Tipranavir is a newly approved protease inhibitor that belongs to the class of 4-hydroxy-5,6-dyhydro-2-pyrones. It exhibits potent in vitro activity against both human immunodeficiency virus (HIV)-1 and HIV-2, including clinical isolates with multiple protease inhibitor-resistant mutations. Tipranavir requires coadministration with ritonavir to achieve clinically meaningful serum concentration. In randomized, phase III, open-label trials, it was found to be superior to the currently available boosted protease inhibitors in highly treatment-experienced patients with multiple protease inhibitor mutations. Thus, it provides a welcome new option for salvage antiretroviral therapy. The most common adverse effects associated with tipranavir are diarrhea, nausea and vomiting. Common laboratory abnormalities include elevations of total cholesterol, triglycerides and liver enzymes.
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