Innohep (Tinzaparin Sodium)

Innohep, a low molecular weight heparin, is used in the management of venous thromboembolic conditions.

• Deep vein thrombosis (DVT) prevention: lowers the incidence of clot formation in at‑risk surgical or immobilised patients.
• Acute DVT treatment: facilitates clot resolution and reduces progression of the thrombus.
• Pulmonary embolism (PE) prevention and treatment: helps avert embolic events and supports recovery after an episode.
• Surgical thromboprophylaxis: provides prophylaxis against thromboembolic complications in patients undergoing major surgery.

• Tinzaparin sodium potentiates antithrombin III, enhancing its inhibition of activated factor Xa and, to a lesser extent, factor IIa (thrombin). This results in reduced generation of thrombin and fibrin, thereby limiting clot formation while preserving a degree of normal coagulation function.

Common Side Effects

• Injection site erythema or bruising.
• Minor bleeding such as nosebleeds or gum bleeding.
• Transient elevation of liver enzymes.
• Mild thrombocytopenia.
• Gastrointestinal discomfort.

Serious or Rare Side Effects

• Major hemorrhage, including intracranial or gastrointestinal bleeding.
• Heparin‑induced thrombocytopenia (HIT) with paradoxical clotting.
• Severe allergic reactions or anaphylaxis.
• Spontaneous bruising or hematoma formation.
• Elevated liver transaminases persisting beyond two weeks.

Before using Innohep, consider the following precautions:

• Renal impairment: adjust dose or monitor anti‑Xa levels in patients with reduced kidney function.
• History of bleeding: evaluate risk and correct coagulopathies prior to initiation.
• Concomitant anticoagulants: avoid simultaneous use with other anticoagulants unless specifically directed.
• Pregnancy and lactation: weigh benefits against potential risks; use only if clearly indicated.
• Surgery or invasive procedures: discontinue appropriately before the procedure to minimise bleeding.
• Store at 2-8°C: keep refrigerated, protect from light, do not freeze or shake.

Innohep may interact with several drug classes.

Major Interactions (Avoid)

• Concurrent use with other anticoagulants (e.g., warfarin, direct oral anticoagulants) markedly increases bleeding risk.
• Systemic thrombolytics: additive anticoagulant effect can lead to severe hemorrhage.
• High‑dose aspirin or NSAIDs: potentiate gastrointestinal bleeding.

Moderate Interactions (Monitor Closely)

• Antiplatelet agents (e.g., clopidogrel): monitor for signs of bleeding.
• Certain antibiotics (e.g., fluoroquinolones) that may affect platelet function.
• Drugs affecting renal clearance (e.g., aminoglycosides): adjust monitoring of anti‑Xa activity.