Tipranavir slows the progress of HIV infection. It is one of a number of medicines that you will need to take regularly.
Take your doses with food and at the same time as your ritonavir doses.Tipranavir has been associated with some side-effects. Your doctor will discuss these with you before you start treatment.
|Type of medicine||A protease inhibitor (PI) antiretroviral medicine|
|Used for||Human immunodeficiency virus (HIV) infection in adults and in children over 2 years of age|
|Available as||Capsules for adults and for children over 12 years of age, and oral liquid medicine for younger children|
Tipranavir is an antiretroviral medicine. It is prescribed for human immunodeficiency virus (HIV) infection. It slows the progress of HIV infection, but it is not a cure. HIV destroys cells in the body, called CD4 T cells. These cells are a type of white blood cell and are important because they are involved in protecting your body from infection. If left untreated, the HIV infection weakens your immune system so that your body cannot defend itself against bacteria, viruses and other germs. Tipranavir slows down the progress of HIV infection by reducing the amount of virus in your body. It does this by stopping the production of a protein that the virus needs to copy (replicate) itself.
Tipranavir will be prescribed for you by a doctor who is a specialist. It belongs to a group of antiretroviral medicines known as protease inhibitors (PIs). It is given alongside a number of other antiretroviral medicines, as part of a combination therapy. Taking three or more antiretroviral medicines at the same time is more effective than taking one alone. Taking a combination of different medicines also reduces the risk that the virus will become resistant to any individual medicine.
It is vital to take your antiretroviral medicines exactly as prescribed in order to maintain success and to help to prevent the virus from becoming resistant to the medicines. These medicines are usually taken for life.
Before taking tipranavir
Some medicines are not suitable for people with certain conditions, and sometimes a medicine can only be used if extra care is taken. For these reasons, before you start taking tipranavir it is important that your doctor knows:
- If you are pregnant, trying for a baby or breast-feeding.
- If you have sugar diabetes.
- If you have liver inflammation (called hepatitis), or any other liver problem.
- If you have been told you are at risk of bleeding, such as if you have recently had surgery or an accident.
- If you have either haemophilia or porphyria, which are both rare inherited blood disorders.
- If you are taking any other medicines. This includes any medicines which are available to buy without a prescription, as well as herbal and complementary medicines.
- If you have ever had an allergic reaction to a medicine.
How to take tipranavir
- Before you start the treatment, read the manufacturer's printed information leaflet from inside the pack. It will give you more information about tipranavir, and it will also provide you with a full list of the side-effects which you could experience from taking it.
- Take tipranavir exactly as your doctor tells you to. The adult dose is two capsules twice daily, at the same time as a medicine called ritonavir - take the doses 12 hours apart. Ritonavir is prescribed to boost the action of tipranavir, so it is important that you take these medicines together. If your child has been given liquid medicine to take, your doctor will advise you about how much you should give for each dose. The directions for taking the medicine will also be printed on the label of the pack to remind you about what the doctor said to you.
- Tipranavir should be taken with food, so after a meal or with a snack. Swallow the capsules whole with a drink of water. Do not crush or open them.
- Try to take tipranavir at the same times of day each day (in the morning and evening), as this will help you to remember to take it regularly.
- If you forget to take a dose on time, take it as soon as you remember providing it is within five hours of the time you should have taken it. If it is more than five hours since you should have taken it, leave out the missed dose but remember to take your next dose when it is due. Do not take two doses together to make up for a missed dose.
Instructions for using the dosing syringe for Aptivus® Oral Solution
- Remove the bottle cap.
- Make sure the plunger of the syringe is pushed in fully, then insert the syringe into the adapter.
- Turn the bottle (with the syringe connected to it) upside down.
- Gently pull out the plunger of the syringe so that the medicine fills the syringe to the mark which corresponds to your child's dose.
- Turn the bottle the correct way up again, and remove the syringe from the bottle.
- Put the tip of the syringe into your child's mouth, and gently push the plunger so that the medicine is released.
- Replace the bottle cap.
Getting the most from your treatment
- Keep your regular appointments with your doctor so that your progress can be monitored. You will need to have regular blood tests, particularly when you first start taking tipranavir.
