Innohep

Generic Name: tinzaparin (tin ZA pa rin)
Brand Name: Innohep

What is Innohep (tinzaparin)?

Tinzaparin is an anticoagulant that helps prevent the formation of blood clots.

Tinzaparin is used together with warfarin (Coumadin) to treat a type of blood clot called deep vein thrombosis (DVT), which can lead to blood clots in the lungs (pulmonary embolism).

Tinzaparin may also be used for purposes not listed in this medication guide.

What is the most important information I should know about Innohep (tinzaparin)?

You should not use this medication if have active bleeding or a history of low platelet counts after receiving heparin.

Tinzaparin can cause a very serious blood clot around your spinal cord if you undergo a spinal tap or receive spinal anesthesia (epidural), especially if you have a genetic spinal defect, a history of spinal surgery or repeated spinal taps, or if you are using other drugs that can affect blood clotting, including blood thinners or NSAIDs (ibuprofen, Advil, Aleve, and others). This type of blood clot can lead to long-term or permanent paralysis.

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Get emergency medical help if you have symptoms of a spinal cord blood clot such as back pain, numbness or muscle weakness in your lower body, or loss of bladder or bowel control.

What should I discuss with my healthcare provider before using Innohep (tinzaparin)?

You should not use this medication if you are allergic to tinzaparin, heparin, sulfites, benzyl alcohol, or pork products, or if you have:

  • active or uncontrolled bleeding; or

  • if you have ever had low platelet counts after receiving heparin.

Tinzaparin may cause you to bleed more easily, especially if you have:

  • a bleeding disorder that is inherited or caused by disease;

  • hemorrhagic stroke;

  • an infection of the lining of your heart (also called bacterial endocarditis);

  • uncontrolled high blood pressure;

  • stomach or intestinal bleeding or ulcer;

  • liver failure;

  • kidney disease (especially if you are an older adult);

  • recent brain, spine, or eye surgery; or

  • amyloidosis (a build-up of certain proteins in tissues and organs of the body).

Tinzaparin can cause a very serious blood clot around your spinal cord if you undergo a spinal tap or receive spinal anesthesia (epidural). This type of blood clot could cause long-term or permanent paralysis, and may be more likely to occur if:

  • you have a genetic spinal defect;

  • you have a spinal cord injury;

  • you have a spinal catheter in place, or if a catheter has been recently removed;

  • you have a history of spinal surgery or repeated spinal taps;

  • you have recently had a spinal tap or epidural anesthesia;

  • you are taking an NSAID (nonsteroidal anti-inflammatory drug)--ibuprofen (Advil, Motrin), naproxen (Aleve), diclofenac, indomethacin, meloxicam, and others; or

  • you are using a blood thinner (warfarin, Coumadin, Jantoven) or other medicines to treat or prevent blood clots.

To make sure tinzaparin is safe for you, tell your doctor if you have:

  • recent stomach ulcer; or

  • eye problems caused by diabetes.

FDA pregnancy category B. Tinzaparin is not expected to harm an unborn baby. However, some forms of this medication contain a preservative that may be harmful to a newborn. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

It is not known whether tinzaparin passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How should I use Innohep (tinzaparin)?

Follow all directions on your prescription label. Do not use this medicine in larger or smaller amounts or for longer than recommended. Tinzaparin is usually given every day until your bleeding condition improves. Follow the directions on your prescription label.

Tinzaparin must not be used as a substitute for heparin. These two drugs are manufactured differently and have different dosages.

Tinzaparin is injected under the skin. You may be shown how to use injections at home. Do not self-inject this medicine if you do not fully understand how to give the injection and properly dispose of used needles and syringes.

You should be sitting or lying down during the injection. Do not inject tinzaparin into a muscle or a vein.

Use a different place on your stomach each time you give the injection. Your care provider will show you the best places on your body to inject the medication. Do not inject into the same place two times in a row.

Prepare your dose in a syringe only when you are ready to give yourself an injection. Do not use tinzaparin if it has changed colors or has particles in it. Call your pharmacist for new medication.

Use a disposable needle only once. Follow any state or local laws about throwing away used needles and syringes. Use a puncture-proof "sharps" disposal container (ask your pharmacist where to get one and how to throw it away). Keep this container out of the reach of children and pets.

Tell any doctor who treats you that you are using tinzaparin. If you need surgery or dental work, tell the surgeon or dentist ahead of time that you are using this medication.

While using tinzaparin, your blood and your stool (bowel movement) may need to be tested often. Your nerve and muscle function may also need to be tested.

Store at room temperature away from moisture and heat.

What happens if I miss a dose?

Use the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose can cause excessive bleeding.

What should I avoid while using Innohep (tinzaparin)?

Avoid activities that may increase your risk of bleeding or injury. Use extra care to prevent bleeding while shaving or brushing your teeth.

Innohep (tinzaparin) side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Also seek emergency medical attention if you have symptoms of a spinal blood clot: back pain, numbness or muscle weakness in your lower body, or loss of bladder or bowel control.

Stop using tinzaparin and call your doctor at once if you have:

  • unusual bleeding (nose, mouth, vagina, or rectum), bleeding from wounds or needle injections, any bleeding that will not stop;

  • easy bruising, purple or red pinpoint spots under your skin;

  • pale skin, feeling light-headed or short of breath, rapid heart rate, trouble concentrating;

  • black or bloody stools, coughing up blood or vomit that looks like coffee grounds;

  • sudden weakness, severe headache, confusion, or problems with speech, vision, or balance;

  • chest pain; or

  • pain or burning when you urinate.

Common side effects may include:

  • mild headache;

  • fever;

  • pain;

  • nausea, vomiting, stomach pain, indigestion; or

  • diarrhea, constipation.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

What other drugs will affect Innohep (tinzaparin)?

Tell your doctor about all medicines you use, and those you start or stop using during your treatment with tinzaparin, especially other medicines used to treat or prevent blood clots, such as:

  • abciximab, anagrelide, cilostazol, clopidogrel, dipyridamole, eptifibatide, ticlopidine, tirofiban;

  • alteplase, reteplase, tenecteplase, urokinase;

  • apixaban, argatroban, bivalirudin, dabigatran, dalteparin, desirudin, enoxaparin, fondaparinux, lepirudin, rivaroxaban; or

  • heparin.

This list is not complete. Other drugs may interact with tinzaparin, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Where can I get more information?

  • Your doctor or pharmacist can provide more information about tinzaparin.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 6.02. Revision Date: 2014-04-13, 8:30:20 PM.

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