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
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
DescriptionCurator'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
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
Sources: https://www.ncbi.nlm.nih.gov/pubmed/22514580
Curator's Comment: Tipranavir do not reach therapeutical concentrations in CSF
Originator
Sources: http://adisinsight.springer.com/drugs/800008750
Curator's Comment: # Pharmacia & Upjohn (now Pfizer)
Approval Year
Targets
Primary Target | Pharmacology | Condition | Potency |
---|---|---|---|
Target ID: CHEMBL243 |
8.0 pM [Ki] |
Conditions
Condition | Modality | Targets | Highest Phase | Product |
---|---|---|---|---|
Primary | APTIVUS Approved UseAPTIVUS, 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 Date2005 |
Cmax
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
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
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
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
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
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
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
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
Dose | Population | Adverse 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%) Sources: Page: p.11Gastrointestinal 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%) |
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 Sources: Page: p.1Hepatic decompensation Intracranial hemorrhage Platelet aggregation Coagulation abnormal Diabetes mellitus Hyperglycemia Immune reconstitution syndrome Fat redistribution Lipids increased |
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
AE | Significance | Dose | Population |
---|---|---|---|
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 |
Overview
CYP3A4 | CYP2C9 | CYP2D6 | hERG |
---|---|---|---|
OverviewOther
Other Inhibitor | Other Substrate | Other Inducer |
---|---|---|
Drug as perpetrator
Drug as victim
Target | Modality | Activity | Metabolite | Clinical evidence |
---|---|---|---|---|
Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2005/21814_000_Aptivus_biopharmr2.pdf Page: 96.0 |
no | |||
Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2005/21814_000_Aptivus_biopharmr1.pdf Page: 2, 7, 34 |
yes | |||
Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2005/21814_000_Aptivus_biopharmr2.pdf Page: 96.0 |
yes | yes (co-administration study) Comment: coadministration with ketaconazole inhibited the metabolism of tipranavir by 90% Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2005/21814_000_Aptivus_biopharmr2.pdf Page: 96.0 |
Tox targets
Target | Modality | Activity | Metabolite | Clinical evidence |
---|---|---|---|---|
Page: 4, 10, 16, 17 |
PubMed
Title | Date | PubMed |
---|---|---|
Structure-based design of HIV protease inhibitors: sulfonamide-containing 5,6-dihydro-4-hydroxy-2-pyrones as non-peptidic inhibitors. | 1996 Oct 25 |
|
Antiviral activity of the dihydropyrone PNU-140690, a new nonpeptidic human immunodeficiency virus protease inhibitor. | 1997 May |
|
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 |
|
Two sulfonamides-containing dihydropyrone derivatives as HIV protease inhibitors. | 2001 Jul |
|
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 |
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
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Classification Tree | Code System | Code | ||
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NCI_THESAURUS |
C97366
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JJ-76
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DTXSID80940718
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163296
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191150-83-1
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9BAN2XG1ZW
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C66604
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DBSALT001882
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CHEMBL222559
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ACTIVE MOIETY
SUBSTANCE RECORD