Aptivus (tipranavir) is an HIV antiretroviral (ARV) medication used in combination with other HIV ARVs for the treatment of HIV. It's not used very often anymore because of side effects, interactions with other medications, and daily doses requiring multiple capsules.
HIV treatment
Aptivus (tipranavir) is a protease (an enzyme) inhibitor (PI). Normally, protease helps process viral proteins so the HIV virus can infect healthy cells. When protease is stopped by PI medications, the HIV virus cannot make copies of itself and infect your cells.
Source: FDA
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Less common
Bleeding gums
confusion
cough producing mucus
coughing up blood
difficulty with breathing or swallowing
dizziness
general feeling of tiredness or weakness
headache
increased menstrual flow or vaginal bleeding
loss of appetite
nausea or vomiting
nosebleeds
paralysis
prolonged bleeding from cuts
red or black, tarry, or light-colored stools
red or dark brown urine
sudden severe weakness
tightness in the chest
unusual bleeding
upper right abdominal or stomach pain
yellow eyes and skin
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Available as an oral solution if you have a hard time swallowing capsules
Can be taken with or without food
Can be used in children aged 2 years and older
Oral solution contains vitamin E
Must be taken with a booster called ritonavir (Norvir)
Not a good option for people with sulfa allergies or moderate to severe liver problems
Typical adult doses require 4 capsules a day
Can cause higher cholesterol and blood sugar
Always take this medication with the booster ritonavir (Norvir). If Aptivus (tipranavir) is taken alone without the booster the medication level won't be high enough and the virus can become resistant to the medication.
Swallow the capsules whole. They should never be opened or chewed. If you or your child have a hard time swallowing them whole, talk to your provider about the oral solution.
Store unopened bottles of the capsules in the fridge. Once you open the bottle store it at room tempterature. Never freeze this medication.
The capsules and oral solution expire 60 days after the bottle is opened. Any remaining medication should be thrown out. It can be helpful to write the expiration date on the bottle once you open it.
Aptivus (tipranavir) interacts with a lot of medications, including birth control pills. Your hormonal birth control pills might not work as well when you are taking Aptivus (tipranavir). You may want to use another form of birth control like a barrier method (condoms).
Aptivus (tipranavir) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Risk factors: History of liver damage | Hepatitis B or C | Having advanced HIV
There have been cases of people having liver problems afer taking Aptivus (tipranavir). It's more common in people who have more advanced HIV who are taking a lot of other medications. The risk is also higher in people who already have liver damage or a chronic hepatitis B or C infection. Your provider will order lab tests before and during treatment to monitor your liver. Talk to your provider if you notice any yellowing of the skin or eyes, dark urine, or pale stools. These can be signs of liver damage.
It's rare, but there have been cases of people having bleeding in their brain while taking Aptivus (tipranavir). Most of these people had other conditions or were taking other medications that may have caused this as well. It's unknown if Aptivus (tipranavir) played a factor in these events. Talk to your provider if this is a concern for you.
Risk factors: Taking other medications or supplements
Aptivus (tipranavir) interacts with many other medications. This might require adjusting the dose of Aptivus (tipranavir) or your other medications. If the medication doses are not adjusted for interactions, the dose may be too low for it to work properly, or the dose might end up being too high, which can cause unwanted side effects. Talk to your healthcare provider or pharmacist before starting or stopping any medications.
Risk factors: Allergic reaction to other sulfa medications
Aptivus (tipranavir) should be used with caution in people who have a sulfa allergy. Make sure your healthcare provider and pharmacist have an updated list of your medication allergies.
Risk factors: Use of protease inhibitors
Aptivus (tipranavir) and other HIV ARVs in the same protease inhibitor (PI) subclass can raise your blood sugar levels and lead to diabetes. If you already have diabetes, this medication can make it worse. Be sure to keep your regularly scheduled appointments and check your blood sugar at home if your provider tells you to.
Risk factors: Weakened immune system | Current untreated infection
HIV attacks your immune system. Over time, if the virus isn't treated your body may become defenseless against bacterial and fungal infections. Your HIV medications are very good at killing the virus, and when the number of viruses goes down, your immune system gets started making more cells. Once your immune system gets better, it will start to fight off any infections you might have, which can lead to a lot of inflammation. Even though it's a good thing that your immune system is getting better, too much inflammation can be bad. Your healthcare provider might check for underlying infections (sometimes called opportunistic infections) before starting Aptivus (tipranavir) especially if it is your first time taking HIV medications. Call your provider if you experience fever, difficulty breathing, or sudden changes to your health after starting Aptivus (tipranavir).
Risk factors: Taking HIV ARVs
Some people taking HIV ARVs, including Aptivus (tipranavir) have noticed changes to the way fat is located in the body. There might be more fat in the abdomen and upper back, and less fat in the face, arms, and legs. Scientists and healthcare providers don't really know why this happens.
Aptivus (tipranavir) can raise the amount of fat and cholesterol in your body. High cholesterol and fat in your blood increases your risk of a heart attack or stroke. Your healthcare provider might need to start you on a statin medication to help with this. Make sure all your providers know your full list of medications. Many statin medications cannot be taken with Aptivus (tipranavir) or can only be taken at a very low dose.
Adults: The typical dose is 500 mg with ritonavir 200 mg twice daily
Children: The typical dose is based on the child's weight, but won't be more than the adult dose
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Treatment of HIV infection in people aged 3 years and older
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