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Details

Stereochemistry ABSOLUTE
Molecular Formula C31H31F3N2O5S.2Na
Molecular Weight 646.628
Optical Activity UNSPECIFIED
Defined Stereocenters 2 / 2
E/Z Centers 0
Charge 0

SHOW SMILES / InChI
Structure of TIPRANAVIR DISODIUM

SMILES

[Na+].[Na+].CCC[C@@]2(CCC1=CC=CC=C1)CC([O-])=C([C@H](CC)C3=CC=CC([N-]S(=O)(=O)C4=NC=C(C=C4)C(F)(F)F)=C3)C(=O)O2

InChI

InChIKey=ZBWMQTUSVWBMQE-KPHXKKTMSA-M
InChI=1S/C31H32F3N2O5S.2Na/c1-3-16-30(17-15-21-9-6-5-7-10-21)19-26(37)28(29(38)41-30)25(4-2)22-11-8-12-24(18-22)36-42(39,40)27-14-13-23(20-35-27)31(32,33)34;;/h5-14,18,20,25H,3-4,15-17,19H2,1-2H3,(H,37,38);;/q-1;2*+1/p-1/t25-,30-;;/m1../s1

HIDE SMILES / InChI

Description
Curator's Comment: Description was created based on several sources, including https://www.ncbi.nlm.nih.gov/pubmed/16802849 | https://www.ncbi.nlm.nih.gov/pubmed/9719600 | http://adisinsight.springer.com/drugs/800008750

Tipranavir (PNU-140690, trade mark APTIVUS) is a potent, orally bioavailable nonpeptidic HIV protease inhibitor of the 5,6-dihydro-4-hydroxy-2-pyrone sulfonamide class. Tipranavir has potent in vitro activity against a variety of HIV-1 laboratory strains and clinical isolates, including those resistant to ritonavir, as well as HIV-2. The drug is launched in several countries, including the US and in the EU. APTIVUS, co-administered with ritonavir, is indicated for combination antiretroviral treatment of HIV-1 infected patients who are treatment-experienced and infected with HIV-1 strains resistant to more than one protease inhibitor.

CNS Activity

Curator's Comment: Tipranavir do not reach therapeutical concentrations in CSF

Originator

Curator's Comment: # Pharmacia & Upjohn (now Pfizer)

Approval Year

Targets

Targets

Primary TargetPharmacologyConditionPotency
8.0 pM [Ki]
Conditions

Conditions

ConditionModalityTargetsHighest PhaseProduct
Primary
APTIVUS

Approved Use

APTIVUS, co-administered with ritonavir, is indicated for combination antiretroviral treatment of HIV-1 infected patients who are treatment-experienced and infected with HIV-1 strains resistant to more than one protease inhibitor (PI). This indication is based on analyses of plasma HIV-1 RNA levels in two controlled studies of APTIVUS/ritonavir of 48 weeks duration in treatment-experienced adults and one open-label 48-week study in pediatric patients age 2 to 18 years. The adult studies were conducted in clinically advanced, 3-class antiretroviral (NRTI, NNRTI, PI) treatment-experienced adults with evidence of HIV-1 replication despite ongoing antiretroviral therapy. The following points should be considered when initiating therapy with APTIVUS/ritonavir: The use of APTIVUS/ritonavir in treatment-naïve patients is not recommended [ see Warnings and Precautions (5.1)

Launch Date

2005
Cmax

Cmax

ValueDoseCo-administeredAnalytePopulation
77.6 μM
500 mg 2 times / day steady-state, oral
dose: 500 mg
route of administration: Oral
experiment type: STEADY-STATE
co-administered: Ritonavir
TIPRANAVIR plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: MALE
food status: FED
94.8 μM
500 mg 2 times / day steady-state, oral
dose: 500 mg
route of administration: Oral
experiment type: STEADY-STATE
co-administered: Ritonavir
TIPRANAVIR plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: FEMALE
food status: FED
135 μM
375 mg/m² 2 times / day steady-state, oral
dose: 375 mg/m²
route of administration: Oral
experiment type: STEADY-STATE
co-administered: Ritonavir
TIPRANAVIR plasma
Homo sapiens
population: UNHEALTHY
age: CHILD
sex: FEMALE / MALE
food status: UNKNOWN
AUC

