Aptivus (Tipranavir) Oral: Uses, Side Effects, Dosages

What Is Aptivus?

Aptivus (tipranavir) is in a class of medications called protease inhibitors. It is used to treat human immunodeficiency virus, commonly known as HIV.

Aptivus is an antiviral drug. It can prevent the virus from replicating by blocking an enzyme called protease. Without the protease enzyme, the virus can no longer break down large viral proteins into smaller pieces required for the virus to grow and multiply (replicate). As a result, it reduces the amount of HIV in your body.

When combined with another anti-HIV medication called Norvir (ritonavir), tipranavir helps prevent the disease from worsening, reduces possible side effects, and keeps your immune system safe.

You can get Aptivus by prescription. It is available as a capsule taken by mouth.

Drug Facts

Generic Name: Tipranavir   

Brand Name(s): Aptivus

Drug Availability: Prescription

Administration Route: Oral

Therapeutic Classification: Antiretroviral agent protease inhibitor 

Available Generically: No

Controlled Substance: N/A

Active Ingredient: Tipranavir

Dosage Form(s): Capsule

What Is Aptivus Used For?

The U.S. Food and Drug Administration (FDA) approved Aptivus to treat HIV in treatment-experienced people (who have previously taken another antiretroviral therapy) and are infected with HIV-1 strains resistant to more than one protease inhibitor.

It is used in combination with another antiretroviral therapy called ritonavir.

How to Take Aptivus

Take this medication as instructed by your healthcare provider.

Aptivus is a capsule that must be swallowed whole by mouth. Do not open, chew, or crush the capsules, which can prevent the medication from working.

Typically, you will take two 250-milligram capsules in the morning, followed by two more capsules 12 hours later. This adds up to 1000 milligrams per day.

Your healthcare provider will prescribe another HIV medication called ritonavir with tipranavir. You should take your ritonavir tablets with meals, although the capsule and liquid formulations can be taken without regard to food in adults. However, it is recommended that children always take their dose with food. Taking your medications with food can also help prevent nausea.


When you first get Aptivus, store the container in the fridge. After opening it, store the medication at room temperature (68 F to 77 F) for 60 days. Write the expiration date on the container. Properly dispose of any remaining medication in open containers after 60 days.

You can dispose of unused or expired medication by dropping it off at a drug take-back site, location, or program in your area or following the disposal instructions on the medication’s package insert. If no other options are available, you can trash medications using the following steps:

  • Mix (do not crush) the capsules with an unappealing substance, like dirt, cat litter, or used coffee grounds.
  • Put the mixture in a sealed plastic bag or container.
  • Throw it away in a home trash container.
  • Remove personal information from the prescription label on empty bottles or packaging before throwing them in the trash.

You can talk to your pharmacist for more information on the safe disposal of medications.

As always, ensure your medication is stored securely, out of reach of children and pets. Contact your pharmacy or healthcare provider to request a refill if you need more medication.

Off-Label Uses

Currently, Aptivus does not have any off-label uses.

How Long Does Aptivus Take to Work?

The rate at which Aptivus works can vary from person to person. However, the general onset of action and peak in plasma for Aptivus is as follows:

  • Onset of action: Eight weeks
  • Peak in plasma: Three hours

The onset of action determines when you will see the full effects of the medication working. The peak in plasma refers to when the drug enters the bloodstream. Therefore, tipranavir takes about three hours to enter the bloodstream; however, your HIV blood levels may decrease within eight weeks, based on clinical studies. Consistently taking Aptivus can help decrease your HIV levels over a long period and maintain them at undetectable levels.

What Are the Side Effects of Aptivus?

This is not a complete list of side effects, and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or a healthcare provider. You may report side effects to the FDA at www.fda.gov/medwatch or 800-FDA-1088.

Common Side Effects

The side effects commonly reported while taking Aptivus include:

  • Headache
  • Fatigue
  • Diarrhea
  • Upset stomach
  • Abdominal pain
  • Fever
  • Rash

Severe Side Effects

Contact your healthcare provider immediately if you are experiencing any severe side effects. Call 911 if you feel your life is at risk or need medical assistance. Rare but serious side effects may include:

  • Liver problems: This medication has a boxed warning (the FDA’s highest safety warning) about liver toxicity risks. Signs may include dark urine or yellowing of the skin/eyes (jaundice).
  • Intracranial hemorrhage (bleeding within the skull), mostly in people with other medical conditions: This medication has a boxed warning about the increased risk of intracranial hemorrhage. Symptoms include a worsening headache, vomiting, dizziness, loss of consciousness, slurred speech, and loss of movement on one side of the body.
  • An allergic reaction: Symptoms may include hives, itching, or closing of the throat.
  • Nervous system disorders, such as peripheral neuropathy: Symptoms may include weakness, numbness, and pain in the hands and feet.
  • Low blood platelet count (thrombocytopenia): Symptoms may include excessive bruising or prolonged bleeding from cuts.
  • Insomnia (trouble sleeping)
  • Metabolic disorders, such as diabetes, hyperglycemia (high blood sugar), or changes in body fat (lipodystrophy syndrome)
  • Increased bleeding in people with hemophilia (a rare blood-clotting disorder)

