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Tipranavir must be given with ritonavir to work effectively. When these two drugs are combined, there have been rare (sometimes fatal) cases of severe liver problems. Your doctor will monitor you closely and perform simple blood tests while you use this medication, especially if you also have infections that affect the liver (chronic hepatitis B or hepatitis C). Patients being treated with tipranavir and ritonavir may rarely have a serious (sometimes fatal) bleeding problem in the brain (intracranial hemorrhage). This effect may be due to other drugs you are taking or conditions you may have, so do not stop taking tipranavir and ritonavir without consulting your doctor. Get medical help right away if you develop severe stomach/abdominal pain, unusual tiredness, loss of appetite, dark urine, yellowing eyes/skin, unusual bleeding or bruising, or mental/mood changes.

Diarrhea, nausea, drowsiness, dizziness, headache or vomiting may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly. Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects. As your immune system gets stronger, it can begin to fight off infections you already had, possibly causing disease symptoms to come back. You could also have symptoms if your immune system becomes overactive. This reaction may happen at any time (soon after starting HIV treatment or many months later). Get medical help right away if you have any serious symptoms, including: unexplained weight loss, severe tiredness, muscle aches/weakness that doesn't go away, headaches that are severe or don't go away, joint pain, numbness/tingling of the hands/feet/arms/legs, vision changes, signs of infection (such as fever, chills, swollen lymph nodes, trouble breathing, cough, non-healing skin sores), signs of an overactive thyroid (such as irritability, nervousness, heat intolerance, fast/pounding/irregular heartbeat, bulging eyes, unusual growth in the neck/thyroid known as a goiter), signs of a certain nerve problem known as Guillain-Barre syndrome (such as unsteadiness, loss of coordination, trouble swallowing/speaking/chewing, trouble moving your eyes). Tell your doctor right away if you have any serious side effects, including: depression, increased thirst, signs of kidney problems (such as change in the amount of urine). Get medical help right away if you have any very serious side effects, including: symptoms of a heart attack (such as chest/jaw/left arm pain, shortness of breath, unusual sweating). Changes in body fat may occur while you are taking this medication (such as increased fat in the upper back and stomach areas, decreased fat in the arms and legs). The cause and long-term effects of these changes are unknown. Discuss the risks and benefits of therapy with your doctor, as well as the possible role of exercise to reduce this side effect. A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing. Tipranavir can commonly cause a mild rash that is usually not serious. However, you may not be able to tell it apart from a rare rash that could be a sign of a severe allergic reaction. Get medical help right away if you develop a rash. Taking estrogen (in birth control or hormone therapy) may increase your risk of developing this rash. This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist. In the US - Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch. In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Some products that may interact with this drug include: antiplatelet drugs (such as clopidogrel), artemether, "blood thinners" (anticoagulants such as warfarin, heparins), NSAIDs (such as ibuprofen, naproxen, sulindac, indomethacin), disulfiram, estrogens (such as ethinyl estradiol), garlic supplements, vitamin E, lumefantrine, metronidazole, orlistat. Other medications can affect the removal of tipranavir from your body, which may affect how tipranavir works. Examples include apalutamide, macrolide antibiotics (such as erythromycin), rifampin, St. John's wort, drugs used to treat seizures (such as carbamazepine, phenytoin), among others. Tipranavir with ritonavir can both speed up and slow down the removal of other drugs from your body, thereby affecting how they work. Examples of affected drugs include alfuzosin, certain benzodiazepines (such as midazolam, triazolam), certain heart rhythm drugs (amiodarone, bepridil, flecainide, propafenone, quinidine), colchicine, eletriptan, eplerenone, ergot-containing drugs (such as ergotamine), fluticasone, other HIV medications (such as etravirine, other protease inhibitors including fosamprenavir, lopinavir), meperidine, pimozide, ranolazine, salmeterol, certain "statin" cholesterol drugs (such as atorvastatin, lovastatin, simvastatin), drugs to treat erectile dysfunction-ED or pulmonary hypertension (such as sildenafil, vardenafil), among others. Aspirin can increase the risk of bleeding when used with this medication. However, if your doctor has told you to take low-dose aspirin to prevent heart attack or stroke (usually 81-162 milligrams a day), you should keep taking the aspirin unless your doctor tells you not to. Ask your doctor or pharmacist for more details. This medication may decrease the effectiveness of hormonal birth control such as pills, patch, or ring. This could cause pregnancy. Discuss with your doctor or pharmacist if you should use reliable backup birth control methods while using this medication. Also tell your doctor if you have any new spotting or breakthrough bleeding, because these may be signs that your birth control is not working well.