Tinzaparin

Tinzaparin, an injected drug sold under the name of Innohep, is used to treat deep vein thrombosis, which is a condition in which blood clots form in the legs. This condition can be life-threatening if the clots travel to the lungs and cause a pulmonary embolism.

Overview

What is Tinzaparin?

Tinzaparin is a drug found in the form of a solution, which is injected under a doctor’s guidance, to break up harmful blood clots that form in the blood vessels of the legs. This condition is known as deep vein thrombosis, or DVT. Signs of DVT may include pain, swelling, redness, warmness and engorged superficial veins, but diagnosis of DVT is done only by a doctor. The danger with these blood clots in the deep veins of the legs is that they can travel to the lungs and cause a condition called pulmonary embolism.

Pulmonary embolism is the sudden blockage of a major artery in the lung by a blood clot. If the clot is large and stops blood flow to the lung, it can prove fatal. Symptoms of pulmonary embolism are sharp pain in the chest that is worse when you take a deep breath, sudden shortness of breath, coughing up blood and other symptoms. If you go through any of these symptoms, seek immediate medical attention.

Tinzaparin may be prescribed as recommended by your health care provider to prevent blood clots by thinning the blood. Other conditions may also be treated by administration of Tinzaparin, which is up to your doctor to decide and discuss with you.

How does Tinzaparin work?

Tinzaparin works by blocking the natural substances found in the blood that form clots. Tinzaparin is formulated based on naturally occurring enzymes found in blood-eating beings, like leeches and mosquitoes. The anticoagulants found in these beings are secreted when you are bitten, keeping the area un-clotted long enough for the leech or mosquito to feed.

Blood clots typically form as part of a reaction by the body to stop bleeding that results from injury to the tissues. Blood cells called platelets clump together and produce enzymes that cause the clotting process. To complete this process, a substance called thrombin is activated, to produce a protein known as fibrin. Fibrin is used to bind the blood platelets together, thus forming a blood clot.

Once in a while, blood clots can form abnormally within the blood vessels, which can be dangerous if they detach themselves and start traveling through the bloodstream. Eventually, they may get lodged in a blood vessel and block the blood supply to a vital organ, like the heart, brain or lungs.

Some people have a tendency to form blood clots within their blood vessels, typically due to slow blood flow in the leg and pelvic veins from being immobile for long periods of time, due to a medical condition or surgery. An additional risk, it has been discovered, is surgery involving the legs, hips, belly or brain, which puts patients at risk for developing DVT and, in turn, pulmonary embolism.

Tinzaparin is prescribed to prevent and treat these abnormal blood clots by inactivating the thrombin portion of the clotting process. This stops the fibrin from forming, which is an essential part of blood clots. Tinzaparin can also be given both pre and post surgery to prevent any complications, as well as being given to patients who are on hemodialysis, to prevent blood clots forming in the dialysis machine.

Conditions treated

  • Blood clots

Type of medicine

  • Anticoagulant

Side effects

The most common side effect of an injection of Tinzaparin is a deep, dark bruise, with swelling and some pain at the site of the injection itself. Patients occasionally experienced other side effects, such as:

  • Bleeding gums
  • Pain in the bladder or during urination
  • Bloody or cloudy urine
  • Blurred vision
  • Chest pain or tightness
  • Chills
  • Cough or cough with blood
  • Confusion
  • Trouble breathing or swallowing
  • Dizziness, light-headedness when sitting or standing
  • Irregular heartbeat
  • Fever
  • Frequent urination
  • Headache
  • Increased menstrual flow or vaginal bleeding
  • Lower back or side pain
  • Nose bleeds
  • Pale skin
  • Paralysis
  • Cuts that don’t heal
  • Red or tarry stools
  • Red or dark brown urine
  • Shortness of breath
  • Nervousness
  • Skin rash
  • Ulcers, sores or white spots around or on the mouth
  • Sore throat
  • Sweating
  • Swollen glands
  • Pain in the chest, abdomen or stomach
  • Joint or muscle pain
  • Unusual bleeding or bruising
  • Fatigue or weakness
  • Vomiting blood or coffee ground-like vomit

These could be signs of serious health issues and should be reported to your health care professional immediately.

