Cannabis + tipranavir
tipranavir brand name: Aptivus.
tipranavir falls into 6 drug categories that Cannabis can interact with; the most serious is rated moderate. Theoretically, CYP3A4 inhibitors might increase the levels and adverse effects of cannabis.
Read the full interaction reportCannabis and tipranavir
These two interact in 6 distinct ways. Each one is explained separately below.
Why Are There 6 Interactions?
Cannabis interacts with whole categories of medication. tipranavir falls into 6 of those categories, so it can interact with Cannabis in 6 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).
CYTOCHROME P450 3A4 (CYP3A4) INHIBITORS
1 of 6Why this applies to tipranavir
tipranavir falls under CYTOCHROME P450 3A4 (CYP3A4) INHIBITORS — the group Cannabis interacts with.
Delta-9-tetrahydrocannabinol (THC), an active constituent of cannabis, is a substrate of CYP3A4 enzymes.
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.
Here's the gist for tipranavir (Aptivus). It's always taken with ritonavir, and that combo is a strong brake on a liver enzyme called CYP3A4. Your body uses that same enzyme to break down THC, the part of cannabis that gets you high. So when you slow down that cleanup crew, THC can hang around longer and build up.
In plain terms, the cannabis effects (feeling stoned, dizzy, sleepy, a racing heart, or feeling anxious) could hit harder or last longer than you expect. This is a theoretical concern based on how these drugs work, not something proven in studies, so don't panic. Still, please check with your doctor or pharmacist before mixing them, since your HIV treatment matters too much to guess on.
- Product information for Marinol. AbbVie. North Chicago, IL 60064. August 2017. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/018651s029lbl.pdf.
CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES
2 of 6tipranavir also falls under CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES.
In vitro research shows that the cannabis constituents delta-9-tetrahydrocannabinol (THC), cannabidiol (CBD), and cannabinol moderately inhibit the CYP2C9-mediated 7-hydroxylation of S-warfarin in a concentration-dependent manner. In vitro research also shows that cannabis extracts modestly inhibit the CYP2C9 metabolism of tolbutamide; extracts providing the specific cannabinoids CBD and cannabigerol (CBG) had stronger inhibitory effects than extracts containing THC and CBD.
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.
Here's the basic idea: cannabis (its THC and CBD components) may gently slow down a liver enzyme called CYP2C9, which is one of the pathways your body uses to clear certain drugs. Tipranavir isn't a prodrug, so if that enzyme is blocked, the medication could linger a bit longer in your system, which could mean stronger effects and a higher chance of side effects like nausea, diarrhea, headache, fatigue, or changes in your liver labs.
That said, this is a theoretical concern based only on lab studies, not real-world patient reports. Tipranavir is mainly handled by a different enzyme (CYP3A), so CYP2C9 likely plays a small role here. Still, since this is a key HIV medication, it's worth mentioning your cannabis use to your pharmacist or doctor.
- Damkier P, Lassen D, Christensen MMH, Madsen KG, Hellfritzsch M, Pottegård A. Interaction between warfarin and cannabis. Basic Clin Pharmacol Toxicol. 2019;124(1):28-31. PubMed
- Treyer A, Reinhardt JK, Eigenmann DE, Oufir M, Hamburger M. Phytochemical comparison of medicinal cannabis extracts and study of their CYP-mediated interactions with coumarinic oral anticoagulants. Med Cannabis Cannabinoids. 2023;6(1):21-31. PubMed
CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES
3 of 6tipranavir also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.
In vitro research shows that cannabis can inhibit the activity of CYP3A4 enzymes, which might decrease the metabolism of CYP3A4 substrates. In vitro research also shows that cannabis extracts modestly inhibit the CYP3A4 metabolism of testosterone; extracts providing the specific cannabinoids CBD and cannabigerol (CBG) had stronger inhibitory effects than extracts containing THC and CBD.
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.
