Disease Information for Tipranavir (Aptivus) Administration/Toxicity

anti viral aids medicine protease inhibitor; often given in combintion with ritinovir; 250 mgm caps oralpreparation can cause hepatic failure, rash, arthralgias;product boehringer ingelheim-------------------

Tipranavir (Aptivus) The FDA has approved tipranavir in combination with the protease inhibitor ritonavir (Norvir) for use in adult HIV patients who have active HIV replication, have used other anti-HIV medications or who show evidence of HIV strains that are resistant to multiple protease inhibitors; tipranavir/ritonavir in combination should be used in combination with other active anti-HIV agents to produce a greater likelihood of a robust treatment response; When considering use of tipranavir, genotypic and phenotypic resistance testing should be performed to help determine which additional agents may yield the best outcome in combination with tipranavir;

Due to FDA concerns about the safety of the tipranavir/ritonavir combination, the agency recommends to clinicians that tipranavir should be prescribed only to HIV patients for whom other effective drug regimens are not available; In addition, tipranavir is contraindicated in individuals with known hypersensitivity to any of the ingredients in this product; It is also contraindicated in individuals with moderate and severe hepatic insufficiency;

Tipranavir is available in 250 mg soft gel capsules and is taken with ritonavir; The recommended dosing regimen is 500 mg tipranavir taken with 200 mg ritonavir twice daily;

Absorption of tipranavir increases when taken with a high-fat meal; Antacids reduce absorption of tipranavir, requiring timing adjustments of antacid use;

Tipranavir/ritonavir at the recommended dosage is an inhibitor of CYP 3A and may thus increase plasma concentrations of agents that are primarily metabolized by this enzyme: Coadministration of tipranavir/ritonavir with drugs that are highly dependent on CYP 3A for clearance are contraindicated; These drugs include amiodarone, bepridil, flecainide, propafenone, quinidine, rifampin, dihydroergotamine, ergonovine, ergotamine, methylergonamine, cisapride, St. John"s wort, lovastatin, simvastatin, pimozide, midazolam, and triazolam;

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