Omeprazole and Tipranavir: Interaction Details
AI-assisted, pharmacist-reviewed · AI content regenerated Jul 11, 2026 · Source data updated Jul 2, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Tipranavir
Omeprazole
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
Let's talk about taking tipranavir (Aptivus), an HIV medicine, together with omeprazole (Prilosec), which lowers stomach acid for heartburn or reflux.
Over time, tipranavir (given with ritonavir) speeds up the enzyme in your body that breaks down omeprazole. That means your body clears the omeprazole faster, so there may be less of it working for you. In plain terms, your heartburn or reflux medicine may not do its job as well. The good news is this is very manageable. Your care team may simply adjust your omeprazole dose so it keeps working. Keep taking both as prescribed, and let your pharmacist or doctor know if your stomach symptoms come back.
Effect: Decreased omeprazole exposure with potential loss of acid-suppression efficacy.
Mechanism: Tipranavir/ritonavir produces modest CYP2C19 inhibition after the first dose but marked induction at steady state. Omeprazole is a CYP2C19 substrate, so its metabolism accelerates, lowering AUC/Cmax.
- Direction: Reduced omeprazole effect (net induction predominates).
- Onset: Delayed (steady state).
- Evidence: Established (phenotypic studies in healthy volunteers).
- Management: Omeprazole dose may need to be increased and individualized; monitor for return of GERD/acid-related symptoms.
What happens
Decreased omeprazole concentrations
Interaction Deep Dive
Phenotypic evaluations conducted in healthy volunteers showed that giving tipranavir/ritonavir produced modest inhibition of CYP2C19 (assessed using omeprazole) after the initial dose, but pronounced induction once steady state was reached. As a result, taking tipranavir together with omeprazole may lower omeprazole levels and diminish its effectiveness. When co-administered with tipranavir and ritonavir, an increase in the omeprazole dose may be required1.
Why it happens (mechanism)
Induction of CYP2C19-mediated omeprazole metabolism at steady state
How to manage this interaction
This interaction is usually easy for your care team to manage. Because tipranavir plus ritonavir can lower omeprazole levels over time, your omeprazole may work less well.
- Keep taking both medicines exactly as prescribed unless your provider tells you otherwise.
- Your omeprazole dose may need to be increased and tailored to you by your care team.
- Watch for returning symptoms like heartburn, acid reflux, or stomach discomfort, and report them.
Raise any concerns with your pharmacist or prescriber so they can adjust and monitor as needed.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Omeprazole and Tipranavir together?
Tipranavir with ritonavir can lower omeprazole levels over time, so your reflux medicine may work less well; your care team may increase and individualize the omeprazole dose. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Omeprazole and Tipranavir interaction?
It is rated moderate. Can be significant — usually manageable with monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How is the Omeprazole and Tipranavir interaction managed?
This interaction is usually easy for your care team to manage. Because tipranavir plus ritonavir can lower omeprazole levels over time, your omeprazole may work less well. Keep taking both medicines exactly as prescribed unless your provider tells you otherwise. Your omeprazole dose may need to be increased and tailored to you by your care team. Watch for returning symptoms like heartburn, acid re… Management is individual — always follow your own care team's guidance.
How strong is the evidence for this interaction?
The evidence is graded "established". Well documented — supported by controlled studies or strong clinical data.
From our Q&A
Real reader questions about these medications, each personally answered by our pharmacist:
Questions for your pharmacist
- Does my dose of Omeprazole or Tipranavir need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there anything you'd monitor while I'm on both?
References (1)
- Product Information: APTIVUS(R) oral capsules, tipranavir oral capsules. Boehringer Ingelheim Pharmaceuticals,Inc, Ridgefield, CT, 2007. DailyMed
Keep reading about Tipranavir
Keep reading about Omeprazole
These medications also interact with supplements
Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
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