Long-Term Side Effects

While Aptivus can help you manage your HIV infection, long-term use of tipranavir can put you at risk of liver toxicity. It is important to talk to your healthcare provider if you notice signs of liver problems, such as dark urine, feeling tired, light-colored stools, or yellowing of the skin or eyes.

Report Side Effects

Aptivus may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your healthcare provider may send a report to the FDA’s MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

Dosage: How Much Aptivus Should I Take?

Drug Content Provided and Reviewed by

IBM Micromedex®

The dose of this medicine will be different for different patients. Follow your doctor’s orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For treatment of HIV infection:

    • For oral dosage forms (capsules or oral solution):

      • Adults—500 milligrams (mg) (two capsules or 5 milliliters (mL)) of tipranavir and 200 mg of ritonavir (Norvir®) two times a day.
      • Children 2 to 18 years of age—Dose is based on body weight or body size and must be determined by your doctor. The dose is usually 14 milligrams (mg) per kilogram (kg) of body weight of tipranavir plus 6 mg per kg of body weight of ritonavir (Norvir®), or 375 mg/m(2) of body size of tipranavir plus 150 mg/m(2) of body size of ritonavir two times a day. Your doctor may adjust your dose if needed. However, the dose should not be more than the recommended adult dose.
      • Children younger than 2 years of age—Use and dose must be determined by your doctor.


Before starting tipranavir, inform your healthcare provider of any health conditions you have and your medical history.

Common reasons your healthcare provider may adjust your dosage or change your treatment include the following:

  • Liver problems: Your healthcare provider will first run tests to see if you’re a good fit to take Aptivus. However, if you know you have severe liver problems, you should not take tipranavir.
  • Age: Although the FDA has approved tipranavir to treat HIV infections in children two years or older, recent guidelines do not recommend its use in this age group.

Missed Dose

If you miss a dose, take the missed dose as soon as you remember. If it is almost time for the next dose, skip the missed dose and continue your normal dose schedule. You must only take one dose at a time, so do not take two doses to make up for the missed dose. Taking more Aptivus than prescribed can put you at risk of liver toxicity. 

Overdose: What Happens If I Take Too Much Aptivus?

Due to limited information, there is not an established amount of Aptivus reported to cause an overdose. However, you should generally not take more than 1000 milligrams of tipranavir within 24 hours. Taking any amount greater per day can put you at risk of liver toxicity.

What Happens If I Overdose on Aptivus?

If you think you or someone else may have overdosed on Aptivus, call a healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses or isn’t breathing after taking Aptivus, call 911 immediately.


Drug Content Provided and Reviewed by

IBM Micromedex®

It is very important that your doctor check the progress of you or your child at regular visits to make sure that this medicine is working properly. Blood tests may be needed to check for unwanted effects.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal (eg, St. John’s wort) or vitamin supplements.

You should not use tipranavir together with alfuzosin (Uroxatral®), amiodarone (Cordarone®, Pacenone®), bepridil (Vascor®), cisapride (Propulsid®), ergot medicines (eg, dihydroergotamine, ergonovine, ergotamine, methylergonovine, Cafergot®, Methergine®, Migranal®), flecainide (Tambocor®), lovastatin (Altocor®, Mevacor®), oral lurasidone (Latuda®), midazolam (Versed®) pimozide (Orap®), propafenone (Rythmol®), quinidine (Cardioquin®, Quinaglute Dura®), rifampin (Rifadin®, Rimactane®), sildenafil (Revatio®), simvastatin (Simcor®, Vytorin®, Zocor®), or triazolam (Halcion®). Using these medicines together with tipranavir may increase your chance of having serious medical problems.

This medicine may decrease the effects of some oral contraceptives (birth control pills). To keep from getting pregnant, use an additional form of birth control with your pills. Other forms include condoms, a diaphragm, or contraceptive foam or jelly.

This medicine may cause intracranial hemorrhage (bleeding in the brain). Make sure your doctor knows if you or your child have a bleeding disorder, or any medical condition that increases your chance of bleeding. Call your doctor right away if you have any unusual or unexplained bleeding.

Check with your doctor right away if you or your child have pain in the upper stomach, pale stools, dark urine, loss of appetite, nausea, unusual tiredness or weakness, or yellow eyes or skin. These could be symptoms of a serious liver problem.

