Interactions between tindamax(tinidazole) and Aptivus (tipranavir)
tinidazole and tipranavir (Moderate Drug-Drug)
GENERALLY AVOID: Ritonavir capsules, ritonavir oral solution, lopinavir-ritonavir oral solution, and tipranavir capsules all contain alcohol, which can produce a disulfiram-like reaction when coadministered with drugs that may be capable of inhibiting aldehyde dehydrogenase (ALDH) such as metronidazole, furazolidone, and cephalosporins with an N-methylthiotetrazole (NMTT) side chain that structurally resembles disulfiram. Following ingestion of alcohol, inhibition of ALDH results in increased concentration of acetaldehyde, the accumulation of which produces an unpleasant physiologic response referred to as the 'disulfiram reaction'. Symptoms include flushing, throbbing in head and neck, throbbing headache, respiratory difficulty, nausea, vomiting, sweating, thirst, chest pain, palpitation, dyspnea, hyperventilation, tachycardia, hypotension, syncope, weakness, vertigo, blurred vision, and confusion. Severe reactions may result in respiratory depression, cardiovascular collapse, arrhythmias, myocardial infarction, acute congestive heart failure, unconsciousness, convulsions, and death. The interaction is well established for disulfiram. However, data for other potential ALDH inhibitors such as metronidazole and cephalosporins are limited and conflicting.
MANAGEMENT: Until further information is available, use of ritonavir capsules, ritonavir oral solution, lopinavir-ritonavir oral solution, or tipranavir capsules with metronidazole (including vaginal formulations), furazolidone, and certain cephalosporins should be avoided if possible. Given its structural similarities to metronidazole, the same precaution may be applicable to tinidazole, although clinical data are lacking.