AUC

ValueDoseCo-administeredAnalytePopulation
710 μM × h
500 mg 2 times / day steady-state, oral
dose: 500 mg
route of administration: Oral
experiment type: STEADY-STATE
co-administered: Ritonavir
TIPRANAVIR plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: MALE
food status: FED
851 μM × h
500 mg 2 times / day steady-state, oral
dose: 500 mg
route of administration: Oral
experiment type: STEADY-STATE
co-administered: Ritonavir
TIPRANAVIR plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: FEMALE
food status: FED
1190 μM × h
375 mg/m² 2 times / day steady-state, oral
dose: 375 mg/m²
route of administration: Oral
experiment type: STEADY-STATE
co-administered: Ritonavir
TIPRANAVIR plasma
Homo sapiens
population: UNHEALTHY
age: CHILD
sex: FEMALE / MALE
food status: UNKNOWN
T1/2

T1/2

ValueDoseCo-administeredAnalytePopulation
6 h
500 mg 2 times / day steady-state, oral
dose: 500 mg
route of administration: Oral
experiment type: STEADY-STATE
co-administered: Ritonavir
TIPRANAVIR plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: MALE
food status: FED
5.5 h
500 mg 2 times / day steady-state, oral
dose: 500 mg
route of administration: Oral
experiment type: STEADY-STATE
co-administered: Ritonavir
TIPRANAVIR plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: FEMALE
food status: FED
8.1 h
375 mg/m² 2 times / day steady-state, oral
dose: 375 mg/m²
route of administration: Oral
experiment type: STEADY-STATE
co-administered: Ritonavir
TIPRANAVIR plasma
Homo sapiens
population: UNHEALTHY
age: CHILD
sex: FEMALE / MALE
food status: UNKNOWN
Funbound

Funbound

ValueDoseCo-administeredAnalytePopulation
0.1%
500 mg 2 times / day steady-state, oral
dose: 500 mg
route of administration: Oral
experiment type: STEADY-STATE
co-administered: Ritonavir
TIPRANAVIR plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: FEMALE
food status: FED
Doses

Doses

DosePopulationAdverse events​
500 mg 2 times / day multiple, oral
Recommended
Dose: 500 mg, 2 times / day
Route: oral
Route: multiple
Dose: 500 mg, 2 times / day
Co-administed with::
ritonavir, oral(200 mg, b.i.d.)
Sources: Page: p.11
unhealthy, 18–65
n = 186
Health Status: unhealthy
Condition: HIV-1 infection
Age Group: 18–65
Sex: M+F
Population Size: 186
Sources: Page: p.11
Disc. AE: Gastrointestinal disorder NOS, Gastrointestinal disorder NOS...
AEs leading to
discontinuation/dose reduction:
Gastrointestinal disorder NOS (grade 1, 1%)
Gastrointestinal disorder NOS (moderate, 2.1%)
Gastrointestinal disorder NOS (severe, 1%)
Transaminases increased (grade 1, 1%)
Transaminases increased (moderate, 1.6%)
Transaminases increased (severe, 4.8%)
Sources: Page: p.11
1200 mg 2 times / day multiple, oral
Highest studied dose
Dose: 1200 mg, 2 times / day
Route: oral
Route: multiple
Dose: 1200 mg, 2 times / day
Sources: Page: p.381
unhealthy, 35.2
n = 10
Health Status: unhealthy
Condition: HIV-1 infection
Age Group: 35.2
Sex: M+F
Population Size: 10
Sources: Page: p.381
500 mg 2 times / day multiple, oral
Recommended
Dose: 500 mg, 2 times / day
Route: oral
Route: multiple
Dose: 500 mg, 2 times / day
Co-administed with::
ritonavir, oral(200 mg, b.i.d.)
Sources: Page: p.1
unhealthy
Health Status: unhealthy
Condition: HIV-1 infection
Sources: Page: p.1
Disc. AE: Hepatitis, Hepatic decompensation...
AEs leading to
discontinuation/dose reduction:
Hepatitis
Hepatic decompensation
Intracranial hemorrhage
Platelet aggregation
Coagulation abnormal
Diabetes mellitus
Hyperglycemia
Immune reconstitution syndrome
Fat redistribution
Lipids increased
Sources: Page: p.1
500 mg 2 times / day multiple, oral
Recommended
Dose: 500 mg, 2 times / day
Route: oral
Route: multiple
Dose: 500 mg, 2 times / day
Co-administed with::
ritonavir, oral(200 mg, b.i.d.)
Sources: Page: p.1, 5
unhealthy
Health Status: unhealthy
Condition: HIV-1 infection
Sources: Page: p.1, 5
Disc. AE: Rash...
AEs leading to
discontinuation/dose reduction:
Rash (0.5%)
Sources: Page: p.1, 5
AEs

