Innohep (Tinzaparin Sodium)

Innohep (tinzaparin sodium) is used in the anticoagulation pathway to manage thrombotic disorders.

• Prevention of venous thromboembolism: reduces the risk of clot formation in patients undergoing surgery or immobilisation.
• Treatment of deep vein thrombosis: facilitates clot resolution and prevents extension of the thrombus.
• Treatment of pulmonary embolism: helps dissolve emboli and lowers the chance of recurrence.

• Tinzaparin sodium binds to antithrombin III, markedly enhancing its inhibition of activated factor Xa and, to a lesser extent, factor IIa (thrombin). This accelerates the inactivation of key clotting factors within the coagulation cascade, decreasing thrombin generation and fibrin formation, thereby producing an anticoagulant effect.

Common Side Effects

• Injection site pain or bruising: mild discomfort at the subcutaneous site.
• Minor bleeding: such as gum or nosebleeds.
• Nausea or headache: transient and usually self‑limiting.
• Elevated liver enzymes: occasional mild laboratory abnormality.

Serious or Rare Side Effects

• Major bleeding: gastrointestinal, intracranial or surgical site hemorrhage.
• Heparin‑induced thrombocytopenia (HIT): immune‑mediated platelet drop with paradoxical clot risk.
• Severe allergic reaction: rash, angioedema or anaphylaxis.
• Spinal or epidural hematoma: rare but critical when neuraxial procedures are performed.

Innohep requires careful clinical monitoring to minimise risks.

• Assess renal function: dose adjustment may be needed in severe renal impairment.
• Monitor platelet count: watch for heparin‑induced thrombocytopenia.
• Evaluate bleeding risk: avoid in patients with active or uncontrolled bleeding.
• Use caution with concurrent anticoagulants or antiplatelet agents.
• Contraindicated in known hypersensitivity to tinzaparin or heparin products.
• Store at ambient temperature: keep in original container, protect from moisture and light.

Innohep can interact with several medicines that affect haemostasis.

Major Interactions (Avoid)

• Other anticoagulants (e.g., warfarin, direct oral anticoagulants): additive bleeding risk.
• Antiplatelet agents (aspirin, clopidogrel): increased hemorrhage potential.
• Fibrinolytic therapy (tPA, streptokinase): synergistic anticoagulant effect.
• Non‑steroidal anti‑inflammatory drugs (NSAIDs): heightened gastrointestinal bleeding.
• Neuraxial anesthesia or spinal puncture: risk of spinal hematoma.

Moderate Interactions (Monitor Closely)

• Concurrent heparin therapy: cumulative anticoagulant effect.
• Certain antibiotics (e.g., quinolones, macrolides): may potentiate bleeding.
• Selective serotonin reuptake inhibitors (SSRIs) and corticosteroids: modest increase in bleeding tendency.