Tinzaparine

Tinzaparine is a low molecular weight heparin (LMWH) used as an anticoagulant. It is derived from unfractionated heparin and is produced from porcine sources. Its anticoagulant effect arises mainly from potentiation of antithrombin III, which inhibits factor Xa; it has additional, lesser activity against thrombin (factor IIa). Compared with unfractionated heparin, tinzaparin offers a more predictable pharmacokinetic profile and generally does not require routine coagulation monitoring, although anti-Xa activity may be measured in selected patients such as those with renal impairment, extreme body weight, or pregnancy.

Common indications include prevention of venous thromboembolism after surgery or in medically ill patients at risk, and the treatment of acute deep vein thrombosis and pulmonary embolism. It has also been used in certain settings for acute coronary syndromes, depending on regional guidelines and product labeling.

Administration is by subcutaneous injection. Dosing is typically fixed for prophylaxis and weight-based for treatment, with regimens determined by local guidelines and the specific product labeling. Routine laboratory monitoring is not required for most patients, but anti-Xa monitoring may be employed in specific populations or clinical scenarios.

Contraindications include active major bleeding, known hypersensitivity to heparins, and a history of heparin-induced thrombocytopenia. Caution is advised in patients with significant renal impairment, a high bleeding risk, or undergoing neuraxial anesthesia, where the risk of spinal or epidural hematoma is a concern. Common adverse effects include bleeding, injection-site reactions, and the potential for heparin-induced thrombocytopenia; osteoporotic effects may occur with long-term use. As with other anticoagulants, interactions with other antithrombotic drugs can increase bleeding risk.