AEs

AESignificanceDosePopulation
Gastrointestinal disorder NOS grade 1, 1%
Disc. AE
500 mg 2 times / day multiple, oral
Recommended
Dose: 500 mg, 2 times / day
Route: oral
Route: multiple
Dose: 500 mg, 2 times / day
Co-administed with::
ritonavir, oral(200 mg, b.i.d.)
Sources: Page: p.11
unhealthy, 18–65
n = 186
Health Status: unhealthy
Condition: HIV-1 infection
Age Group: 18–65
Sex: M+F
Population Size: 186
Sources: Page: p.11
Transaminases increased grade 1, 1%
Disc. AE
500 mg 2 times / day multiple, oral
Recommended
Dose: 500 mg, 2 times / day
Route: oral
Route: multiple
Dose: 500 mg, 2 times / day
Co-administed with::
ritonavir, oral(200 mg, b.i.d.)
Sources: Page: p.11
unhealthy, 18–65
n = 186
Health Status: unhealthy
Condition: HIV-1 infection
Age Group: 18–65
Sex: M+F
Population Size: 186
Sources: Page: p.11
Transaminases increased moderate, 1.6%
Disc. AE
500 mg 2 times / day multiple, oral
Recommended
Dose: 500 mg, 2 times / day
Route: oral
Route: multiple
Dose: 500 mg, 2 times / day
Co-administed with::
ritonavir, oral(200 mg, b.i.d.)
Sources: Page: p.11
unhealthy, 18–65
n = 186
Health Status: unhealthy
Condition: HIV-1 infection
Age Group: 18–65
Sex: M+F
Population Size: 186
Sources: Page: p.11
Gastrointestinal disorder NOS moderate, 2.1%
Disc. AE
500 mg 2 times / day multiple, oral
Recommended
Dose: 500 mg, 2 times / day
Route: oral
Route: multiple
Dose: 500 mg, 2 times / day
Co-administed with::
ritonavir, oral(200 mg, b.i.d.)
Sources: Page: p.11
unhealthy, 18–65
n = 186
Health Status: unhealthy
Condition: HIV-1 infection
Age Group: 18–65
Sex: M+F
Population Size: 186
Sources: Page: p.11
Gastrointestinal disorder NOS severe, 1%
Disc. AE
500 mg 2 times / day multiple, oral
Recommended
Dose: 500 mg, 2 times / day
Route: oral
Route: multiple
Dose: 500 mg, 2 times / day
Co-administed with::
ritonavir, oral(200 mg, b.i.d.)
Sources: Page: p.11
unhealthy, 18–65
n = 186
Health Status: unhealthy
Condition: HIV-1 infection
Age Group: 18–65
Sex: M+F
Population Size: 186
Sources: Page: p.11
Transaminases increased severe, 4.8%
Disc. AE
500 mg 2 times / day multiple, oral
Recommended
Dose: 500 mg, 2 times / day
Route: oral
Route: multiple
Dose: 500 mg, 2 times / day
Co-administed with::
ritonavir, oral(200 mg, b.i.d.)
Sources: Page: p.11
unhealthy, 18–65
n = 186
Health Status: unhealthy
Condition: HIV-1 infection
Age Group: 18–65
Sex: M+F
Population Size: 186
Sources: Page: p.11
Coagulation abnormal Disc. AE
500 mg 2 times / day multiple, oral
Recommended
Dose: 500 mg, 2 times / day
Route: oral
Route: multiple
Dose: 500 mg, 2 times / day
Co-administed with::
ritonavir, oral(200 mg, b.i.d.)
Sources: Page: p.1
unhealthy
Health Status: unhealthy
Condition: HIV-1 infection
Sources: Page: p.1
Diabetes mellitus Disc. AE
500 mg 2 times / day multiple, oral
Recommended
Dose: 500 mg, 2 times / day
Route: oral
Route: multiple
Dose: 500 mg, 2 times / day
Co-administed with::
ritonavir, oral(200 mg, b.i.d.)