- It is important that you continue to take tipranavir and your other antiretroviral treatment regularly. This will help to prevent the HIV from becoming resistant to the medicines you are taking. Even if you miss only a small number of doses, the virus can become resistant to treatment.
- If you develop any infection soon after you start this treatment, let your doctor know. As a result of taking tipranavir, your immune system may start fighting an infection which was present before you started the treatment, but which you may not have been aware of.
- Follow carefully any advice your doctor gives to you about making lifestyle changes to reduce any risk of damage to your heart and blood vessels. These can include stopping smoking, eating healthily and taking regular exercise.
- Some people taking antiretroviral medicines develop changes to the way body fat is distributed in the body. This can result in changes to body image. Your doctor will discuss the possibility of this with you.
- Although treatment with antiretroviral medicines may reduce the risk of you passing HIV to others through sexual contact, it does not stop it. It is important that you use condoms.
- It is not uncommon for people with HIV to feel low or even depressed, especially soon after the diagnosis has been made and treatment has been started. If you have any feelings of depression, or any distressing thoughts about harming yourself then you should speak with your doctor straightaway.
- Some people who have taken antiretroviral medicines (particularly over a long time) have developed a condition called osteonecrosis. This is a bone disease where bone tissue dies because there is a reduced blood supply to it. It leads to joint pains and stiffness, and can cause difficulties in movement. If you notice any of these symptoms, speak with your doctor.
- If you buy any medicines or herbal remedies, check with a pharmacist that they are suitable to take with tipranavir and your other medicines. This is because some remedies interfere with tipranavir and stop it from working properly. In particular, do not take indigestion remedies during the two hours before or during the two hours after you take your doses. Also, do not take St John's wort.
- If you have diabetes you may need to check your blood sugar (glucose) more frequently, as this medicine can affect the levels of sugar in your blood. Your doctor will advise you about this.
- If you are having an operation or dental treatment, tell the person carrying out the treatment which medicines you are taking.
- Treatment for HIV is usually lifelong. Continue to take tipranavir regularly for as long as your doctor tells you to, even if you feel well. This is to keep your immune system healthy.
Can tipranavir cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with tipranavir. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.
|Very common tipranavir side-effects (these affect more than 1 in 10 people)||What can I do if I experience this?|
|Feeling sick||Stick to simple meals - avoid fatty or spicy food. If it continues, speak with your doctor|
|Diarrhoea||Drink plenty of water to replace lost fluids|
|Common tipranavir side-effects (these affect less than 1 in 10 people)||What can I do if I experience this?|
|Headache||Ask your doctor to recommend a suitable painkiller|
|Stomach upset, tummy (abdominal) pain, wind, indigestion||Stick to simple meals - avoid fatty or spicy food|
|Feeling tired||Do not drive and do not use tools or machines while affected|
|Skin rash||If troublesome, speak with your doctor|
|Changes to some blood tests||Your doctor will check for this|
If you experience any other symptoms which you think may be due to the medicine, speak with your doctor or pharmacist for further advice.
How to store tipranavir
- Keep all medicines out of the reach and sight of children.
- Store unopened packs of Aptivus® Capsules in a refrigerator. Once opened, they can be stored in a cool, dry place, away from direct heat and light for up to 60 days.
- Store Aptivus® Oral Solution at room temperature - do not refrigerate. Once a bottle has been opened it will keep for 60 days - after this time, make sure you have a fresh supply. If crystals start to form on the top of the medicine, ask your doctor or pharmacist to replace the bottle. You should continue to take the medicine until the fresh supply is available.
Important information about all medicines
Never take more than the prescribed dose. If you suspect that you or someone else might have taken an overdose of this medicine, go to the accident and emergency department of your local hospital at once. Take the container with you, even if it is empty.
This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.
Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.
If you have any questions about this medicine ask your pharmacist.
Further reading & references
- Manufacturer's PIL, Aptivus® 250 mg Soft Capsules; Boehringer Ingelheim Limited, The electronic Medicines Compendium. Dated February 2016.
- Manufacturer's PIL, Aptivus® 100 mg/ml oral solution; Boehringer Ingelheim Limited, The electronic Medicines Compendium. Dated February 2016.
- British National Formulary; 71st Edition (March-September 2016) British Medical Association and Royal Pharmaceutical Society of Great Britain, London
Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. EMIS has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.
Dr Adrian Bonsall