Dosage

Different patients will receive different doses of Tinzaparin, depending on their condition, body type, age and other factors. Follow your doctor’s orders for dose and frequency of this and all medications.

Injections of Tinzaparin are typically given in the side of the abdomen, at least two inches from the belly button, under the skin (subcutaneously). It is possible that, after the first injection, you will be able to administer the maintenance doses of Tinzaparin yourself, to avoid having to visit the hospital or medical clinic.

The dose and number of injections vary widely and depend on whether Tinzaparin is being used to prevent or treat a blood clot situation.

Surgical patients

General surgical patients who receive a dose of Tinzaparin to prevent blood clots typically receive 3500 International Units (IU) two hours before surgery, followed by 3500 IU once a day for seven to 10 days.

Patients having hip surgery receive 50 IU per kilogram of body weight two full hours before surgery, with a follow up dose of 50 to 75 IU per kilogram after surgery on a once daily basis, continuing this dose for seven to 10 days.

Surgical patients who are having operations on their knees receive 75 IU per kilogram of body weight after surgery on a once daily basis for seven to 10 days.

Children do not typically receive doses of Tinzaparin unless specifically prescribed by their doctor.

Deep vein thrombosis patients

Administration of a course of Tinzaparin to patients suffering from deep vein thrombosis is on a treatment basis. These patients may or may not also have blood clots in their lungs.

Adults with deep vein thrombosis receive a dose of Tinzaparin that is based on their body weight and determined by their health care professional. On a general basis, typically a patient will receive 175 IU per kilogram of body weight, injected on a once daily basis for six or seven days in a row. Children do not typically receive doses of Tinzaparin unless it is specifically prescribed by their doctor.

Interactions

If you have been prescribed the drug Defibrotide it is advised that you are not treated at the same time with Tinzaparin. Your doctor may want to change the medication completely or change the dose as they see fit, based on your medical situation.

Tinzaparin may also interact with the following medicines in an undesired way, either by reducing the effectiveness of the drug or by causing unwanted side effects that can lead to health issues:

  • Abciximab
  • Aceclofenac
  • Alipogene Tiparvovec
  • Alteplase
  • Amtolmetin Guacil
  • Bemiparin
  • Bivalirudin
  • Bromfenac
  • Fepradinol
  • Feprazone
  • Floctafenine
  • Flufenamic Acid
  • Fluoxetine
  • Flurbiprofen
  • Anagrelide
  • Acemetacin
  • Acenocoumarol
  • Anistreplase
  • Antithrombin
  • Apixaban
  • Collagenase
  • Dabigatran Etexilate
  • Dalteparin
  • Danaparoid
  • Argatroban
  • Bufexamac
  • Celecoxib
  • Choline Salicylate
  • Citalopram
  • Dipyridamole
  • Dipyrone
  • Drotrecogin
  • Droxicam
  • Clonixin
  • Clopidogrel
  • Dexibuprofen
  • Dexketoprofen
  • Dextran
  • Diclofenac
  • Diflunisal
  • Edoxaban
  • Enoxaparin
  • Eptifibatide
  • Escitalopram
  • Etodolac
  • Etofenamate
  • Etoricoxib
  • Felbinac
  • Fenofibrate
  • Fenofibric Acid
  • Fenoprofen
  • Fluvoxamine
  • Ibuprofen
  • Iloprost
  • Indomethacin
  • Ketoprofen
  • Ketorolac
  • Lepirudin
  • Tenecteplase
  • Tenoxicam
  • Tiaprofenic Acid
  • Ticlopidine
  • Tirofiban
  • Tolfenamic Acid
  • Tolmetin
  • Treprostinil
  • Levomilnacipran
  • Lornoxicam
  • Morniflumate
  • Nabumetone
  • Nadroparin
  • Naproxen
  • Nepafenac
  • Niflumic Acid
  • Nimesulide
  • Nimesulide Beta Cyclodextrin
  • Nintedanib
  • Orlistat
  • Oxaprozin
  • Oxyphenbutazone
  • Parecoxib
  • Paroxetine
  • Pentosan Polysulfate Sodium
  • Phenindione
  • Phenprocoumon
  • Loxoprofen
  • Lumiracoxib
  • Meclofenamate
  • Mefenamic Acid
  • Meloxicam
  • Phenylbutazone
  • Piketoprofen
  • Piracetam
  • Piroxicam
  • Prasugrel
  • Proglumetacin
  • Propionic Acid
  • Propyphenazone
  • Proquazone
  • Reteplase
  • Rivaroxaban
  • Rofecoxib
  • Salicylic Acid
  • Salsalate
  • Sertraline
  • Sodium Salicylate
  • Streptokinase
  • Sulfinpyrazone
  • Sulindac
  • Urokinase
  • Valdecoxib
  • Venlafaxine
  • Vilazodone
  • Vorapaxar
  • Vortioxetine
  • Warfarin

