Drug Interactions
See also How to Use section. Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for it. Do not start, stop or change the dosage of any medicine before checking with them first. This drug should not be used with the following medications because very serious interactions may occur: cisapride, pimozide, certain heart rhythm drugs (amiodarone, bepridil, flecainide, propafenone, quinidine), benzodiazepines (e.g., midazolam, triazolam), certain cholesterol-lowering drugs (lovastatin, simvastatin), eletriptan, eplerenone, ergot-containing drugs (e.g., ergotamine), etravirine, ranolazine, certain drugs affecting liver enzymes that remove tipranavir from your body (rifampin, St. John's wort). If you are currently using any of these medications listed above, tell your doctor or pharmacist before starting tipranavir. Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially of: antiplatelet drugs (e.g., aspirin, clopidogrel), artemether, "blood thinners" (anticoagulants such as warfarin, heparins), NSAIDs (e.g., ibuprofen, naproxen, sulindac, indomethacin), disulfiram, estrogens (e.g., ethinyl estradiol), garlic supplements, vitamin E, lumefantrine, metronidazole, solifenacin, drugs affecting liver enzymes that remove tipranavir from your body (such as atazanavir, certain anti-seizure medicines including carbamazepine/phenytoin, azole antifungals including fluconazole/itraconazole/ketoconazole, macrolide antibiotics including erythromycin). Tipranavir can both speed up and slow down the removal of other drugs from your body, thereby affecting how they work. These affected drugs include (not a complete list): atorvastatin, clarithromycin, fluticasone, omeprazole, rosuvastatin, temsirolimus, valproic acid, trazodone, calcium channel blockers such as felodipine, drugs that suppress the immune system such as cyclosporine/sirolimus/tacrolimus, certain narcotic pain medications such as meperidine/methadone, other protease inhibitors including amprenavir/lopinavir/saquinavir, other rifamycins including rifabutin, drugs to treat erectile dysfunction/pulmonary hypertension (such as sildenafil, vardenafil), antidepressants such as fluoxetine/sertraline/desipramine. This medication may decrease the effectiveness of hormonal birth control (e.g., pill, patch, ring). This effect can result in pregnancy. Ask your doctor or pharmacist for details. Discuss whether you should use additional reliable birth control methods during treatment with tipranavir. (See also Side Effects section). This document does not contain all possible interactions. Tipranavir is always given with ritonavir which also has many drug interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist.