Instruct patients to inform any unusual or unexplined bleeding to their doctor
2. Inform patients that tipranavir administered with ritonavir 200mg has been associated with severe
liver diseases, including some deaths.
3. Instruct patients with signs or symptoms of clinical hepatitis to discontinue treatment and
seek medical help. Symptoms include, fatigue, malaise, anorexia, nausea, jaundice,
bilirubinemia, acholic stools, liver tendrrness or hepatomegaly
4. Advice patients that liver function tests will be performed prior to initiating therapy and
the duration of treatment
5. Excercise caution when administring to patients with liver enzyme abnormalites, or
history of chronic liver diseases. Increased liver function fuunction testing is warranted
in these patients.
6. Mild to moderate rash has been reported in HIV -infected men andwomen receiving
tipranavir/ retinovir .
7. Instruct women receiving estrogen based hormonal contraceptives to use additional or
alternative contraceptive measures during therapy.
8. Inform patients that tipranair must be co-administered with ritonavir 200mg to ensure
its therapeutic effects.
9. Instruct patients to take tipranavir and other concomittant antiretroviral therapy every day
as prescribed. If the dose is missed instruct patients to take the dose as soon as possible.
and then return to the normal dose. Do not double the next dose.
10. Inform patients that tipranavir is not a cure for HIV-1 infections and that they may continue
to develop oppurtunistic infections and other complicatiions associated with HIV disease.
Pregnancy and lactation:
Use tipranavir/retonivir during prgnancy only if required
Instruct mothers not to breast feed if they receiving tipranavir.
Safety and efficacy not established
Excercise caution while administering to elderly patients