Tinzaparin

Tinzaparin is a medicine called an anticoagulant, also known as a blood thinner

• It belongs to group of drugs known as low molecular weight heparins.
• You may hear tinzaparin called by its brand name, Innohep.
• Tinzaparin comes as a clear liquid for injection. It is given by a needle just under the skin (subcutaneously or SC).
• Tinzaparin works by changing the way blood normally clots together. It helps to prevent unwanted blood clots or break up harmful blood clots.
  

Before giving tinzaparin to your child

Tell your doctor if your child:

• is allergic to tinzaparin, other low molecular weight heparins, heparin, sulfites, benzyl alcohol or pork products
• has any blood clotting problems, other conditions that increase the risk of bleeding or any active major bleeding
• has had a blood clotting reaction to heparin called thrombocytopenia, which is low platelet count

Talk with your doctor or pharmacist if your child has any of the following conditions. Precautions may need to be taken with this medicine if your child has:

• kidney or liver problems
• stomach ulcers
• high blood pressure

How to give your child tinzaparin

Your child's first dose of tinzaparin will likely be given in the hospital or in clinic. If your child is to receive tinzaparin at home, arrangements may be made to have a nurse come into the home to give it. Alternatively, you may be taught by one of the nurses to give your child the subcutaneous (SC) injections, which are injections under the skin, at home.

If you give the injections at home:

• Make sure you understand and are comfortable with the way to prepare and inject tinzaparin and know how to dispose of the needle and syringe.
• Please see the "Tinzaparin: Injecting at home" Family Med Aid for more information.
• Dispose of needles in a needle or sharps disposal container.

Knowing how much to give

Tinzaparin is available in several different strengths. The dosing information below applies to the 20,000 units/mL (2 mL) multidose vials.

It is important that you know:

• your child's dose as the number of units of tinzaparin
• the volume of solution that your child needs

Tinzaparin is usually injected using insulin syringes that are specially designed for injections into the skin. It is important to note that the volume is measured in units on an insulin syringe, and that one unit of insulin is not equal to one unit of tinzaparin.

1 unit on the insulin syringe = 200 units of tinzaparin.

Your child has been prescribed _______ units of tinzaparin each dose.

This dose is equal to _______mL of 20,000 units per mL. This is equal to _______units on an insulin syringe.

The doctor may sometimes need to change the dose. Please bring this Med-aid to all your child's Thrombosis Clinic appointments. If your child's dose of tinzaparin changes, please ask one of the nurses or the pharmacist to complete the dose chart at the end of this Med-aid for you.

Tinzaparin dosing chart

For more information, see Tinzaparin: Injecting at Home.

What to do if your child misses a dose of tinzaparin

• Give the missed dose as soon as you remember.
• If it is almost time for the next dose, skip the missed dose. Give the next dose at the regular time.
• Do not give your child two doses to make up for one missed dose.
  
  

Possible side effects of this medicine

Your child may have some of these side effects while they take tinzaparin:

• irritation, pain or redness at the place of injection
• back pain
• headache
• dizziness
• for older girls, longer or heavier menstrual periods
• bleeding or bruising more easily than normal

Most of the following side effects are not common, but they may be a sign of a serious problem. Call the Thrombosis Team or your child's doctor, or take your child to Emergency if your child has any of these side effects:

• signs of a life-threatening reaction, including: wheezing, shortness of breath, chest tightness or chest pain, fever, itching, bad cough, blue skin colour, or swelling of the face, lips, tongue or throat
• rash
• deep, dark purple bruise, or pain and swelling at the site of injection
• unusual bleeding, such as a very long nosebleed, blood in the urine, coughing or throwing up blood, bleeding at the place of injection, or bleeding or oozing from the surgical site
• black, sticky, tarry stools or stools with red streaks

Safety measures to take when your child is using tinzaparin

• Talk to your doctor immediately if your child has a bad fall, especially if your child hits their head.
• Head protection is important for sports, such as bicycling or rollerblading. Do not let your child play rough sports, like hockey or football. They can get bruised or injured.
• Before your child has any kind of surgery, such as dental work, a medical procedure or emergency treatment, tell the doctor or dentist that your child is taking tinzaparin. Please call the Thrombosis Service, in advance.
• It may be recommended that your child wear a Medic Alert bracelet or necklace while on tinzaparin. The Thrombosis Team will tell you depending on how long your child will be on tinzaparin.

There are some medicines that should not be taken together with tinzaparin, or in some cases the dose of tinzaparin or the other medicine may need to be adjusted. It is important that you tell your doctor and pharmacist if your child takes any other medicines (prescription, over-the-counter or herbal), including:

• non-steroid anti-inflammatory drugs (NSAIDs), such as ASA and ibuprofen
• some cold and flu medicines contain ASA or ibuprofen too; check with your pharmacist or doctor first
• any other medications that can affect blood clotting, such as warfarin

Other important information to know about tinzaparin

• Once opened, the vial can be used for 30 days only. After the 30 days, the vial must be discarded, even if there is still some tinzaparin remaining.
• Keep a list of all medicines your child is on and show the list to the doctor or pharmacist.
• Do not share your child's medicine with others. Do not give anyone else's medicine to your child.
• Make sure you always have enough tinzaparin to last through weekends, holidays and vacations. Call your pharmacy at least two days before your child runs out of medicine to order refills.
• Keep tinzaparin at room temperature in a cool, dry place away from sunlight. Do not store it in the bathroom or kitchen.
• Do not keep any medicines that are out of date. Check with your pharmacist about the best way to throw away outdated or leftover medicines.
  

Personal stories about the use of low molecular weight heparins

Two families share their experiences with using low molecular weight heparins. This video will help to answer any questions you may have if you or someone you know will be taking this medication.

If you are using a printout of this page you can watch two videos at www.aboutkidshealth.ca/tinzaparin.

Thrombosis Learning Hub

For more information on thrombosis, post-thrombotic syndrome and the management of these conditions, please visit the Thrombosis Learning Hub.

Keep tinzaparin out of your child’s sight and reach and locked up in a safe place. If your child takes too much tinzaparin, call your local Poison Information Centre at one of these numbers. These calls are free. 

• Call 1-844 POISON-X, or 1-844-764-7669, from anywhere in Canada except Quebec.
• Call 1-800-463-5060 if you live in Quebec.