Before beginning treatment with Tinzaparin, inform your doctor of any other medicines you are taking, whether they are prescription, non-prescription, herbal, vitamin or holistic remedies. Your health care provider should be given a history of your treatment for any other diseases, as well as a family history for any possible health interactions that could happen during or after treatment.

While a comprehensive list, this is not the full listing of drug interactions. The information provided in writing with your prescription will list all drug interactions and be updated regularly in order to provide the most current information.

Warnings

When you are under treatment with Tinzaparin, expect to be closely monitored for progress during routine screenings with your doctor. This monitoring may include blood tests, which provide indication of side effects that could be harmful to your health.

Tinzaparin may create a severe allergic reaction known as anaphylaxis, which is a life-threatening condition that requires emergency medical attention. If, after being injected with Tinzaparin, you experience chest pain, trouble breathing or swelling of the throat, tongue or face, tell your doctor immediately.

Prior to being given Tinzaparin, inform your physician if you’ve ever been allergic to pork products, benzyl alcohol, heparin or sulfites of any kind.

Tinzaparin, due to its anticoagulant properties desired to treat blood clots, may give you an increased chance of bruising or bleeding. Having a catheter for pain medication, anesthesia or epidural, or if you experience kidney issues, will increase bleeding or bruising risks. Notify your doctor immediately if you notice any strange bruises on your body or any unexplained bleeding, including stools that are black or tarry in appearance, gums that bleed, urine or stools with blood or tiny red spots on your skin.

While you are on Tinzaparin, do not participate in contact or heavy sports or put yourself in situation where bruising, cuts or injuries are possible in any way. Take extra care when using objects with edges or points, such as kitchen knives, razors or nail clippers. Avoid blowing your nose with excessive force and consult with your dentist on gentle ways to perform oral hygiene while on Tinzaparin. Before having any dentistry performed, it’s best to check with your medical advisors, and to let your dentist know that you have been using Tinzaparin.

Using alcohol or tobacco with Tinzaparin should be discussed with your physician, as certain interactions may occur. Other health issues may affect the use of Tinzaparin, either by reducing the effectiveness of the drug or by creating unwanted health situations. Inform your physician if you have or have ever had the following medical conditions:

  • Major bleeding
  • Thromboctopenia
  • Blood disease
  • Bleeding disorders
  • Spinal catheter
  • Eye problems as a result of diabetes or uncontrolled hypertension
  • Infection of the lining of the heart
  • Infection of the heart valves
  • Blood pressure that is too high (hypertension)
  • Decreased liver function or disease of the liver
  • Intestinal or stomach ulcer or active peptic ulcer
  • Stroke
  • Eye, brain or spine surgery
  • Kidney disease or decreased kidney function
  • Prosthetic heart valve
  • Women having a miscarriage

Women who may potentially become pregnant are advised to use effective methods of contraception during treatment with Tinzaparin. No adequate data exists of the effects of Tinzaparin on pregnant women or effects on the fetus, but, as a precaution, Tinzaparin should not be used during pregnancy. Additionally, there is no data on breast feeding and how Tinzaparin is transferred via breast milk. Discuss breastfeeding with your health care professional before being treated with Tinzaparin.