Here's the basic idea with tipranavir (Aptivus). Your body uses an enzyme called CYP3A4 to help break this drug down. Lab studies suggest cannabis may slow that enzyme a bit. If that happened in real life, tipranavir levels could creep up, which in theory means a higher chance of side effects like nausea, diarrhea, headache, rash, or stress on your liver.
I want to be honest about how solid this is: the evidence here comes from test-tube and animal research only, not from people, so it's mostly theoretical. Tipranavir is already a tricky drug taken with ritonavir, so I wouldn't add or stop cannabis on your own. Just give your pharmacist or HIV doctor a heads-up so they can keep an eye on you.
- Pellinen, P., Honkakoski, P., Stenback, F., Niemitz, M., Alhava, E., Pelkonen, O., Lang, M. A., and Pasanen, M. Cocaine N-demethylation and the metabolism-related hepatotoxicity can be prevented by cytochrome P450 3A inhibitors. Eur.J Pharmacol 1-3-1994;2 PubMed
- Treyer A, Reinhardt JK, Eigenmann DE, Oufir M, Hamburger M. Phytochemical comparison of medicinal cannabis extracts and study of their CYP-mediated interactions with coumarinic oral anticoagulants. Med Cannabis Cannabinoids. 2023;6(1):21-31. PubMed
P-GLYCOPROTEIN SUBSTRATES
4 of 6tipranavir also falls under P-GLYCOPROTEIN SUBSTRATES.
Most in vitro research suggests that constituents of cannabis, including cannabidiol (CBD) and delta-9-tetrahydrocannabinol (THC), can inhibit P-gp and increase the accumulation of probe compounds by reducing P-gp mediated drug efflux. In vitro studies in kidney cell lines show that a 1-hour exposure to CBD and THC inhibits P-gp. Cannabis may also alter the expression of P-gp, although this effect appears to vary based on duration of exposure. Some in vitro research in lymphoblastoid leukemia cell lines indicates that a 1-hour exposure to cannabinoids does not affect P-gp expression, while a prolonged 72-hour exposure decreases P-gp expression. Other in vitro research in these cell lines shows that a 4-hour exposure to THC and CBD induces P-gp gene expression, while exposure for longer than 4 hours and up to 48 hours does not induce P-gp gene expression.
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.
Here's the gist for tipranavir (Aptivus). Your body uses a kind of cellular pump called P-glycoprotein to push certain drugs back out of cells, and tipranavir rides along with that pump. Lab studies hint that cannabis compounds (THC and CBD) may slow this pump down. If that happened in real life, a bit more tipranavir could stay in your system, which might mean stronger side effects like nausea, stomach upset, tiredness, or changes in liver tests.
I want to be honest: this is theoretical, based only on cell and animal research, not real-world cases. Tipranavir is too important to your HIV treatment to guess with, though. Please loop in your pharmacist or HIV doctor before mixing in cannabis.
- Zhu, H. J., Wang, J. S., Markowitz, J. S., Donovan, J. L., Gibson, B. B., Gefroh, H. A., and Devane, C. L. Characterization of P-glycoprotein inhibition by major cannabinoids from marijuana. J Pharmacol Exp.Ther. 2006;317(2):850-857. PubMed
- Holland, M. L., Panetta, J. A., Hoskins, J. M., Bebawy, M., Roufogalis, B. D., Allen, J. D., and Arnold, J. C. The effects of cannabinoids on P-glycoprotein transport and expression in multidrug resistant cells. Biochem.Pharmacol 4-14-2006;71(8):1146-115 PubMed
- Tournier N, Lucie Chevillard L, Megarbane B, et al. Interaction of drugs of abuse and maintenance treatments with human P-glycoprotein (ABCB1) and breast cancer resistance protein (ABCG2). Int J Neuropsychopharmacol. 2010;13(7):905-15. PubMed
- Arnold JC, Hone P, Holland ML, Allen JD. CB2 and TRPV1 receptors mediate cannabinoid actions on MDR1 expression in multidrug resistant cells. Pharmacol Rep. 2012;64(3):751-7. PubMed
CYTOCHROME P450 3A4 (CYP3A4) INDUCERS
5 of 6tipranavir also falls under CYTOCHROME P450 3A4 (CYP3A4) INDUCERS.
