Drug & supplement interaction

Adrafinil + tipranavir

tipranavir brand name: Aptivus.

Moderate Interaction
Medically reviewed by · Updated September 2026
The bottom line Moderate

tipranavir falls into 5 drug categories that Adrafinil can interact with; the most serious is rated moderate. Theoretically, adrafinil might increase the levels and clinical effects of CYP2C19 substrates.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions5
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Adrafinil and tipranavir

These two interact in 5 distinct ways. Each one is explained separately below.

Why Are There 5 Interactions?

Adrafinil interacts with whole categories of medication. tipranavir falls into 5 of those categories, so it can interact with Adrafinil in 5 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

CYTOCHROME P450 2C19 (CYP2C19) SUBSTRATES

1 of 5

Why this applies to tipranavir

tipranavir falls under CYTOCHROME P450 2C19 (CYP2C19) SUBSTRATES — the group Adrafinil interacts with.

Theoretically, adrafinil might increase the levels and clinical effects of CYP2C19 substrates.
Adrafinil is a precursor to the stimulant prescription drug modafinil. Modafinil has been shown to inhibit CYP2C19 activity in vitro.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the gist with adrafinil and tipranavir (Aptivus). Once your liver turns adrafinil into modafinil, that modafinil may gently slow down a liver enzyme called CYP2C19. Since tipranavir is partly handled by that same enzyme, the theory is that your tipranavir levels could nudge upward. Tipranavir is already an active drug (not a prodrug), so higher levels would mean a stronger drug effect and a greater chance of side effects like nausea, diarrhea, headache, rash, or stress on the liver.

I want to be honest: this is a theoretical concern based on lab data, not real-world cases, so it may not amount to much. Still, both adrafinil and tipranavir can be tough on the liver, so please check with your doctor or pharmacist before combining them.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Urban AE, Cubala WJ. The role of eugeroics in the treatment of affective disorders. Psychiatr Pol. 2020;54(1):21-33. PubMed
  2. Kumar R. Approved and investigational uses of modafinil: an evidence-based review. Drugs. 2008;68(13):1803-39. PubMed
  3. Provigil (modafinil) [package insert]. North Wales, PA: Teva Pharmaceuticals USA, Inc. Published: January 2015. Accessed on: Nov 11, 2022.
Moderate

CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES

2 of 5

tipranavir also falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES.

Theoretically, adrafinil might reduce the levels and clinical effects of CYP1A2 substrates.
Adrafinil is a precursor to the stimulant prescription drug modafinil. Modafinil has been shown to weakly induce CYP1A2 activity in vitro.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the basic idea with adrafinil and tipranavir (Aptivus). Once your liver turns adrafinil into modafinil, that modafinil may gently speed up an enzyme called CYP1A2, which is one of the pathways your body uses to break down certain drugs. In theory, speeding up that enzyme could lower the amount of tipranavir in your blood.

With an HIV medicine, keeping blood levels steady really matters. If levels drop too low, the virus has more room to multiply and could become resistant. That said, this concern is theoretical and based on lab studies, not real-world cases, and tipranavir is usually boosted with ritonavir anyway. Still, since this is HIV treatment, please run it by your doctor or pharmacist before combining them.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Urban AE, Cubala WJ. The role of eugeroics in the treatment of affective disorders. Psychiatr Pol. 2020;54(1):21-33. PubMed
  2. Kumar R. Approved and investigational uses of modafinil: an evidence-based review. Drugs. 2008;68(13):1803-39. PubMed
  3. Provigil (modafinil) [package insert]. North Wales, PA: Teva Pharmaceuticals USA, Inc. Published: January 2015. Accessed on: Nov 11, 2022.
Moderate

CYTOCHROME P450 3A4 (CYP3A4) INHIBITORS

3 of 5

tipranavir also falls under CYTOCHROME P450 3A4 (CYP3A4) INHIBITORS.

Theoretically, drugs that inhibit CYP3A4 might increase the levels and clinical effects of adrafinil.
Adrafinil is a precursor to the stimulant prescription drug modafinil. Modafinil is metabolized by CYP3A4.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the gist for this pairing. Tipranavir (Aptivus), which you take with ritonavir for HIV, blocks a liver enzyme called CYP3A4. That same enzyme handles modafinil, the active stimulant your body makes from adrafinil. So if you slow that enzyme down, modafinil can hang around longer and build up.

In plain terms, the wakefulness effect could get stronger than expected, and so could side effects like a racing heart, jitteriness, trouble sleeping, headache, and higher blood pressure. This is a theoretical concern based on how the drugs work, not proven in studies, so don't panic. Still, adrafinil is unregulated and rough on the liver, and so is this HIV regimen. Please run it by your doctor or pharmacist before combining them.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Urban AE, Cubala WJ. The role of eugeroics in the treatment of affective disorders. Psychiatr Pol. 2020;54(1):21-33. PubMed
  2. Provigil (modafinil) [package insert]. North Wales, PA: Teva Pharmaceuticals USA, Inc. Published: January 2015. Accessed on: Nov 11, 2022.
Moderate

CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES

4 of 5

tipranavir also falls under CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES.

Theoretically, adrafinil might increase the levels and clinical effects of CYP2C9 substrates.
Adrafinil is a precursor to the stimulant prescription drug modafinil. Modafinil has been shown to reduce CYP2C9 expression in vitro.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the gist for tipranavir (Aptivus). Adrafinil itself doesn't do much until your liver turns it into modafinil. There's a lab-based idea that modafinil can slow down a liver enzyme called CYP2C9, which helps clear certain medicines. Tipranavir is partly handled by that enzyme, so in theory blocking it could let tipranavir build up a bit, possibly nudging up side effects like nausea, diarrhea, stomach upset, or fatigue.

