Drug General Information (ID: DDIATKZ5WY)
Drug Name			Ritonavir		Drug Info		Tipranavir		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Anti-Hiv Agents				Anti-Hiv Agents
Structure

Mechanism of Ritonavir-Tipranavir Interaction (Severity Level: Major)
Increased risk of hepatotoxicity Click to Show/Hide Mechanism Graph
Drug Name		Ritonavir				Tipranavir
Mechanism		Hepatotoxicity				Hepatotoxicity
Key Mechanism Factor 1
		Factor Name		Hepatotoxicity
		Factor Description		Combination of drugs that can induce hepatotoxicity may increase the risk of liver injury. Symptoms vary depending on the level of exposure and the total extent of liver damage, and may cause few symptoms if the damage is mild, and eventually lead to liver failure in patients with severe damage.
Mechanism Description		Increased risk of hepatotoxicity by the combination of Ritonavir and Tipranavir

Recommended Action
Management		Close monitoring of hepatic function is recommended in patients treated with tipranavir and ritonavir. Particular caution is warranted in patients with chronic hepatitis B or C coinfection, as they may have an increased risk of hepatotoxicity. Patients should be advised to notify their physician if they experience signs and symptoms of hepatotoxicity such as fever, rash, anorexia, nausea, vomiting, fatigue, right upper quadrant pain, dark urine, and jaundice.

References
1	Product Information. Aptivus (tipranavir). Boehringer-Ingelheim, Ridgefield, CT.
2	Product Information. Norvir (ritonavir). Abbott Pharmaceutical, Abbott Park, IL.
3	Durant J, Clevenbergh P, Garraffo R, Halfon P, Icard S, DelGiudice P, Montagne N, Schapiro JM, Dellamonica P "Importance of protease inhibitor plasma levels in HIV-infected patients treated with genotypic-guided therapy: pharmacological data from the Viradapt Study." Aids 14 (2000): 1333-9.[PMID: 10930147]