Delta-9-tetrahydrocannabinol (THC), an active constituent of cannabis, is a substrate of CYP3A4 enzymes.
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.
Here's the key thing to understand about this pairing: it's the cannabis that may be affected, not your HIV medication. Tipranavir (taken with ritonavir) acts as a CYP3A4 inducer, meaning it can speed up the enzyme that breaks down THC, the active compound in cannabis. In theory, that could clear THC from your body a bit faster, so the cannabis might feel weaker or wear off sooner than you'd expect.
I want to be honest that this is a theoretical concern based on how these drugs work, not something proven in studies. It won't reduce how well tipranavir controls your HIV. Still, if you use cannabis, please mention it to your doctor or pharmacist so they can keep an eye on the whole picture.
- Product information for Marinol. AbbVie. North Chicago, IL 60064. August 2017. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/018651s029lbl.pdf.
CYTOCHROME P450 2C19 (CYP2C19) SUBSTRATES
6 of 6tipranavir also falls under CYTOCHROME P450 2C19 (CYP2C19) SUBSTRATES.
Research shows that cannabidiol (CBD), a constituent of cannabis, inhibits CYP2C19. In clinical studies and case reports, cannabidiol use resulted in significant increases in the serum levels of topiramate, methadone, citalopram, omeprazole, and N-desmethylclobazam, the primary active metabolite of clobazam. These chemicals are metabolized by CYP2C19. Concomitant use of cannabis with CYP2C19 substrates may increase the risk for adverse effects from these substrates.
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.
Here's the gist for tipranavir (Aptivus). The CBD in cannabis can gently slow down a liver enzyme called CYP2C19, which is one of the pathways that helps clear tipranavir from your body. When that pathway slows, levels of the drug can creep up a bit, which in theory could mean more of tipranavir's usual side effects, things like nausea, diarrhea, stomach upset, or changes in your liver tests.
I want to be honest about how solid this is: it's a theoretical concern based on how these chemicals behave, not something proven for tipranavir specifically. Tipranavir is already taken with ritonavir, so its handling in the body is complex. Before you mix cannabis with this regimen, please loop in your HIV doctor or pharmacist so they can keep an eye on you.
- Harvey DJ. Absorption, distribution, and biotransformation of the cannabinoids. Marijuana and Medicine. 1999;91-103. DOI
- Bornheim LM, Everhart ET, Li J, Correia MA. Characterization of cannabidiol-mediated cytochrome P450 inactivation. Biochem Pharmacol 1993;45(6):1323-31. PubMed
- Gaston TE, Bebin EM, Cutter GR, Liu Y, Szaflarski JP; UAB CBD Program. Interactions between cannabidiol and commonly used antiepileptic drugs. Epilepsia. 2017 Sep;58(9):1586-92. PubMed
- Devinsky O, Marsh E, Friedman D, et la. Cannabidiol in patients with treatment-resistant epilepsy: an open-label interventional trial. Lancet Neurol. 2016 Mar;15(3):270-8.
