Interactions between alu-tab(aluminum hydroxide) and Aptivus (tipranavir)
aluminum hydroxide and tipranavir (Moderate Drug-Drug)
ADJUST DOSING INTERVAL: Concurrent administration of antacids or other agents with acid-neutralizing effects may decrease the oral bioavailability of tipranavir and reduce its concentrations in plasma. The mechanism of interaction has not been described. When tipranavir (in combination with low-dose ritonavir) was coadministered with 20 mL of an aluminum- and magnesium-based liquid antacid, tipranavir peak plasma concentration (Cmax) and area under the plasma concentration-time curve (AUC) were reduced by 25% to 29%. The clinical significance of these changes is unknown. However, subtherapeutic antiretroviral drug levels may lead to reduced viral susceptibility and development of resistance.
MANAGEMENT: Consideration should be given to separating tipranavir/ritonavir dosing from antacid administration to prevent reduced absorption of tipranavir.