Sources: Page: p.1
unhealthy
Health Status: unhealthy
Condition: HIV-1 infection
Sources: Page: p.1
Fat redistribution Disc. AE
500 mg 2 times / day multiple, oral
Recommended
Dose: 500 mg, 2 times / day
Route: oral
Route: multiple
Dose: 500 mg, 2 times / day
Co-administed with::
ritonavir, oral(200 mg, b.i.d.)
Sources: Page: p.1
unhealthy
Health Status: unhealthy
Condition: HIV-1 infection
Sources: Page: p.1
Hepatic decompensation Disc. AE
500 mg 2 times / day multiple, oral
Recommended
Dose: 500 mg, 2 times / day
Route: oral
Route: multiple
Dose: 500 mg, 2 times / day
Co-administed with::
ritonavir, oral(200 mg, b.i.d.)
Sources: Page: p.1
unhealthy
Health Status: unhealthy
Condition: HIV-1 infection
Sources: Page: p.1
Hepatitis Disc. AE
500 mg 2 times / day multiple, oral
Recommended
Dose: 500 mg, 2 times / day
Route: oral
Route: multiple
Dose: 500 mg, 2 times / day
Co-administed with::
ritonavir, oral(200 mg, b.i.d.)
Sources: Page: p.1
unhealthy
Health Status: unhealthy
Condition: HIV-1 infection
Sources: Page: p.1
Hyperglycemia Disc. AE
500 mg 2 times / day multiple, oral
Recommended
Dose: 500 mg, 2 times / day
Route: oral
Route: multiple
Dose: 500 mg, 2 times / day
Co-administed with::
ritonavir, oral(200 mg, b.i.d.)
Sources: Page: p.1
unhealthy
Health Status: unhealthy
Condition: HIV-1 infection
Sources: Page: p.1
Immune reconstitution syndrome Disc. AE
500 mg 2 times / day multiple, oral
Recommended
Dose: 500 mg, 2 times / day
Route: oral
Route: multiple
Dose: 500 mg, 2 times / day
Co-administed with::
ritonavir, oral(200 mg, b.i.d.)
Sources: Page: p.1
unhealthy
Health Status: unhealthy
Condition: HIV-1 infection
Sources: Page: p.1
Intracranial hemorrhage Disc. AE
500 mg 2 times / day multiple, oral
Recommended
Dose: 500 mg, 2 times / day
Route: oral
Route: multiple
Dose: 500 mg, 2 times / day
Co-administed with::
ritonavir, oral(200 mg, b.i.d.)
Sources: Page: p.1
unhealthy
Health Status: unhealthy
Condition: HIV-1 infection
Sources: Page: p.1
Lipids increased Disc. AE
500 mg 2 times / day multiple, oral
Recommended
Dose: 500 mg, 2 times / day
Route: oral
Route: multiple
Dose: 500 mg, 2 times / day
Co-administed with::
ritonavir, oral(200 mg, b.i.d.)
Sources: Page: p.1
unhealthy
Health Status: unhealthy
Condition: HIV-1 infection
Sources: Page: p.1
Platelet aggregation Disc. AE
500 mg 2 times / day multiple, oral
Recommended
Dose: 500 mg, 2 times / day
Route: oral
Route: multiple
Dose: 500 mg, 2 times / day
Co-administed with::
ritonavir, oral(200 mg, b.i.d.)
Sources: Page: p.1
unhealthy
Health Status: unhealthy
Condition: HIV-1 infection
Sources: Page: p.1
Rash 0.5%
Disc. AE
500 mg 2 times / day multiple, oral
Recommended
Dose: 500 mg, 2 times / day
Route: oral
Route: multiple
Dose: 500 mg, 2 times / day
Co-administed with::
ritonavir, oral(200 mg, b.i.d.)
Sources: Page: p.1, 5
unhealthy
Health Status: unhealthy
Condition: HIV-1 infection
Sources: Page: p.1, 5
OverviewDrug as perpetrator​

