Drug reference

Tinzaparin sodium

BNF 80 (2020–2021)

Source: BNF 80 (2020–2021)
PDF pages: 166, 167

Review source pages for extracted sections and age labels. BNF dose snippets show only their first line.

Overview

Indications And Dose

INNOHEP ® 10,000 UNITS/ML Prophylaxis of deep-vein thrombosis (general surgery) ▶BY SUBCUTANEOUS INJECTION ▶Adult: 3500 units for 1 dose, dose to be given 2 hours before surgery, then 3500 units every 24 hours Prophylaxis of deep-vein thrombosis (orthopaedic surgery) ▶BY SUBCUTANEOUS INJECTION ▶Adult: Initially 50 units/kg for 1 dose, dose to be given 2 hours before surgery, then 50 units/kg every 24 hours, alternatively initially 4500 units for 1 dose, dose to be given 12 hours before surgery, then 4500 units every 24 hours Prevention of clotting in extracorporeal circuits ▶TO THE DEVICE AS A FLUSH ▶Adult: (consult product literature) INNOHEP ® 20,000 UNITS/ML Extended treatment of venous thromboembolism and prevention of recurrence in patients with active cancer ▶BY SUBCUTANEOUS INJECTION ▶Adult: 175 units/kg once daily for 6 months; the beneﬁt of continued treatment beyond 6 months should be evaluated Treatment of deep-vein thrombosis | Treatment of pulmonary embolism ▶BY SUBCUTANEOUS INJECTION ▶Adult: 175 units/kg once daily until adequate oral anticoagulation established, treatment regimens do not require anticoagulation monitoring Treatment of venous thromboembolism in pregnancy ▶BY SUBCUTANEOUS INJECTION ▶Adult: 175 units/kg once daily, dose based on early pregnancy body-weight, treatment regimens do not require anticoagulation monitoring l UNLICENSED USE Not licensed for the treatment of venous thromboembolism in pregnancy.

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Safety

Interactions

→Appendix 1: low molecular-weight heparins

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Side Effects

▶Common or very common Anaemia ▶Rare or very rare Angioedema. Stevens-Johnson syndrome

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Pregnancy

Not known to be harmful, low molecular weight heparins do not cross the placenta. Vials contain benzyl alcohol—manufacturer advises avoid.

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Breast Feeding

Due to the relatively high molecular weight of tinzaparin and inactivation in the gastro- intestinal tract, passage into breast-milk and absorption by the nursing infant are likely to be negligible; however manufacturer advise avoid.

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Renal Impairment

Risk of bleeding may be increased. Unfractionated heparin may be preferable. Manufacturer advises caution if eGFR less than 30 mL/minute/1.73 m2. Monitoring In renal impairment monitoring of anti-Factor Xa may be required if eGFR less than 30 mL/minute/1.73 m2.

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Monitoring Requirements

Routine monitoring of anti- Factor Xa activity is not usually required during treatment with tinzaparin, but may be necessary in patients at increased risk of bleeding (e.g. in renal impairment and those who are underweight or overweight).

PDF pages 166, 167

Dose and formulations

Medicinal Forms

There can be variation in the licensing of different medicines containing the same drug. Solution for injection EXCIPIENTS: May contain Benzyl alcohol, sulfites ▶Innohep (LEO Pharma) Tinzaparin sodium 10000 unit per 1 ml Innohep 20,000units/2ml solution for injection vials | 10 vial P £105.66 DT = £105.66 Tinzaparin sodium 20000 unit per 1 ml Innohep 18,000units/0.9ml solution for injection pre-filled syringes | 6 pre-filled disposable injection P £64.25 | 10 pre-filled disposable injection P £107.08 DT = £107.08 Innohep 40,000units/2ml solution for injection vials | 1 vial P £34.20 DT = £34.20 Innohep 14,000units/0.7ml solution for injection pre-filled syringes | 6 pre-filled disposable injection P £49.98 | 10 pre-filled disposable injection P £83.30 DT = £83.30 Innohep 10,000units/0.5ml solution for injection pre-filled syringes | 6 pre-filled disposable injection P £35.70 | 10 pre-filled disposable injection P £59.50 DT = £59.50 ANTITHROMBOTIC DRUGS › THROMBIN INHIBITORS, DIRECT

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Dose text by age group

Adult

3500 units for 1 dose, dose to be given 2 hours

First-line fragment. Read the complete Indications and Dose section above.

PDF page 166

Adult

Initially 50 units/kg for 1 dose, dose to be given

First-line fragment. Read the complete Indications and Dose section above.

PDF page 166

Adult

(consult product literature)

First-line fragment. Read the complete Indications and Dose section above.

PDF page 166

Adult

175 units/kg once daily for 6 months; the beneﬁt

First-line fragment. Read the complete Indications and Dose section above.

PDF page 166

Adult

175 units/kg once daily until adequate oral

First-line fragment. Read the complete Indications and Dose section above.

PDF page 166

Adult

175 units/kg once daily, dose based on early

First-line fragment. Read the complete Indications and Dose section above.

PDF page 166

Age labels are extracted for navigation. Check the complete source section and current local guidance before clinical use.

Drug reference

Tinzaparin sodium

BNF 80 (2020–2021)

Source: BNF 80 (2020–2021)
PDF pages: 166, 167

Review source pages for extracted sections and age labels. BNF dose snippets show only their first line.

Overview

Indications And Dose

PDF page 166

Safety

Interactions

→Appendix 1: low molecular-weight heparins

PDF page 166

Side Effects

▶Common or very common Anaemia ▶Rare or very rare Angioedema. Stevens-Johnson syndrome

PDF page 166

Pregnancy

Not known to be harmful, low molecular weight heparins do not cross the placenta. Vials contain benzyl alcohol—manufacturer advises avoid.

PDF page 166

Breast Feeding

PDF page 166

Renal Impairment

PDF page 166

Monitoring Requirements

PDF pages 166, 167

Dose and formulations

Medicinal Forms

PDF page 167

Dose text by age group

Adult

3500 units for 1 dose, dose to be given 2 hours

First-line fragment. Read the complete Indications and Dose section above.

PDF page 166

Adult

Initially 50 units/kg for 1 dose, dose to be given

First-line fragment. Read the complete Indications and Dose section above.

PDF page 166

Adult

(consult product literature)

First-line fragment. Read the complete Indications and Dose section above.

PDF page 166

Adult

175 units/kg once daily for 6 months; the beneﬁt

First-line fragment. Read the complete Indications and Dose section above.

PDF page 166

Adult

175 units/kg once daily until adequate oral

First-line fragment. Read the complete Indications and Dose section above.

PDF page 166

Adult

175 units/kg once daily, dose based on early

First-line fragment. Read the complete Indications and Dose section above.

PDF page 166

Age labels are extracted for navigation. Check the complete source section and current local guidance before clinical use.