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Generic name: tinzaparin (TIN-za-PAR-in)
Brand name: Innohep

Tell your doctor you use Innohep before you have any type of spinal or epidural procedure. Patients who have these procedures while they use Innohep are at risk for developing bleeding around your spine. This could result in long-term or permanent paralysis.

The risk is increased in patients who have an indwelling epidural catheter. It is also increased in patients with a history of traumatic or repeated epidural or spinal puncture, a deformed spine, or spinal surgery. It is also increased in patients who use medicines that may affect blood clotting, such as other anticoagulants (eg, warfarin), aspirin, platelet inhibitors (eg, clopidogrel), and nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, ibuprofen, naproxen).

If you have a spinal or epidural procedure while you use Innohep, tell your doctor at once if you notice any symptoms of nerve problems (eg, back pain; numbness or tingling, especially in the legs and feet; muscle weakness; paralysis; loss of bladder or bowel control).

Talk with your doctor if you have recently had or will be having a spinal or epidural procedure. Some time may need to pass between the use of Innohep and your procedure. Discuss any questions or concerns with your doctor.

Innohep is used for:

Preventing blood clots in patients who will be having certain types of surgery. It is also used to treat certain types of blood clots (deep vein thrombosis, pulmonary embolism). It is also used to prevent blood from clotting in dialysis lines. It may also be used for other conditions as determined by your doctor.

Innohep is a low molecular weight heparin (LMWH). It works by blocking the formation of blood clots.

Do NOT use Innohep if:

  • you are allergic to any ingredient in Innohep or to heparin or other similar medicines (eg, enoxaparin)
  • you have uncontrolled, severe high blood pressure; eye problems caused by diabetes (diabetic retinopathy) or bleeding (hemorrhagic retinopathy); or a bacterial infection of the heart (endocarditis)
  • you have hemophilia, blood clotting problems that increase your risk of bleeding, or active bleeding (eg, bleeding ulcer)
  • you bleed easily or have conditions or diseases with high risk of bleeding (eg, severe liver problems, an abortion with a large amount of vaginal bleeding)
  • you have a history of low blood platelets or bleeding problems due to the use of heparin (heparin-induced thrombocytopenia)
  • you have recently had a stroke, or an injury or surgery involving the brain, spinal cord, eyes, or ears
  • you are older than 70 years old and have kidney problems
  • you are taking apixaban, dabigatran, desirudin, or rivaroxaban

Contact your doctor or health care provider right away if any of these apply to you.

Before using Innohep:

Some medical conditions may interact with Innohep. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

  • if you are pregnant, planning to become pregnant, or are breast-feeding
  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
  • if you have allergies to medicines, foods, or other substances
  • if you are allergic to the preservative benzyl alcohol or sodium metabisulfite. Some of these products may contain these preservatives
  • if you have a history of kidney problems, liver problems, or stomach or bowel problems (eg, ulcers), stroke; or asthma
  • if you have an artificial heart valve, diabetes, high blood potassium levels, high blood acid levels (metabolic acidosis), or amyloidosis
  • if you have low blood platelet levels, high blood pressure, or a bleeding disorder; if you are at risk for bleeding; or if you have a history of brain bleeding or blood conditions
  • if you are scheduled to have brain, spine, ear, or eye surgery, or have recently had another type of surgery
  • if you have recently had or are scheduled to have an epidural catheter or a spinal puncture
  • if you are receiving other medicines via injection into muscle or you drink alcohol
  • if you have high body weight (more than 265 lbs [120 kg]) or low body weight (less than 100 lbs [45 kg])

Some MEDICINES MAY INTERACT with Innohep. Tell your health care provider if you are taking any other medicines, especially any of the following:

  • Potassium-sparing diuretics (eg, spironolactone) because the risk of high blood potassium levels may be increased
  • Activated protein C, anticoagulants (eg, warfarin), antithrombin, direct thrombin inhibitors (eg, dabigatran), NSAIDs (eg, ibuprofen, ketorolac, naproxen), platelet inhibitors (eg, clopidogrel, ticlopidine), rivaroxaban, salicylates (eg, aspirin), or thrombolytics (eg, streptokinase) because the risk of side effects, such as bleeding, may be increased
  • Palifermin because the risk of its side effects may be increased by Innohep

This may not be a complete list of all interactions that may occur. Ask your health care provider if Innohep may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Innohep:

Use Innohep as directed by your doctor. Check the label on the medicine for exact dosing instructions.