- Geffrey AL, Pollack SF, Bruno PL, Thiele EA. Drug-drug interaction between clobazam and cannabidiol in children with refractory epilepsy. Epilepsia. 2015 Aug;56(8):1246-51. PubMed
- Madden K, Tanco K, Bruera E. Clinically Significant Drug-Drug Interaction Between Methadone and Cannabidiol. Pediatrics. 2020;e20193256. PubMed
- Anderson LL, Doohan PT, Oldfield L, et al. Citalopram and Cannabidiol: In Vitro and In Vivo Evidence of Pharmacokinetic Interactions Relevant to the Treatment of Anxiety Disorders in Young People. J Clin Psychopharmacol. 2021. PubMed
- Nasrin S, Watson CJW, Perez-Paramo YX, Lazarus P. Cannabinoid Metabolites as Inhibitors of Major Hepatic CYP450 Enzymes, with Implications for Cannabis-Drug Interactions. Drug Metab Dispos 2021;49(12):1070-1080. PubMed
- Bansal S, Zamarripa CA, Spindle TR, et al. Evaluation of Cytochrome P450-Mediated Cannabinoid-Drug Interactions in Healthy Adult Participants. Clin Pharmacol Ther 2023.
What These Ratings Mean
Every interaction above is graded three ways — here’s the key to each label.
Clinically significant. Avoid the combination, or use only under close professional supervision.
Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.
Generally not serious. Be aware of it and mention it to your pharmacist.
- 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.
- 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.
Cannabis Also Interacts With Other Medications
Cannabis has 2 major, 1,108 moderate, 25 minor 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.
Check Another of Your Medications Against Cannabis
We haven’t checked that one against Cannabis yet — ask our pharmacists directly.
Covers the 2,830 medications we’ve checked against Cannabis. Pick one to open its full report.
Questions About Cannabis or tipranavir
These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Cannabis or tipranavir, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:
Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.
See Every Supplement That Interacts With tipranavir
This page covers Cannabis 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
Taking Cannabis as Part of a Dietary Supplement Product? Check It for Interactions
We hold 21 real supplement products containing Cannabis, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Cannabis. Your product may carry other ingredients that interact with tipranavir too, on top of Cannabis — and those would not show on this page. Find your product and we’ll check every ingredient on its label:
Where Cannabis 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.
#240 of 1,452 supplements looked up here in the last 7 days
#2,017 of 2,830 medications looked up here in the last 7 days
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.
About Cannabis
What is Cannabis?
- Chronic pain
- Nausea and vomiting from chemotherapy
- Muscle spasticity (e.g., multiple sclerosis)
- Anxiety and stress
- Sleep problems
- Appetite stimulation
Cannabis contains many active compounds, mainly THC (which causes a 'high') and CBD (which does not). Some uses, such as chemotherapy-related nausea, certain seizure disorders, and muscle spasticity, have meaningful evidence, while many other popular uses are not well proven. It can cause real side effects and impairment, so talk to your doctor or pharmacist and follow your local laws before using it.
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.
Other Drugs & Cannabis
Browse every other medication we’ve checked against Cannabis — both the ones with a known interaction and the ones without. Select any drug for the full detail.
No drugs match “”.
2 interactions
1,108 interactions
- Diclofenac Sodium ›
- Diltiazem ›
- Theophylline ›
- Nifedipine ›
- Ibuprofen ›
- Metronidazole ›
- Diphenhydramine ›
- Aspirin ›
- Hydrocortisone ›
- Naproxen ›
- Doxycycline ›
- Erythromycin ›
- Estradiol ›
- Minocycline ›
- Propranolol ›
- Tetracycline ›
- Lidocaine ›
- Ranitidine ›
- Norethindrone ›
- Testosterone ›
- Verapamil ›
- Fenofibrate ›
- Levonorgestrel ›
- Prednisone ›
- Quinidine ›
- Cyclosporine ›
- Dexamethasone ›
- Flurazepam ›
- Glyburide ›
- Triazolam ›
- Zopiclone ›
- Ciprofloxacin ›
- Colchicine ›
- Fentanyl ›
- Flurbiprofen ›
- Oxybutynin ›
- Oxycodone ›
- Phenytoin ›
- Prednisolone ›
- Tacrolimus ›
- Temazepam ›
- Triamcinolone ›
- Apomorphine ›
- Budesonide ›
- Carbamazepine ›
- Clindamycin ›
- Dextromethorphan ›
- Diclofenac Potassium ›
- Dipyridamole ›
- Doxorubicin ›
- Fluticasone ›
- Formoterol ›
- Indomethacin ›
- Miconazole ›
- Morphine Sulfate ›
- Nitrazepam ›
- Trimipramine ›
- Acetaminophen ›
- Buprenorphine ›
- Conjugated Estrogens ›
Showing 60 of 1,108 moderate interactions — see all 1,108 on the Cannabis page.