Drug as perpetrator​

TargetModalityActivityMetaboliteClinical evidence
inconclusive
inconclusive
inconclusive
inconclusive
inconclusive
inconclusive
likely
moderate [IC50 16.3 uM]
yes (co-administration study)
Comment: coadministration with dextromethorphan led to potent inhibition of CYP2D5
Page: 100.0
moderate
weak
yes [IC50 0.26 uM]
no (co-administration study)
Comment: coadministration with warfarin had no effect
Page: 100.0
yes [IC50 2.3 uM]
yes [IC50 2.7 uM]
yes [IC50 >50 uM]
yes (co-administration study)
Comment: coadministration with caffeine led to moderate induction at steady state
Page: 100.0
yes
yes
Drug as victim

Drug as victim

Tox targets

Tox targets

TargetModalityActivityMetaboliteClinical evidence
PubMed

PubMed

TitleDatePubMed
Structure-based design of HIV protease inhibitors: sulfonamide-containing 5,6-dihydro-4-hydroxy-2-pyrones as non-peptidic inhibitors.
1996 Oct 25
In vitro combination of PNU-140690, a human immunodeficiency virus type 1 protease inhibitor, with ritonavir against ritonavir-sensitive and -resistant clinical isolates.
1997 Nov
Tipranavir (PNU-140690): a potent, orally bioavailable nonpeptidic HIV protease inhibitor of the 5,6-dihydro-4-hydroxy-2-pyrone sulfonamide class.
1998 Aug 27
6-Hydroxy-1,3-dioxin-4-ones as non-peptidic HIV protease inhibitors.
2000 Dec 4
Tipranavir inhibits broadly protease inhibitor-resistant HIV-1 clinical samples.
2000 Sep 8
In vitro antiviral interaction of lopinavir with other protease inhibitors.
2002 Jul
Analysis of protease inhibitor combinations in vitro: activity of lopinavir, amprenavir and tipranavir against HIV type 1 wild-type and drug-resistant isolates.
2004 Mar
Design of HIV-1 protease inhibitors active on multidrug-resistant virus.
2005 Mar 24
Selection and characterization of HIV-1 showing reduced susceptibility to the non-peptidic protease inhibitor tipranavir.
2005 Oct
Tipranavir: PNU 140690, tipranivir.
2006
Susceptibility to protease inhibitors in HIV-2 primary isolates from patients failing antiretroviral therapy.
2006 Apr
Tipranavir: the first nonpeptidic protease inhibitor for the treatment of protease resistance.
2007 Nov
Tipranavir: a new option for the treatment of drug-resistant HIV infection.
2007 Sep 15
Potent inhibition of HIV-1 replication by novel non-peptidyl small molecule inhibitors of protease dimerization.
2007 Sep 28
Characterization of a novel human immunodeficiency virus type 1 protease inhibitor, A-790742.
2008 Apr
Intracranial hemorrhage and liver-associated deaths associated with tipranavir/ritonavir: review of cases from the FDA's Adverse Event Reporting System.
2008 Nov
Cytotoxicological analysis of a gp120 binding aptamer with cross-clade human immunodeficiency virus type 1 entry inhibition properties: comparison to conventional antiretrovirals.
2009 Jul
Novel protease inhibitors (PIs) containing macrocyclic components and 3(R),3a(S),6a(R)-bis-tetrahydrofuranylurethane that are potent against multi-PI-resistant HIV-1 variants in vitro.
2010 Aug
In vitro activity of antiretroviral drugs against Plasmodium falciparum.
2011 Nov
Activity of human immunodeficiency virus type 1 protease inhibitors against the initial autocleavage in Gag-Pol polyprotein processing.
2012 Jul
Early identification of clinically relevant drug interactions with the human bile salt export pump (BSEP/ABCB11).
2013 Dec
GRL-0519, a novel oxatricyclic ligand-containing nonpeptidic HIV-1 protease inhibitor (PI), potently suppresses replication of a wide spectrum of multi-PI-resistant HIV-1 variants in vitro.
2013 May
P2' benzene carboxylic acid moiety is associated with decrease in cellular uptake: evaluation of novel nonpeptidic HIV-1 protease inhibitors containing P2 bis-tetrahydrofuran moiety.
2013 Oct
Substrate envelope-designed potent HIV-1 protease inhibitors to avoid drug resistance.
2013 Sep 19
Patents