  • An extra patient leaflet is available with Innohep. Talk to your pharmacist if you have questions about this information.
  • Innohep is usually administered as an injection at your doctor's office, hospital, or clinic. If you are using Innohep at home, carefully follow the injection procedures taught to you by your health care provider.
  • Use the proper technique taught to you by your doctor. Inject deep under the skin, NOT into the muscle or a vein.
  • Do not use Innohep if it contains particles, is cloudy or discolored, or if the vial is cracked or damaged.
  • Keep this product, as well as syringes and needles, out of the reach of children and pets. Do not reuse needles, syringes, or other materials. Ask your health care provider how to dispose of these materials after use. Follow all local rules for disposal.
  • If you miss a dose of Innohep, contact your doctor immediately.

Ask your health care provider any questions you may have about how to use Innohep.

Important safety information:

  • Some of these products contain sulfites. An allergic reaction to sulfites occurs more frequently in asthma patients than in people that do not have asthma. If you have ever had an allergic reaction to sulfites, ask your pharmacist if your product has sulfites in it.
  • Innohep may reduce the number of clot-forming cells (platelets) in your blood. Avoid activities that may cause bruising or injury. Tell your doctor if you have unusual bruising or bleeding. Tell your doctor if you have dark, tarry, or bloody stools.
  • Innohep may rarely cause a prolonged, painful erection. This could happen even when you are not having sex. If this is not treated right away, it could lead to permanent sexual problems such as impotence. Contact your doctor right away if this happens.
  • Tell your doctor or dentist that you take Innohep before you receive any medical or dental care, emergency care, or surgery.
  • Do not change between Innohep and heparin or similar medicines (eg, enoxaparin) without talking to your doctor.
  • Before you begin taking any new prescription or nonprescription medicine, check the label to see if it has aspirin or an NSAID (eg, ibuprofen) in it. If it does or you are not sure, contact your doctor or pharmacist.
  • Innohep may affect certain lab tests, including liver function tests. Be sure your doctor and lab personnel know you are using Innohep.
  • Lab tests, including complete blood cell counts (eg, platelet counts), kidney function, blood pressure, blood potassium levels, and tests for blood in the stool, may be performed while you use Innohep. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
  • Use Innohep with caution in the ELDERLY; the risk of bleeding may be increased. Do not use Innohep in patients older than 70 years old who have decreased kidney function. Discuss any concerns with your doctor.
  • Innohep may have benzyl alcohol in it. Do not use medicines containing benzyl alcohol if you are pregnant, or in CHILDREN younger than 2 years old, including NEWBORNS and INFANTS. It may cause serious and sometimes fatal nervous system problems and other side effects. Ask your pharmacist if your product has benzyl alcohol in it.
  • Innohep should be used with extreme caution in CHILDREN; safety and effectiveness in children have not been confirmed.
  • PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Innohep while you are pregnant. It is not known if this medicine is found in breast milk. If you are or will be breast-feeding while you use Innohep, check with your doctor. Discuss any possible risks to your baby.

Possible side effects of Innohep:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Mild bleeding, bruising, irritation, pain, redness or swelling at the injection site.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing or swallowing; tightness in the chest; swelling of the mouth, face, lips, or tongue; unusual hoarseness); bloody, black, or tarry stools; chest, jaw, or arm pain; confusion; coughing up blood; difficult or painful urination; difficulty walking; fainting; fever, chills, or sore throat; irregular heartbeat; joint or muscle pain; nosebleed; one-sided weakness; pale skin; pink or red urine; prolonged, painful erection; red, swollen, blistered, or peeling skin; severe or persistent dizziness or weakness; severe or persistent headache or stomach pain; shortness of breath; slurred speech; sudden, severe nausea or vomiting; swelling; tingling, numbness (especially in the legs and feet), and muscle weakness; unusual bleeding or bruising; unusual sweating; vision problems; vomit that looks like coffee grounds.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include unusual bleeding or bruising (eg, nosebleeds, easy bruising, bloody urine or stools).

Proper storage of Innohep:

Innohep is usually handled and stored by a health care provider. If you are using Innohep at home, store Innohep as directed by your pharmacist or health care provider. Keep Innohep out of the reach of children and away from pets.

General information:

  • If you have any questions about Innohep, please talk with your doctor, pharmacist, or other health care provider.
  • Innohep is to be used only by the patient for whom it is prescribed. Do not share it with other people.
  • If your symptoms do not improve or if they become worse, check with your doctor.
  • Check with your pharmacist about how to dispose of unused medicine.

This information should not be used to decide whether or not to take Innohep or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about Innohep. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to Innohep. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using Innohep.

Issue Date: June 3, 2015

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.