Tinzaparin
Encyclopedia
Tinzaparin is an antithrombotic
Antithrombotic
A antithrombotic is a drug which reduces thrombus formation.Different antithrombotics affect different processes:* Antiplatelet drugs limit the migration or aggregation of platelets.* Anticoagulants limit the ability of the blood to clot....

 drug in the heparin
Heparin
Heparin , also known as unfractionated heparin, a highly sulfated glycosaminoglycan, is widely used as an injectable anticoagulant, and has the highest negative charge density of any known biological molecule...

 group. It is a low molecular weight heparin
Low molecular weight heparin
In medicine, low-molecular-weight heparin is a class of medication used as an anticoagulant in diseases that feature thrombosis, as well as for prophylaxis in situations that lead to a high risk of thrombosis....

 (LMWH) marketed as Innohep worldwide. It has been approved by the U.S. Food and Drug Administration (FDA) for once daily treatment and prophylaxis of deep vein thrombosis
Deep vein thrombosis
Deep vein thrombosis is the formation of a blood clot in a deep vein. Deep vein thrombosis commonly affects the leg veins or the deep veins of the pelvis. Occasionally the veins of the arm are affected...

 and pulmonary embolism
Pulmonary embolism
Pulmonary embolism is a blockage of the main artery of the lung or one of its branches by a substance that has travelled from elsewhere in the body through the bloodstream . Usually this is due to embolism of a thrombus from the deep veins in the legs, a process termed venous thromboembolism...

. Tinzaparin sodium is the only low molecular weight heparin shown to be safe in pregnancy and in critically ill people with renal failure
Renal failure
Renal failure or kidney failure describes a medical condition in which the kidneys fail to adequately filter toxins and waste products from the blood...

 at both treatment and prophylaxis dose levels.

It can be given subcutaneously by syringe
Syringe
A syringe is a simple pump consisting of a plunger that fits tightly in a tube. The plunger can be pulled and pushed along inside a cylindrical tube , allowing the syringe to take in and expel a liquid or gas through an orifice at the open end of the tube...

, or intravenously.
it is manufactured by Leo pharmacutical company

F.D.A approved indications

In the United States, tinzaparin is FDA approved for the following indications:
  • 1-Prophylaxis of DVT in medically ill and elderly patient.
  • 2-Total hip & knee replacement,
  • 3-Extended hip-replacement,
  • 4-Abdominal surgery.
  • 5-Treatment of DVT with or without PE.
  • 6-prophylaxis and treatment of DVT in pregnant women.
  • 7-as an assistant in the process of In Vitro Fertilization (IVF).

Indications approved in the UK and Australia

Tinzaparin is approved for the following
  • 1-The prophylaxis of thromboembolism disorders of venous origin, in particular those that may be associated with orthopaedic surgery.
  • 2-The prophylaxis of venous thromboembolism (VTE) in medical patients bedridden due to acute illness.
  • 3-prophylaxis and treatment of DVT in pregnant women.
  • 4-The treatment of venous thromboembolism disease (VTED) presenting with deep vein thrombosis (DVT), pulmonary embolism (PE) or both.
  • 5-The treatment of unstable angina (UA) and non-Q-wave myocardial infarction (NQMI), administered concurrently with aspirin.
  • 6-The prevention of thrombus formation in the extracorporeal circulation during haemodialysis.
  • 7-The prevention of thrombus formation during episodes of lone Atrial Fibrillation, administered concurrently with aspirin (in the absence of long term anticoagulation treatment with warfarin.

Use in elderly

In July 2008, the company revised the prescribing information to restrict the use of tinzaparin in patients 90 years of age or older. FDA is concerned that the preliminary data from the IRIS study suggest that the increased risk of mortality is limited only to patients 90 years of age or older. Therefore, it is the best LMWH to be used in elderly patient less than 90 years old

Use in pregnancy

No LMWH, except tinzaparin, is licensed for use in gestational hypercoagulability. Still, tinzaparin is often the LMWH of choice in pregnant women.

Monitoring

Tinzaparin does NOT affect the international normalized ratio (INR), prothrombin time (PT)
Anti-factor Xa levels can be measured, and are often used to monitor tinzaparin
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