When you start taking HIV medicines, your immune system may get stronger. If you have certain infections that are hidden in your body, such as pneumonia or tuberculosis, you or your child may notice new symptoms when your body tries to fight them. If this occurs, tell your doctor right away.

This medicine will not keep you from giving HIV to your partner during sex. Make sure you understand and practice safe sex, even if your partner also has HIV. Do not share needles with anyone.

Serious skin reactions can occur with this medicine. Check with your doctor right away if you or your child have more than one of the following symptoms while using this medicine: blistering, peeling, or loosening of the skin, fever or chills, itching, joint or muscle pain, severe rash, red skin lesions, sunburn, throat tightness, or sores, ulcers, or white spots in the mouth or on the lips.

This medicine may make your skin more sensitive to sunlight. Use a sunscreen when you are outdoors. Wear protective clothing and hats. Avoid sunlamps and tanning beds.

This medicine may cause you to have excess body fat. Tell your doctor if you or your child notice changes in your body shape, such as an increased amount of fat in the upper back and neck, or around the chest and stomach area, or a loss of fat from the legs, arms, and face.

What Are Reasons I Shouldn’t Take Aptivus?

You should not take Aptivus if:

  • You have known allergies to sulfa medications
  • You are diagnosed with liver problems
  • You are pre-diabetic or currently have diabetes (speak to your healthcare provider before starting Aptivus)
  • You have high cholesterol (talk to your healthcare provider before starting Aptivus, as this medication may significantly increase your cholesterol levels)

What Other Medications Interact With Aptivus?

When taking Aptivus, you must be aware that medications or supplements can worsen your side effects or lower your treatment’s effectiveness.

Avoid taking tipranavir with the following medications:

  • Antiarrhythmics, such as Pacerone (amiodarone) and quinidine: The combination of antiarrhythmic drugs and tipranavir can cause serious and life-threatening heart problems.
  • Cholesterol-lowering medications, such as Altoprev (lovastatin) and Zocor (simvastatin)
  • Medications for tuberculosis, such as rifampin: When using rifampin and tipranavir together, this combination can lead to Aptivus not working or can make the HIV not responsive to the medication.
  • Sedatives, such as midazolam or Halcion (triazolam): The combination of sedatives and tipranavir can cause serious adverse effects, such as slowed breathing. 

Before starting treatment, tell your healthcare provider about any other medicines you take or plan to take, including over-the-counter (OTC) nonprescription products, vitamins, herbs, supplements, and plant-based medicines.

What Medications Are Similar?

Other protease inhibitors used for HIV include:

  • Norvir (ritonavir)
  • Reyataz (atazanavir)
  • Prezista (darunavir)
  • Lexiva (fosamprenavir)
  • Viracept (nelfinavir)

Darunavir or atazanavir coadministered with ritonavir are common first-line antiretroviral therapy choices. Ritonavir is typically prescribed as part of a combination treatment as it acts as a “booster,” enhancing the effects of other protease inhibitors.

Typically, when other HIV medications do not work, your healthcare provider will prescribe tipranavir. Compared to tipranavir and other protease inhibitors, atazanavir has fewer side effects.

Frequently Asked Questions

  • What happens if I stop taking Aptivus suddenly?

    If you suddenly stop taking your medication, the drug’s levels can drop too low in the body, giving the virus an opportunity to grow.

  • Do you store Aptivus in the fridge or at room temperature?

    You must store an unopened container of Aptivus in the fridge. Once you open the container, you can store the medication at room temperature. It is then good for 60 days.

  • What if I can’t afford my medication?

    How much you spend out-of-pocket on your prescription will depend on your health insurance and pharmacy. Unfortunately, there is no generic medication available for a lower price. However, there are options available if you need cost assistance. Ask your healthcare provider or pharmacist about prescription payment assistance programs, sometimes offered by the drug’s manufacturer or non-profit organizations.

How Can I Stay Healthy While Taking Aptivus?

To stay healthy while taking Aptivus, take your medication exactly as your healthcare provider prescribes.

Since HIV can weaken your immune system, you are at a higher risk of illness. Stay up-to-date with vaccinations recommended by the Centers for Disease Control and Prevention (CDC) for people living with HIV, including pneumococcal vaccines, influenza vaccines, and the herpes zoster vaccine, among others. Talk to your healthcare provider about immunizations.

Your mental well-being is also important for staying healthy. Getting diagnosed and living with HIV can be overwhelming and leave you feeling stressed. Try building a support team with the people you love, and talk to your healthcare team about what to expect. While living with HIV might be scary, following the appropriate treatment and care can help you live a long and healthy life.

Medical Disclaimer

Verywell Health’s drug information is meant for educational purposes only and is not intended to replace medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

The author would like to recognize and thank Alexya Rosas for contributing to this article.