Sample Use Guides

Adults: 500 mg APTIVUS® (tipranavir), co-administered with 200 mg ritonavir, twice daily. Pediatric patients (age 2 to 18 years): Dosing is based on body weight or body surface area not to exceed adult dose.
Route of Administration: Oral
Tipranavir inhibits the replication of laboratory strains of HIV-1 and clinical isolates in acute models of T-cell infection, with EC50 ranging from 0.03 to 0.07 µM (18-42 ng/mL)
Name Type Language
TIPRANAVIR DISODIUM
USAN  
USAN  
Official Name English
TIPRANAVIR SODIUM [MART.]
Common Name English
TIPRANAVIR SODIUM
MART.   WHO-DD  
Common Name English
TIPRANAVIR DISODIUM [USAN]
Common Name English
Tipranavir Sodium [WHO-DD]
Common Name English
PNU-140690E
Code English
Classification Tree Code System Code
NCI_THESAURUS C97366
Created by admin on Fri Dec 15 15:55:09 GMT 2023 , Edited by admin on Fri Dec 15 15:55:09 GMT 2023
Code System Code Type Description
USAN
JJ-76
Created by admin on Fri Dec 15 15:55:09 GMT 2023 , Edited by admin on Fri Dec 15 15:55:09 GMT 2023
PRIMARY
EPA CompTox
DTXSID80940718
Created by admin on Fri Dec 15 15:55:09 GMT 2023 , Edited by admin on Fri Dec 15 15:55:09 GMT 2023
PRIMARY
PUBCHEM
163296
Created by admin on Fri Dec 15 15:55:09 GMT 2023 , Edited by admin on Fri Dec 15 15:55:09 GMT 2023
PRIMARY
CAS
191150-83-1
Created by admin on Fri Dec 15 15:55:09 GMT 2023 , Edited by admin on Fri Dec 15 15:55:09 GMT 2023
PRIMARY
FDA UNII
9BAN2XG1ZW
Created by admin on Fri Dec 15 15:55:09 GMT 2023 , Edited by admin on Fri Dec 15 15:55:09 GMT 2023
PRIMARY
NCI_THESAURUS
C66604
Created by admin on Fri Dec 15 15:55:09 GMT 2023 , Edited by admin on Fri Dec 15 15:55:09 GMT 2023
PRIMARY
DRUG BANK
DBSALT001882
Created by admin on Fri Dec 15 15:55:09 GMT 2023 , Edited by admin on Fri Dec 15 15:55:09 GMT 2023
PRIMARY
ChEMBL
CHEMBL222559
Created by admin on Fri Dec 15 15:55:09 GMT 2023 , Edited by admin on Fri Dec 15 15:55:09 GMT 2023
PRIMARY