Tinzaparin is a low molecular weight heparin used for the treatment of acute symptomatic deep vein thrombosis with or without pulmonary embolism when administered in conjunction with warfarin.

Brand Names
Generic Name
DrugBank Accession Number

Tinzaparin is a low molecular weight heparin (LMWH), produced by enzymatic depolymerization of unfractionated heparin from porcine intestinal mucosa. It is a heterogeneous mixture of with an average molecular weight between 5500 and 7500 daltons. Tinzaparin is composed of molecules with and without a special site for high affinity binding to antithrombin III (ATIII). This complex greatly accelerates the inhibition of factor Xa. It is an anticoagulant and considered an antithrombotic. Tinzaparin must be given either subcutaneously or parenterally. LMWHs are less effective at inactivating factor IIa due to their shorter length compared to unfractionated heparin.

Small Molecule
  • Tinzaparin sodium
  • Tinzaparina



Tinzaparin is used for the prevention of postoperative venous thromboembolism in patients undergoing orthopedic surgery and in patients undergoing general surgery who are at high risk of developing postoperative venous thromboembolism. It is also used for the treatment of deep vein thrombosis and/or pulmonary embolism. It is indicated for use in preventing clot formation in indwelling intravenous lines for hemodialysis.

Reduce drug development failure rates
Build, train, & validate machine-learning models
with evidence-based and structured datasets.
See how
Build, train, & validate predictive machine-learning models with structured datasets.
See how
Associated Conditions
Contraindications & Blackbox Warnings
Avoid life-threatening adverse drug events
Improve clinical decision support with information on contraindications & blackbox warnings, population restrictions, harmful risks, & more.
Learn more
Avoid life-threatening adverse drug events & improve clinical decision support.
Learn more

Tinzaparin, like other LMWHs, have a higher anti-Xa activity than anti-IIa activity. The anti-Xa activity of tinzaparin is 2.0 +/- 0.5 times greater than its to anti-IIa activity. Heparin exhibits approximately equal inhibitory activity against Xa and IIa. Tinzaparin is an anticoagulant that blocks the formation of thrombi. Like all LMWHs, tinzaparin only causes activated partial thromboplastin time (aPTT) prolongation at higher doses and routine monitoring is not recommended. However, anti-factor Xa levels may be monitored in some conditions such as pregnancy and renal dysfunction. Its use should be avoided in patients with a creatinine clearance less than 20 mL/min. In these patients, unfractionated heparin should be used. Tinzaparin can be used in patients who have a creatinine clearance between 20-30 mL/min, giving it the highest safety threshold for use in renal failure patients compared to all the LMWHs.

Mechanism of action

Tinzaparin binds to the plasma protein antithrombin III, forming a complex with then accelerates the inhibition of factor Xa. Its affinity for factor Xa is 2-4 times greater than that of unbound ATIII. The inactivation of factor Xa in turn will exponentially generation of thrombin (factor IIa) molecules, which is needed to activate fibrinogen to fibrin. The coagulation cascade is inhibited because fibrin cannot be formed in the presence of tinzaparin. Like all LMWH, it cannot be given intramuscularly due to increased risk of hematoma.

UIntegrin alpha-4
UStromal cell-derived factor 1

Subcutaneous injection - about 90% when measured as anti-Xa activity versus 67% for anti-IIa activity.

Volume of distribution

Anti-Xa activity is 4 L. Anti-IIa activity is 10.9 L

Protein binding

Low protein binding compared to unfractionated heparin.


Sulfation and polymerization occurs in the liver.

Route of elimination

Linear elimination through kidneys


Anti-Xa activity is 82 minutes. Anti-IIa activity is 71 minutes.


Clearance is dose-dependant. The clearance of tinzaparin based on anti-Xa activity ranged from 1.14 to 2.04 L/hr

Adverse Effects
Improve decision support & research outcomes
With structured adverse effects data, including: blackbox warnings, adverse reactions, warning & precautions, & incidence rates.
Learn more
Improve decision support & research outcomes with our structured adverse effects data.
Learn more

Osteoporosis with increasing duration of use, bleeding, alopecia, heparin induced thrombocytopenia (HIT). All of these adverse drug reactions occur less with LMWH compared to unfractionated heparin. Tinzaparin showed no toxic effects at doses up to 5 mg/kg in mice, rats, or dogs in standard acute, subacute, and chronic toxicity studies.

Not Available
Pharmacogenomic Effects/ADRs
Not Available


Drug Interactions
This information should not be interpreted without the help of a healthcare provider. If you believe you are experiencing an interaction, contact a healthcare provider immediately. The absence of an interaction does not necessarily mean no interactions exist.
AbciximabThe risk or severity of bleeding can be increased when Abciximab is combined with Tinzaparin.
AcebutololThe risk or severity of hyperkalemia can be increased when Acebutolol is combined with Tinzaparin.
AceclofenacThe risk or severity of bleeding and hemorrhage can be increased when Aceclofenac is combined with Tinzaparin.
AcemetacinThe risk or severity of bleeding and hemorrhage can be increased when Tinzaparin is combined with Acemetacin.
AcenocoumarolThe risk or severity of bleeding can be increased when Acenocoumarol is combined with Tinzaparin.
Acetylsalicylic acidAcetylsalicylic acid may increase the anticoagulant activities of Tinzaparin.
Albutrepenonacog alfaThe therapeutic efficacy of Albutrepenonacog alfa can be decreased when used in combination with Tinzaparin.
AlclofenacThe risk or severity of bleeding and hemorrhage can be increased when Alclofenac is combined with Tinzaparin.
AldesleukinThe risk or severity of bleeding can be increased when Tinzaparin is combined with Aldesleukin.
AlemtuzumabThe risk or severity of bleeding can be increased when Tinzaparin is combined with Alemtuzumab.
Identify potential medication risks
Easily compare up to 40 drugs with our drug interaction checker.
Get severity rating, description, and management advice.
Learn more
Food Interactions
  • Avoid herbs and supplements with anticoagulant/antiplatelet activity. Examples include garlic, ginger, bilberry, danshen, piracetam, and ginkgo biloba.


Drug product information from 10+ global regions
Our datasets provide approved product information including:
dosage, form, labeller, route of administration, and marketing period.
Access now
Access drug product information from over 10 global regions.
Access now
Brand Name Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing EndRegionImage
InnohepInjection, solution20000 [iU]/1mLSubcutaneousLeo Pharma2010-07-012013-08-01US flag
InnohepSolution10000 unit / mLSubcutaneousLeo Pharma2011-09-09Not applicableCanada flag
InnohepSolution12000 unit / 0.6 mLSubcutaneousLeo Pharma2014-09-30Not applicableCanada flag
InnohepSolution20000 unit / mLSubcutaneousLeo Pharma1997-02-28Not applicableCanada flag
InnohepSolution20000 unit / mLSubcutaneousLeo Pharma2011-09-16Not applicableCanada flag
InnohepInjection20000 [iU]/1mLSubcutaneousCelgene2008-04-14Not applicableUS flag
InnohepSolution20000 unit / mLSubcutaneousLeo Pharma1997-09-23Not applicableCanada flag
InnohepSolution8000 unit / 0.4 mLSubcutaneousLeo Pharma2014-09-30Not applicableCanada flag
InnohepSolution10000 unit / mLSubcutaneousLeo Pharma1995-12-31Not applicableCanada flag
InnohepSolution10000 unit / mLSubcutaneousLeo Pharma2011-12-10Not applicableCanada flag


ATC Codes
B01AB10 — Tinzaparin
Drug Categories
Not classified
Affected organisms
Not Available

