innohep Special Precautions

Tinzaparin sodium (innohep) should be given with caution to patients with: hepatic and renal insufficiency; uncontrolled arterial hypertension; gastrointestinal ulceration; suspicion of malignoma with bleeding tendency; history of peptic ulcer disease; nephrolith and/or ureterolith; concomitant use of drugs which increase the serum potassium levels, oral anticoagulants, platelet inhibitors (e.g. ASA).
Precaution is recommended in the treatment of patients with severe renal impairment (creatinine clearance < 30 mL/min).
Precaution is recommended in the treatment of elderly patients with renal impairment. Renal function should be assessed and in patients with severe renal impairment (creatinine clearance < 30 mL/min), monitoring of anti-factor Xa activity should be considered.
Platelet counts are recommended before administration of tinzaparin, on the first day of therapy and then regularly every 3 or 4 days and at the end of therapy.
As with other LMWHs, the administration of Tinzaparin sodium (innohep) in some patients undergoing surgical procedures (especially orthopaedic) or presenting a concomitant inflammatory process, has coincided with an asymptomatic increase of platelet count, which in many cases subsided without stopping administration of Tinzaparin sodium (innohep). If an increase in platelet count occurs, evaluation of the benefit/risk of continuing therapy for that patient should be made.
Due to the content of sodium metabisulfite, Tinzaparin sodium (innohep) should not be used in patients with asthma and hypersensitivity to sulphites.
Caution in the treatment of elderly patients.
Must not be administered by intramuscular or intravenous injection.
Due to the risk of haematoma during Tinzaparin sodium (innohep) therapy the intramuscular injection of other agents should be avoided.