Tinzaparin, when found under the brand name Innohep in multi-dose vials, contain benzyl alcohol, and, therefore, must never be used to treat premature babies, newborn infants or infants up to one month of age. Those with allergies to benzyl alcohol should not be treated with this brand and form of the drug. Be aware that Innohep brand pre-filled syringes do not contain benzyl alcohol.

Tinzaparin is dangerous to use in patients who have received spinal anesthesia, sometimes referred to as an epidural. Patients who have had a spinal tap procedure are also at a higher risk for complications with use of Tinzaparin. A blood clot can form around the spinal cord, especially if you have a spinal defect or history of spinal issues that resulted in surgery. This type of blood clot is very dangerous and can lead to paralysis, which is permanent. Patients with spinal issues should avoid injection and treatment with Tinzaparin if at all possible.

Storage

This medicine is typically injected by a health care professional and, as such, proper storage is carried out for you by the hospital or medical care facility. If you are self-administering Tinzaparin, however, keep the drug and accompanying syringes out of sight and reach of children. Store in the original packaging in the refrigerator but do not allow Tinzaparin to freeze. Do not re-use syringes or needles and dispose of them properly using a puncture-resistant, disposable container, or as directed by your health care professional.

Any unused Tinzaparin or out of date product should be disposed of properly. Contact your health care provider for instructions on safe disposal. Do not use this medicine after the expiration date noted on the pack. Additionally, if the liquid is discolored or cloudy, or contains foreign particles, do not use the Tinzaparin. If you know the product has been exposed to extreme temperatures, do not use Tinzaparin.

Summary

Tinzaparin is an injected drug that is branded under the name Innohep. It is an anticoagulant drug used to treat blood clots, including those formed as a result of deep vein thrombosis. Deep vein thrombosis, or DVT, is a dangerous condition in which harmful blood clots form deep in the blood vessels of the legs. These blood clots can potentially travel through the blood stream and block major organs such as the heart, brain or lungs. Blocking these major organs can be fatal.

Tinzaparin works by blocking the natural substances found in the blood that form clots. Blood clots typically form when the body naturally acts to stop bleeding because of injury. Blood platelets clump together and produce enzymes that cause the clotting process, completed by a substance called thrombin, which produces the fibrin structure of the blood clot.

Slow blood flow in the leg and pelvic veins from being immobile for long periods of time, due to a medical condition or surgery, puts patients at high risk for blood clots. An additional risk, it has been discovered, is surgery involving the legs, hips, belly or brain, which puts patients at risk for developing DVT and, as a result, pulmonary embolism.

Tinzaparin is prescribed to prevent and treat these abnormal blood clots by inactivating the thrombin portion of the clotting process, stopping the fibrin from forming, which is an essential part of the clot. Tinzaparin can also be given both pre and post surgery to prevent any complications, as well as being given to patients who are on hemodialysis, as it prevents blood clots forming in the dialysis machine.

Side effects are normally limited to bruising, swelling and pain at the injection site. Any other side effects should be immediately reported to your health care provider, as they could be a sign of serious health complications. As with any drug, informing your doctor of any medications you are taking and pre-existing conditions is a vital part of the effectiveness and safety of all drugs. Patients who have renal diseases or infections, as well as those experiencing abnormal bleeding, should not take Tinzaparin. Pregnant women or those that become pregnant should not receive treatment by Tinzaparin unless their doctor has decided that the benefits outweigh the serious risks of exposing a fetus or infant to the drug.

Storage and administration of Tinzaparin is typically done in a hospital or medical setting, but at home, storage should be out of sight and reach of children in the original packaging and the drug should not exposed to heat, light or moisture. Unused or expired Tinzaparin should be disposed of per the safety advice of medical professionals.

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Last Reviewed:
December 23, 2017
Last Updated:
January 01, 2018
Content Source: