Tipranavir

Please read this factsheet together with the patient information leaflet carefully before taking your medicine. If you have any questions or are unsure about anything, ask your doctor or pharmacist.

Tipranavir also known as Aptivus™ belongs to a class of drugs called protease inhibitors. Protease Inhibitors are used for the treatment of HIV infection, in combination with other anti-HIV drugs. Please speak to your clinic doctor or pharmacist if you would like more information about how these drugs work.

Before taking tipranavir
Tell your doctor about:

* All other drugs that you are taking, including any that you buy over the counter in a community
pharmacy, herbal medicines and recreational drugs;
* Previous allergy to any medicines;
* If you have ever had any liver disease;
* If you are pregnant / planning to become pregnant;
* If you are breast feeding;
* If you are diabetic;

Taking your tipranavir

* Tipranavir is available as a pink, oblong, soft gelatine capsule containing 250mg tipranavir;
* Tipranavir is taken twice a day and MUST be taken in combination with ritonavir twice a day;
Ritonavir boosts the amount of tipranavir in the body, making it more effective.
* The recommended dose of tipranavir is 500mg (2x250mg capsules) twice a day along with ritonavir 200mg (2x100mg capsules) twice a day;
* Tipranavir should be taken with food to improve its absorption;
* Do not open the capsules; always swallow them whole with a large glass of water;
* Try to take your tipranavir as close as possible to twelve hours apart, at the same time each day;
It is essential that you do not miss your doses. If you forget a dose, take it as soon as you remember. If it is almost time for your next dose anyway, forget about the missed dose. Wait and take the next dose at the regular time. Do not double the next dose.

Do not run out of tipranavir. If you are going on holiday and need additional supplies, tell your doctor. When receiving a supply from pharmacy, ensure that you have an adequate supply to last until your next appointment.

Other drugs and tipranavir
Tipranavir is metabolised (processed in the body) by the liver. Some other drugs are metabolised in the same way. This is why it is important to tell your doctor about all the medicines that you take even if you only take them occasionally, including herbal and recreational drugs. Examples of some drugs that are metabolised in the same way as tipranavir and should NOT be taken are rifampicin, phenytoin, ergotamine, certain benzodiazepines and St. Johns Wort.

Other examples of drugs that are metabolised in the same way as tipranavir include rifabutin, warfarin, theophyliine, methadone, drugs for erectile dysfunction (e.g Viagra®), NNRTIs and other protease inhibitors. Your doctor may alter your doses if you are taking one of these drugs.

Didanosine enteric coated capsules and antacids (for indigestion) should be taken at least two hours apart from tipranavir, as the formulations are incompatible. Tipranavir can stop hormonal contraceptives from working effectively, so you must use an alternative form of contraception, e.g. barrier methods. The antibiotic metronidazole must NOT be taken with tipranavir. This is because tipranavir capsules contain alcohol, which is contraindicated with metronidazole.

Side effects.
Tipranavir, like all other medicines has some side effects. The most important ones are:

* Nausea, vomiting, headache, diarrhoea, rash and fatigue;
* Raised liver enzymes. Your doctor will monitor this from your blood tests;

Combination regimes containing protease inhibitors have been associated with redistribution of body fat in some patients. They are also associated with metabolic abnormalities such as raised cholesterol, increased risk of diabetes and heart disease. Your doctor will monitor you for these side effects.

If you experience any of these side effects or any new symptoms after you start tipranavir, tell your doctor who will advise you on what to do. If you decide to stop tipranavir it is important you tell your doctor so that he or she can discuss other treatment options with you.

Admission to hospital
If you are admitted to hospital please bring all your medicines with you. This is especially important for anti-HIV drugs, as they have to be taken regularly. Thomas Macaulay Ward operates a self medication programme. Some people are able to self administer their own medicines to enable them to stick to the routine they are used to at home.

Storing your tipranavir
Tipranavir should ideally be stored in a refrigerator. Once the bottle is opened it may be stored at room
temperature and the drug must be used within 60 days.