I want to be honest though: this is theoretical, based only on test-tube data, not real patient cases. Tipranavir is also mainly processed by a different enzyme (CYP3A4), so the practical effect here is likely small. Still, since you're on HIV therapy, please run any adrafinil use past your doctor or pharmacist first.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Urban AE, Cubala WJ. The role of eugeroics in the treatment of affective disorders. Psychiatr Pol. 2020;54(1):21-33. PubMed
  2. Kumar R. Approved and investigational uses of modafinil: an evidence-based review. Drugs. 2008;68(13):1803-39. PubMed
Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

5 of 5

tipranavir also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.

Theoretically, adrafanil might reduce levels and clinical effects of CYP3A4 substrates.
Adrafinil is a precursor to the stimulant prescription drug modafinil. Modafinil has been shown to weakly induce CYP3A4 activity.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the concern with pairing adrafinil and tipranavir (Aptivus). Once your liver turns adrafinil into modafinil, that modafinil can mildly speed up an enzyme called CYP3A4, which is one of the main pathways your body uses to handle tipranavir. Speeding up that pathway could, in theory, clear tipranavir a bit faster and lower its blood levels.

Why does that matter? Tipranavir is part of your HIV treatment, and lower levels could mean it works less well at keeping the virus controlled. That's the worry with any HIV medicine. To be fair, this is a theoretical interaction based on how the drugs behave, not strong real-world studies, and the enzyme effect is described as weak. Still, with HIV therapy you don't want to gamble. Please run this by your pharmacist or doctor before combining them.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Urban AE, Cubala WJ. The role of eugeroics in the treatment of affective disorders. Psychiatr Pol. 2020;54(1):21-33. PubMed
  2. Provigil (modafinil) [package insert]. North Wales, PA: Teva Pharmaceuticals USA, Inc. Published: January 2015. Accessed on: Nov 11, 2022.

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Adrafinil Also Interacts With Other Medications

Adrafinil has 1 major, 1,055 moderate known drug interactions in our database — the tipranavir one above is among them. If you take anything else, check it against the full list below.

Major 1 Moderate 1,055 No known interaction 1,774 (incl. tipranavir)
Taking anything else?

Check Another of Your Medications Against Adrafinil

Covers the 2,830 medications we’ve checked against Adrafinil. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With tipranavir

This page covers Adrafinil only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the tipranavir page lists 212 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Grapefruit (major), St. John's Wort (major), 1,3-dmaa (moderate) and Acacia Rigidula (moderate).

By severity: 3 major · 165 moderate · 44 minor.

From our pharmacist’s overview on the tipranavir page

“Keeping tipranavir (Aptivus) at a steady blood level is what keeps HIV suppressed, so this is a supplement list that deserves genuine care, and the three major-rated entries come first. St.”

Reviewed by 2 · Jul 18, 2026

Open the tipranavir interaction page

One more smart check

Taking Adrafinil as Part of a Dietary Supplement Product? Check It for Interactions

We hold 7 real supplement products containing Adrafinil, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Adrafinil. Your product may carry other ingredients that interact with tipranavir too, on top of Adrafinil — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Adrafinil and tipranavir Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Adrafinil
Top half

#496 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication tipranavir
Steady interest

#1,735 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Adrafinil

What is Adrafinil?

Adrafinil
  • Wakefulness and alertness
  • Fatigue
  • Focus and concentration
  • Cognitive enhancement (nootropic)
  • Daytime sleepiness

Adrafinil is a synthetic compound that the body converts into modafinil, a prescription wakefulness-promoting drug. It is sometimes sold as a nootropic supplement, but it is unregulated, carries real risks (especially to the liver), and is banned in some sports and countries. Talk with a doctor or pharmacist before using it.

Read the full Adrafinil monograph & all interactions
Medication

About Tipranavir

What Is Tipranavir Used For?

Brand name: Aptivus

Aptivus (tipranavir) is used to treat HIV-1 infection in adults and in pediatric patients weighing at least 36 kg (about 79 lbs). It is specifically for people who have already tried other HIV treatments and whose virus has become resistant to more than one protease inhibitor. It is always taken together with a low dose of ritonavir and with other HIV medications.

Aptivus is not recommended for people who have never taken HIV treatment before (treatment-naïve patients). Using tipranavir alongside additional active HIV drugs improves the chances of it working well.

See full Tipranavir drug information
Keep checking

Other Drugs & Adrafinil

Browse every other medication we’ve checked against Adrafinil — both the ones with a known interaction and the ones without. Select any drug for the full detail.

1Major
1,055Moderate
0Minor
1,773No known interaction
1 Major 1,055 Moderate 1,773 No interaction
Major

1 interaction

Moderate

1,055 interactions

Showing 60 of 1,055 moderate interactions — see all 1,055 on the Adrafinil page.

No interaction 1,773 drugs checked — show the list

We also checked Adrafinil against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 1,773 medications checked with no known interaction — see the full Adrafinil list.

See the full Adrafinil interactions page
See every supplement checked against tipranavir, ranked by severity
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

Keep exploring
Adrafinil monograph › Uses, safety, and every drug interaction in one place tipranavir supplement interactions › Every supplement checked against tipranavir, ranked by severity Tipranavir drug information › The full plain-English guide to this medication Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Adrafinil and tipranavir Together: Common Questions

Can you take Adrafinil with tipranavir?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
Why are there 5 interactions listed for Adrafinil and tipranavir?
tipranavir belongs to more than one drug category, and Adrafinil interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Adrafinil and tipranavir interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About tipranavir and Adrafinil?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.