Chemical Identifiers

CAS number


General References
  1. Friedel HA, Balfour JA: Tinzaparin. A review of its pharmacology and clinical potential in the prevention and treatment of thromboembolic disorders. Drugs. 1994 Oct;48(4):638-60. [Article]
  2. Simonneau G, Sors H, Charbonnier B, Page Y, Laaban JP, Azarian R, Laurent M, Hirsch JL, Ferrari E, Bosson JL, Mottier D, Beau B: A comparison of low-molecular-weight heparin with unfractionated heparin for acute pulmonary embolism. The THESEE Study Group. Tinzaparine ou Heparine Standard: Evaluations dans l'Embolie Pulmonaire. N Engl J Med. 1997 Sep 4;337(10):663-9. [Article]
  3. Planes A, Samama MM, Lensing AW, Buller HR, Barre J, Vochelle N, Beau B: Prevention of deep vein thrombosis after hip replacement--comparison between two low-molecular heparins, tinzaparin and enoxaparin. Thromb Haemost. 1999 Jan;81(1):22-5. [Article]
  4. Cheer SM, Dunn CJ, Foster R: Tinzaparin sodium: a review of its pharmacology and clinical use in the prophylaxis and treatment of thromboembolic disease. Drugs. 2004;64(13):1479-502. [Article]
  5. Hoy SM, Scott LJ, Plosker GL: Tinzaparin sodium: a review of its use in the prevention and treatment of deep vein thrombosis and pulmonary embolism, and in the prevention of clotting in the extracorporeal circuit during haemodialysis. Drugs. 2010 Jul 9;70(10):1319-47. doi: 10.2165/11203710-000000000-00000. [Article]
  6. Hedner U: Development of tinzaparin: a heparinase-digested low-molecular-weight heparin. Semin Thromb Hemost. 2000;26 Suppl 1:23-9. [Article]
  7. Pautas E, Siguret V, d'Urso M, Laurent M, Gaussem P, Fevrier M, Durand-Gasselin B: [Monitoring of tinzaparin in a ten day treatment dose in elderly patients]. Rev Med Interne. 2001 Feb;22(2):120-6. [Article]
  8. Pineo GF, Hull RD: Tinzaparin in the treatment of venous thromboembolism. Expert Opin Pharmacother. 2003 Dec;4(12):2355-62. [Article]
  9. Fossler MJ, Barrett JS, Hainer JW, Riddle JG, Ostergaard P, van der Elst E, Sprogel P: Pharmacodynamics of intravenous and subcutaneous tinzaparin and heparin in healthy volunteers. Am J Health Syst Pharm. 2001 Sep 1;58(17):1614-21. [Article]
  10. Cambus JP, Saivin S, Heilmann JJ, Caplain H, Boneu B, Houin G: The pharmacodynamics of tinzaparin in healthy volunteers. Br J Haematol. 2002 Mar;116(3):649-52. [Article]
PubChem Substance

Clinical Trials

Clinical Trials
4Active Not RecruitingTreatmentCoronavirus Disease 2019 (COVID‑19)1
4CompletedNot AvailableVenous Thromboembolism1
4CompletedPreventionCoronavirus Disease 2019 (COVID‑19) / COVID / Deep Vein Thrombosis / Pulmonary Embolism / Thrombosis1
4CompletedPreventionDeep Vein Thrombosis / Pulmonary Embolism1
4CompletedPreventionRenal Failure, Chronic Renal Failure1
4CompletedTreatmentAcute Pulmonary Embolism (PE)1
4CompletedTreatmentArterial Occlusion1
4CompletedTreatmentDeep Vein Thrombosis1
4CompletedTreatmentIntrauterine Growth Retardation (IUGR)1
4CompletedTreatmentThromboembolism / Thrombosis / Venous Thrombosis (Disorder)2


Not Available
Not Available
Dosage Forms
InjectionSubcutaneous20000 [iU]/1mL
Injection, solution
Injection, solutionParenteral10000 UI/0.5ML
Injection, solutionParenteral12000 UI/0.6ML
Injection, solutionParenteral14000 UI/0.7ML
Injection, solutionParenteral16000 UI/0.8ML
Injection, solutionParenteral18000 UI/0.9ML
Injection, solutionParenteral2500 UI/0.25ML
Injection, solutionParenteral3500 UI/0.35ML
Injection, solutionParenteral4500 UI/0.45ML
Injection, solutionParenteral8000 UI/0.4ML
Injection, solutionSubcutaneous20000 [iU]/1mL
Solution20000 IU/1mL
SolutionSubcutaneous10000 unit / mL
SolutionSubcutaneous12000 unit / 0.6 mL
SolutionSubcutaneous16000 unit / 0.8 mL
SolutionSubcutaneous20000 unit / mL
SolutionSubcutaneous8000 unit / 0.4 mL
Suspension10000 IU/1mL
Injection, solution20000 IU/1mL
Injection, solutionParenteral
Injection, solutionParenteral10.000 IE/0.5ML
Injection, solutionParenteral12.000 IE/0.6ML
Injection, solutionSubcutaneous14000 IU/0.7mL
Injection, solutionParenteral14.000 IE/0.7ML
Injection, solutionParenteral16.000 IE/0.8ML
Injection, solutionParenteral18.000 IE/0.9ML
InjectionSubcutaneous18000 iu/0.9ml
Injection, solutionParenteral20000 IU
Injection, solutionParenteral0.35 ML
Injection, solutionParenteral4500 IU
Injection, solutionParenteral8.000 IE/0.4ML
Injection, solutionParenteral8000 IE/0.4ML
LiquidSubcutaneous11700 unit / mL
InjectionSubcutaneous10,000 axa iu/ml
Injection, solutionSubcutaneous10000 IU/0.5mL
Injection, solutionSubcutaneous10000 IU/mL
InjectionSubcutaneous14,000 IU
InjectionSubcutaneous20000 axa iu/ml
InjectionSubcutaneous3500 axa iu/0.35 ml
Injection, solutionSubcutaneous3500 IU/0.35mL
InjectionSubcutaneous4,500 IU
Injection, solutionSubcutaneous4500 IU/0.45mL
SolutionParenteral2500 IU
SolutionParenteral3500 IU
InjectionParenteral10 IU
SolutionParenteral20000 IU
LiquidSubcutaneous10000 unit / mL
Not Available
Not Available


