Skip to Content

Tinzaparin Disease Interactions

There are 5 disease interactions with tinzaparin:

Major

Anticoagulants (Includes Tinzaparin) ↔ Peptic Ulcer Disease

Severe Potential Hazard, Moderate plausibility

Applies to: Bleeding

Anticoagulants are contraindicated in patients with active major bleeding or those patients at risk for hemorrhage. Hemorrhage due to heparin derivatives may be treated with protamine sulfate 1%. However, protamine sulfate may not completely neutralize the anti- Factor Xa activity.

References

  1. "Product Information. Lovenox (enoxaparin)." Rhone-Poulenc Rorer, Collegeville, PA.
  2. "Product Information. Heparin Sodium (heparin)." Lilly, Eli and Company, Indianapolis, IN.
  3. "Product Information. Fragmin (dalteparin)." Pharmacia and Upjohn, Kalamazoo, MI.
View all 11 references
Major

Heparin (Includes Tinzaparin) ↔ Active Bleeding

Severe Potential Hazard, High plausibility

Applies to: Abnormal Uterine Bleeding, Diverticulitis, Hypertension, Bleeding, Peptic Ulcer, Colonic Ulceration, Ulcerative Colitis, Myeloproliferative Disorders, Liver Disease, Coagulation Defect, Infectious Endocarditis

The use of heparin is contraindicated in patients with uncontrollable active bleeding, except when the bleeding is due to disseminated intravascular coagulation. Hemorrhage can occur at virtually any site in patients receiving heparin. An unexplained drop in hematocrit or blood pressure, or any other unexplained symptom, should lead to serious consideration of a hemorrhagic event. Therapy with heparin should be used with extreme caution in patients with known bleeding disorders or disease states that may predispose to hemorrhage during heparin administration, including hemophilia, thrombocytopenia, certain vascular purpuras, ulcerative gastrointestinal lesions, diverticulitis, ulcerative colitis, severe liver disease, subacute bacterial endocarditis, severe hypertension, myeloproliferative disorders, and threatened abortion. Blood coagulation tests (e.g., whole blood clotting time, activated partial thromboplastin time) should be performed at appropriate intervals during full-dose heparin administration. In addition, periodic platelet counts, hematocrits, and tests for occult blood in stool are recommended during the entire course of heparin therapy. There is usually no need to monitor coagulation parameters in patients receiving low-dose heparin, except in patients undergoing major surgery. For low molecular weight heparin (LMWH), coagulation tests such as prothrombin time (PT) and aPTT are relatively insensitive measures of LMWH activity and not suitable for routine monitoring. Anti-Factor Xa may be used to monitor the anticoagulant effect of LMWH in patients with significant renal impairment, abnormal coagulation parameters, or bleeding during therapy.

References

  1. Sugiyama T, Itoh M, Ohtawa M, Natsuga T "Study on neutralization of low molecular weight heparin (LHG) by protamine sulfate and its neutralization characteristics." Thromb Res 68 (1992): 119-29
  2. Breddin HK "Low molecular weight heparins and bleeding." Semin Thromb Hemost 15 (1989): 401-4
  3. Nieuwenhuis HK, Albada J, Banga JD, Sixma JJ "Identification of risk factors for bleeding during treatment of acute venous thromboembolism with heparin or low molecular weight heparin." Blood 78 (1991): 2337-43
View all 12 references
Major

Heparin (Includes Tinzaparin) ↔ Renal Dysfunction

Severe Potential Hazard, High plausibility

Applies to: Renal Dysfunction

Systemic exposure and the risk of bleeding may be increased when heparin is used in the presence of severe renal impairment. Therapy with heparin should be administered cautiously in patients with significantly impaired renal function. A reduction in dosage may be necessary.

Major

Heparin (Includes Tinzaparin) ↔ Thrombocytopenia

Severe Potential Hazard, High plausibility

Applies to: Thrombocytopenia, Heparin-Induced Thrombocytopenia

The use of heparin is contraindicated in patients with severe thrombocytopenia. Acute thrombocytopenia can occur in patients receiving heparin, with a reported incidence of up to 30%. Platelet counts should be obtained before and periodically during heparin administration, including regular and repeated use of heparin flush solutions if given for longer than 5 days. Mild thrombocytopenia with counts above 100,000/mm3 may remain stable or reverse despite continued heparin administration. However, thrombocytopenia of any degree should be closely monitored. Therapy should be discontinued if the count falls below 100,000/mm3 or if recurrent thrombosis develops, and an alternative, nonheparin anticoagulant (e.g., argatroban, bivalirudin, lepirudin) administered if necessary. Heparin-induced thrombocytopenia (HIT) is a serious antibody-mediated reaction resulting from irreversible aggregation of platelets. HIT may progress to the development of venous and arterial thromboses, a condition referred to as heparin-induced thrombocytopenia and thrombosis (HITT). Thrombotic events may also be the initial presentation for HITT, and may include deep vein thrombosis, pulmonary embolism, cerebral vein thrombosis, limb ischemia, stroke, myocardial infarction, mesenteric thrombosis, renal artery thrombosis, skin necrosis, gangrene of the extremities that may lead to amputation, and possibly death. Both HIT and HITT can occur up to several weeks after the discontinuation of heparin therapy. Patients presenting with thrombocytopenia or thrombosis after discontinuation of heparin should be evaluated for HIT and HITT. Following an episode, any future use of heparin should be avoided, and use of low-molecular weight heparin should consider the potential for cross-reactivity with the HIT antibody and approached with extreme caution, if not otherwise contraindicated.

References

  1. Warkentin TE, Hirsh J, Kelton JG "Heparin-induced thrombocytopenia." N Engl J Med 333 (1995): 1007
  2. Magnani HN "Heparin-induced thrombocytopenia (HIT): an overview of 230 patients treated with orgaran (Org 10172) [published erratum appears in Thromb Haemost 1993 Dec 20;70(6):1072]." Thromb Haemost 70 (1993): 554-61
  3. Force RW "Heparin-induced thrombocytopenia." Am J Health Syst Pharm 52 (1995): 2528
View all 39 references
Major

Lmwh (Includes Tinzaparin) ↔ Prematurity

Severe Potential Hazard, Moderate plausibility

Applies to: Prematurity/Underweight in Infancy

Some preparations (i.e., multiple-dose vials) of low molecular weight heparin (LMWH) contain benzyl alcohol as a preservative. Benzyl alcohol in bacteriostatic saline intravascular flush and endotracheal tube lavage solutions has been associated with fatalities and severe respiratory and metabolic complications in low-birthweight premature infants. Symptoms include a striking onset of gasping respiration, hypotension, bradycardia, and cardiovascular collapse. The manufacturers recommend that use of these products be avoided in all neonates whenever possible. Nevertheless, many experts feel that, in the absence of benzyl alcohol-free equivalents, the amount of the preservative present in these formulations should not necessarily preclude their use if they are clearly indicated. The American Academy of Pediatrics considers benzyl alcohol in low doses (such as when used as a preservative in some medications) to be safe for newborns. LMWHs are not approved for use in pediatric patients.

tinzaparin drug Interactions

There are 274 drug interactions with tinzaparin

tinzaparin alcohol/food Interactions

There is 1 alcohol/food interaction with tinzaparin

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.

Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.

Do not stop taking any medications without consulting your healthcare provider.

Disclaimer: Every effort has been made to ensure that the information provided by Multum is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. Multum's information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill, knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective, or appropriate for any given patient. Multum Information Services, Inc. does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. Copyright 2000-2016 Multum Information Services, Inc. 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.

Hide