Tinzaparin

Tinzaparin is a low molecular weight heparin (LMWH) anticoagulant derived from heparin by controlled depolymerization. It inhibits coagulation by potentiating antithrombin III, with activity against factor Xa and, to a lesser extent, thrombin (factor IIa). Compared with unfractionated heparin, tinzaparin has a longer half-life and more predictable pharmacokinetics.

Indications include treatment of acute deep vein thrombosis (DVT) with or without pulmonary embolism, and prevention of DVT after surgery such as hip or knee replacement. It is also used as part of therapy for acute coronary syndromes in selected patients when anticoagulation is appropriate.

Administration and dosing: tinzaparin is given by subcutaneous injection. Dosing is weight-based and regimen-dependent, with higher therapeutic doses for treatment and lower prophylactic doses for prevention; many regimens permit once-daily dosing due to the longer half-life, though some indications use twice-daily dosing. Kidney function markedly affects tinzaparin clearance; dose adjustment or avoidance is advised in advanced renal impairment.

Monitoring and safety: routine laboratory monitoring is not usually required, but anti-Xa activity may be checked in certain populations (e.g., pregnancy, obesity, renal impairment) or when precision dosing is needed. Potential adverse effects include bleeding and bruising, with a risk of heparin-induced thrombocytopenia being lower than with unfractionated heparin. Spinal/epidural hematoma can occur with neuraxial anesthesia or puncture. Long-term use can contribute to osteoporosis.

Contraindications and precautions: active major bleeding, known hypersensitivity to heparin, a history of heparin-induced thrombocytopenia, and conditions where anticoagulation is unsuitable.