Experimental Properties
Not Available
Predicted Properties
Not Available
Predicted ADMET Features
Not Available


Mass Spec (NIST)
Not Available
Not Available


Build, predict & validate machine-learning models
Use our structured and evidence-based datasets to unlock new
insights and accelerate drug research.
Learn more
Use our structured and evidence-based datasets to unlock new insights and accelerate drug research.
Learn more
Pharmacological action
General Function
Serine-type endopeptidase inhibitor activity
Specific Function
Most important serine protease inhibitor in plasma that regulates the blood coagulation cascade. AT-III inhibits thrombin, matriptase-3/TMPRSS7, as well as factors IXa, Xa and XIa. Its inhibitory a...
Gene Name
Uniprot ID
Uniprot Name
Molecular Weight
52601.935 Da
  1. Bisio A, Vecchietti D, Citterio L, Guerrini M, Raman R, Bertini S, Eisele G, Naggi A, Sasisekharan R, Torri G: Structural features of low-molecular-weight heparins affecting their affinity to antithrombin. Thromb Haemost. 2009 Nov;102(5):865-73. doi: 10.1160/TH09-02-0081. [Article]
  2. Florian-Kujawski M, Hoppensteadt D, Maddineni J, Ziegler H, Fareed J: Differential regulation of thrombin activatable fibrinolytic inhibitor by low molecular weight heparins. Pharmacologic implications. Int Angiol. 2004 Dec;23(4):346-54. [Article]
  3. Morris TA, Jacobson A, Marsh JJ, Lane JR: Pharmacokinetics of UH and LMWH are similar with respect to antithrombin activity. Thromb Res. 2005;115(1-2):45-51. [Article]
Pharmacological action
General Function
Metal ion binding
Specific Function
Integrins alpha-4/beta-1 (VLA-4) and alpha-4/beta-7 are receptors for fibronectin. They recognize one or more domains within the alternatively spliced CS-1 and CS-5 regions of fibronectin. They are...
Gene Name
Uniprot ID
Uniprot Name
Integrin alpha-4
Molecular Weight
114898.745 Da
  1. Schlesinger M, Simonis D, Schmitz P, Fritzsche J, Bendas G: Binding between heparin and the integrin VLA-4. Thromb Haemost. 2009 Nov;102(5):816-22. doi: 10.1160/TH09-01-0061. [Article]
Pharmacological action
General Function
Not Available
Specific Function
Not Available
Gene Name
Uniprot ID
Uniprot Name
Stromal cell-derived factor 1
Molecular Weight
10665.75 Da
  1. Koo CY, Sen YP, Bay BH, Yip GW: Targeting heparan sulfate proteoglycans in breast cancer treatment. Recent Pat Anticancer Drug Discov. 2008 Nov;3(3):151-8. [Article]


Pharmacological action
General Function
Zinc ion binding
Specific Function
Cleaves aggrecan, a cartilage proteoglycan, and may be involved in its turnover. May play an important role in the destruction of aggrecan in arthritic diseases. Could also be a critical factor in ...
Gene Name
Uniprot ID
Uniprot Name
A disintegrin and metalloproteinase with thrombospondin motifs 4
Molecular Weight
90196.02 Da
  1. Mousa SA: Effect of low molecular weight heparin and different heparin molecular weight fractions on the activity of the matrix-degrading enzyme aggrecanase: structure-function relationship. J Cell Biochem. 2005 May 1;95(1):95-8. [Article]

Drug created at September 14, 2010 16:21 / Updated at September 25, 2023 18:32