Skip to main content

Drug Interactions between miconazole and tipranavir

This report displays the potential drug interactions for the following 2 drugs:

Edit list (add/remove drugs)

Interactions between your drugs

Moderate

miconazole tipranavir

Applies to: miconazole and tipranavir

ADJUST DOSE: Coadministration with azole antifungal agents may substantially increase the plasma concentrations of tipranavir administered in combination with low-dose ritonavir. The proposed mechanism is inhibition of CYP450 3A4, the isoenzyme responsible for the metabolic clearance of both tipranavir and ritonavir. In 20 study subjects, fluconazole (100 mg once a day for 12 days) increased the mean peak plasma concentration (Cmax), area under the concentration-time curve (AUC) and trough plasma concentration (Cmin) of steady-state tipranavir (500 mg with ritonavir 200 mg twice a day) by 32%, 50% and 69%, respectively, compared to historical data. Tipranavir/ritonavir had negligible effects on fluconazole. The interaction has not been studied with other azole antifungal agents but is expected to occur due to their potent inhibitory effects on CYP450 3A4.

MANAGEMENT: In patients treated with tipranavir/ritonavir, dosages of fluconazole, itraconazole, and ketoconazole exceeding 200 mg/day are not recommended. Due to multiple enzymes involved with voriconazole metabolism, the interaction is difficult to predict and no recommendations are available.

References

  1. "Product Information. Aptivus (tipranavir)." Boehringer-Ingelheim (2005):

Switch to consumer interaction data

Drug and food interactions

Moderate

tipranavir food

Applies to: tipranavir

ADJUST DOSING INTERVAL: Food does not appear to substantially alter the pharmacokinetics of tipranavir. When tipranavir capsules or oral solution was coadministered with ritonavir capsules at steady-state, no clinically significant changes in tipranavir peak plasma concentration (Cmax) and systemic exposure (AUC) were observed under fed conditions (500 to 682 kcal, 23% to 25% calories from fat) relative to fasted conditions. The effect of food on tipranavir exposure during coadministration with ritonavir tablets has not been evaluated. High-fat foods may enhance the gastrointestinal absorption of tipranavir. In a multiple-dose study, administration of tipranavir capsules with a high-fat meal (868 kcal, 53% from fat, 31% from carbohydrates) increased the oral bioavailability of tipranavir by 31% compared to administration with toast and skimmed milk, but did not significantly affect tipranavir Cmax. Thus, tipranavir may be safely taken with standard or high-fat meals.

MANAGEMENT: Tipranavir coadministered with low-dose ritonavir should be taken with food to improve the gastrointestinal tolerability of ritonavir. According to the product labeling, tipranavir coadministered with ritonavir capsules or solution can be taken with or without meals, whereas tipranavir coadministered with ritonavir tablets must be taken with meals.

References

  1. "Product Information. Aptivus (tipranavir)." Boehringer-Ingelheim (2005):
  2. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  3. Canadian Pharmacists Association "e-CPS. http://www.pharmacists.ca/function/Subscriptions/ecps.cfm?link=eCPS_quikLink" (2006):
  4. Cerner Multum, Inc. "Australian Product Information." O 0
View all 4 references

Switch to consumer interaction data

Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

See also

Report options

Loading...
QR code containing a link to this page

Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer