Drug & supplement interaction

Gymnema + tipranavir

tipranavir brand name: Aptivus.

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

tipranavir falls into 3 drug categories that Gymnema can interact with; the most serious is rated moderate. Theoretically, gymnema might increase levels of drugs metabolized by CYP1A2.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions3
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Gymnema and tipranavir

These two interact in 3 distinct ways. Each one is explained separately below.

Why Are There 3 Interactions?

Gymnema interacts with whole categories of medication. tipranavir falls into 3 of those categories, so it can interact with Gymnema in 3 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES

1 of 3

Why this applies to tipranavir

tipranavir falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES — the group Gymnema interacts with.

Theoretically, gymnema might increase levels of drugs metabolized by CYP1A2.
Animal and in vitro research shows that gymnema can inhibit the CYP1A2 enzyme. In one animal study, oral administration of gymnema for 7 days increased the plasma concentrations of phenacetin, a CYP1A2 substrate, by about 1.4-fold and reduced the clearance of phenacetin by about 29%.
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 Gymnema and tipranavir (Aptivus). Your body uses a liver enzyme called CYP1A2 to help break down some medicines, and lab and animal studies hint that gymnema can slow that enzyme down a bit. If a drug clears more slowly, its levels can creep up, which can mean stronger effects and more side effects. For tipranavir, that might look like more nausea, diarrhea, stomach upset, or tiredness.

That said, this is theoretical and only based on test-tube and animal data, so I wouldn't lose sleep over it. Tipranavir is also mostly handled by other liver pathways, so CYP1A2 may play a small role here. Still, since keeping HIV therapy steady matters, please run gymnema past your pharmacist or doctor before starting it.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Rammohan B, Samit K, Chinmoy D, et al. Human cytochrome P450 enzyme modulation by gymnema sylvestre: a predictive safety evaluation by LC-MS/MS. Pharmacogn Mag. 2016 Jul;12(Suppl 4):S389-S394.
  2. Vaghela M, Sahu N, Kharkar P, Pandita N. In vivo pharmacokinetic interaction by ethanolic extract of gymnema sylvestre with CYP2C9 (tolbutamide), CYP3A4 (amlodipine) and CYP1A2 (phenacetin) in rats. Chem Biol Interact. 2017 Dec 25;278:141-151. PubMed
  3. Vaghela M, Iyer K, Pandita N. In vitro inhibitory effect of gymnema sylvestre extracts and total gymnemic acids fraction on select cytochrome P450 activities in rat liver microsomes. Eur J Drug Metab Pharmacokinet. 2017 Oct 10. PubMed
Moderate

CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES

2 of 3

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

Theoretically, gymnema might increase or decrease levels of drugs metabolized by CYP2C9.
Animal research shows that gymnema can induce the CYP2C9 enzyme. In one animal study, gymnema caused a 2.4-fold increase in the clearance of tolbutamide, a CYP2C9 substrate, in rats. In vitro research also shows that gymnema can inhibit CYP2C9.
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 honest picture: tipranavir (Aptivus) is partly handled by a liver enzyme called CYP2C9, and gymnema may nudge that enzyme either way. In animal studies it sped the enzyme up, which would clear a drug faster, but in lab dish studies it slowed the enzyme down. So the direction in real people isn't settled.

Why this matters for your HIV treatment: tipranavir needs to stay at a steady, effective level to keep the virus suppressed. If gymnema lowered your levels, the medicine could work less well over time. If it raised them, side effects like nausea, diarrhea, or liver strain might increase. This is theoretical and based only on animal and lab data, so don't panic, but please check with your pharmacist or doctor before adding gymnema.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Rammohan B, Samit K, Chinmoy D, et al. Human cytochrome P450 enzyme modulation by gymnema sylvestre: a predictive safety evaluation by LC-MS/MS. Pharmacogn Mag. 2016 Jul;12(Suppl 4):S389-S394.
  2. Vaghela M, Sahu N, Kharkar P, Pandita N. In vivo pharmacokinetic interaction by ethanolic extract of gymnema sylvestre with CYP2C9 (tolbutamide), CYP3A4 (amlodipine) and CYP1A2 (phenacetin) in rats. Chem Biol Interact. 2017 Dec 25;278:141-151. PubMed
  3. Vaghela M, Iyer K, Pandita N. In vitro inhibitory effect of gymnema sylvestre extracts and total gymnemic acids fraction on select cytochrome P450 activities in rat liver microsomes. Eur J Drug Metab Pharmacokinet. 2017 Oct 10. PubMed
Minor

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

3 of 3

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

Theoretically, gymnema might increase levels of drugs metabolized by CYP3A4.
One in vitro study using rat liver microsomes shows that gymnema can modestly inhibit the CYP3A4 enzyme. However, other in vitro research using human liver microsomes shows that gymnema does not affect CYP3A4 activity. Animal research also shows that gymnema does not alter the function of CYP3A4. In one study in rats, oral administration of gymnema for 7 days did not alter the clearance of amlodipine, a CYP3A4 substrate.
Severity Minor Likelihood Unlikely Evidence D

Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans..

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

Here's the gist for your HIV medicine, tipranavir (Aptivus). Your body clears tipranavir partly through a liver enzyme called CYP3A4. The idea on file is that gymnema might slow that enzyme down a little, which could in theory let tipranavir build up and bump up side effects like nausea, diarrhea, tiredness, or changes in your liver tests.

I want to be straight with you though: this concern comes only from lab and animal studies, and the results actually conflict. Some testing in human liver tissue showed gymnema did not affect this enzyme at all. So a real-world problem is unlikely. Since keeping your HIV treatment steady really matters, just run gymnema by your pharmacist or doctor before adding it.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Rammohan B, Samit K, Chinmoy D, et al. Human cytochrome P450 enzyme modulation by gymnema sylvestre: a predictive safety evaluation by LC-MS/MS. Pharmacogn Mag. 2016 Jul;12(Suppl 4):S389-S394.
  2. Vaghela M, Sahu N, Kharkar P, Pandita N. In vivo pharmacokinetic interaction by ethanolic extract of gymnema sylvestre with CYP2C9 (tolbutamide), CYP3A4 (amlodipine) and CYP1A2 (phenacetin) in rats. Chem Biol Interact. 2017 Dec 25;278:141-151. PubMed
  3. Vaghela M, Iyer K, Pandita N. In vitro inhibitory effect of gymnema sylvestre extracts and total gymnemic acids fraction on select cytochrome P450 activities in rat liver microsomes. Eur J Drug Metab Pharmacokinet. 2017 Oct 10. PubMed

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

Gymnema Also Interacts With Other Medications

Gymnema has 346 moderate, 504 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.

Moderate 346 Minor 504 No known interaction 1,980 (incl. tipranavir)
Taking anything else?

Check Another of Your Medications Against Gymnema

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

Everything else you take

See Every Supplement That Interacts With tipranavir

This page covers Gymnema 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 Gymnema as Part of a Dietary Supplement Product? Check It for Interactions

We hold 1,084 real supplement products containing Gymnema, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Gymnema. Your product may carry other ingredients that interact with tipranavir too, on top of Gymnema — 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 Gymnema 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 Gymnema
Top 25%

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

29 days ago today
Medication tipranavir
Steady interest

#1,947 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 Gymnema

What is Gymnema?

Gymnema
  • Blood sugar support
  • Type 2 diabetes
  • Sugar cravings
  • Weight management
  • Cholesterol support

Gymnema is an Ayurvedic herb best known for possibly helping lower blood sugar and reducing the taste of sweetness on the tongue. Some early human studies are encouraging for blood sugar support, but the evidence is still limited and not strong enough to replace standard treatment. If you have diabetes or take other medicines, talk with your pharmacist or doctor before using it.

Read the full Gymnema 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 & Gymnema

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

0Major
346Moderate
504Minor
1,979No known interaction
346 Moderate 504 Minor 1,979 No interaction
Moderate

346 interactions

Showing 60 of 346 moderate interactions — see all 346 on the Gymnema page.

Minor

504 interactions

Showing 60 of 504 minor interactions — see all 504 on the Gymnema page.

No interaction 1,979 drugs checked — show the list

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

Showing the 60 most looked-up of 1,979 medications checked with no known interaction — see the full Gymnema list.

See the full Gymnema 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
Gymnema 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 Gymnema and tipranavir Together: Common Questions

Can you take Gymnema 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 3 interactions listed for Gymnema and tipranavir?
tipranavir belongs to more than one drug category, and Gymnema 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 Gymnema 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 Gymnema?

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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.