25 interactions
- Fluphenazine ›
- Asenapine ›
- Clozapine ›
- Prochlorperazine ›
- Acetophenazine ›
- Butaperazine ›
- Carphenazine ›
- Chlorprothixene ›
- Isopropamide Iodide ›
- Mesoridazine Besylate ›
- Methotrimeprazine Maleate ›
- Molindone ›
- Olanzapine ›
- Paliperidone ›
- Paliperidone Palmitate ›
- Pericyazine ›
- Perphenazine ›
- Piperacetazine ›
- Promazine ›
- Sertindole ›
- Thiothixene ›
- Trifluoperazine ›
- Triflupromazine ›
- Isopropamide, Trifluoperazine ›
- Isopropamide, Prochlorperazine ›
No interaction 1,694 drugs checked — show the list
We also checked Cannabis against these medications and found no known interaction in our sources. Open any page to confirm.
- Levothyroxine ›
- Methylphenidate ›
- Metoprolol ›
- Rosuvastatin ›
- Escitalopram ›
- Docusate ›
- Tirzepatide ›
- Methamphetamine ›
- Hydroxyurea ›
- Valacyclovir ›
- Sumatriptan ›
- Semaglutide ›
- Lisdexamfetamine ›
- Metformin ›
- Amoxicillin ›
- Lisinopril ›
- Isotretinoin ›
- Methotrexate ›
- Bendamustine ›
- Bupropion ›
- Amphetamine ›
- Acyclovir ›
- Azithromycin ›
- Dextroamphetamine ›
- Levothyroxine, Liothyronine ›
- Methylene Blue ›
- Duloxetine ›
- Bisoprolol ›
- Candesartan Cilexetil ›
- Amoxicillin, Clavulanate Potassium ›
- Cyclopentolate ›
- Cephalexin ›
- Mannitol ›
- Ezetimibe ›
- Spironolactone ›
- Dexmethylphenidate ›
- Levothyroxine Sodium ›
- Carbidopa, Levodopa ›
- Thyroid Hormone ›
- Pizotifen ›
- Levodopa ›
- Venlafaxine ›
- Daptomycin ›
- Nortriptyline ›
- Lenvatinib ›
- Mitomycin ›
- Canagliflozin, Metformin ›
- Magnesium Hydroxide (otc Drug) ›
- Flutemetamol F-18 ›
- Insulin Degludec, Liraglutide ›
- Pegunigalsidase Alfa-iwxj ›
- Cefaclor ›
- Bentoquatam ›
- Atenolol ›
- Factor 7a ›
- Alglucosidase Alpha ›
- Salbutamol Sulfate ›
- Hethylphenidate Hcl ›
- Azelaic Acid ›
- Minoxidil ›
Showing the 60 most looked-up of 1,694 medications checked with no known interaction — see the full Cannabis list.
Sources & How We Checked
Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference for vitamins, herbs and supplements — the basis for our interaction data.
- MedlinePlus, U.S. National Library of Medicine — NIH consumer drug information, used for the medication overviews.
- NIH Dietary Supplement Label Database (DSLD) — Official supplement product labels.
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
Taking Cannabis and tipranavir Together: Common Questions
Can you take Cannabis with tipranavir?
Why are there 6 interactions listed for Cannabis and tipranavir?
How serious is the Cannabis and tipranavir interaction?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
Still Have a Question About tipranavir and Cannabis?
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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.