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What is the most important information I should know about tinzaparin?

Do not use this medication if you are allergic to tinzaparin, heparin, sulfites, benzyl alcohol, or pork products. Do not take aspirin or other NSAIDs (non-steroidal anti-inflammatory drugs) without your doctor's advice. These medicines may lead to bleeding when taken with tinzaparin. NSAIDs include ibuprofen (Motrin, Advil), naproxen (Aleve, Naprosyn), diclofenac (Voltaren), diflunisal (Dolobid), etodolac (Lodine), flurbiprofen (Ansaid), indomethacin (Indocin), ketoprofen (Orudis), ketorolac (Toradol), mefenamic acid (Ponstel), meloxicam (Mobic), nabumetone (Relafen), piroxicam (Feldene), and others.

Tinzaparin may cause severe or life-threatening side effects if you use it while you have any active bleeding or hemorrhage, such as a bleeding ulcer, nosebleeds, unusual bruising, blood in your urine or stools, unusual vaginal bleeding, or coughing up blood.

Call your doctor at once if you have any signs of bleeding, such as feeling light-headed, fainting, uncontrolled nosebleeds, pale skin, unusual weakness, easy bruising or bleeding, purple or red pinpoint spots under your skin, blood in your urine or stools, or coughing up blood.

Tinzaparin should not be used together with certain other blood thinners or medicines that prevent blood from clotting. Do not use any other blood thinners without your doctor's advice.

What is tinzaparin?

Tinzaparin is a blood thinner (anticoagulant) that prevents blood clots from forming in the body.

Tinzaparin is used together with warfarin (Coumadin) to treat a type of blood clot called deep vein thrombosis, or DVT. This condition sometimes occurs with a blood clot in lungs (pulmonary embolism).

Tinzaparin may also be used for purposes other than those listed in this medication guide.

What should I discuss with my healthcare provider before using tinzaparin?

Do not use this medication if you are allergic to tinzaparin, heparin, sulfites, benzyl alcohol, or pork products.

Tinzaparin may cause severe or life-threatening side effects if you you use it while you have any active bleeding or hemorrhage, such as:

• a bleeding stomach ulcer;

• uncontrolled nosebleeds;

• blood vessel damage in the eyes (retinopathy) caused by diabetes;

• large purple spots or red pinpoint spots under your skin;

• bleeding from your rectum or vagina;

• blood in your urine;

• bloody or black, tarry stools; or

• coughing up blood or vomit that looks like coffee grounds.

Tinzaparin should not be used together with other blood thinners or medicines that prevent blood from clotting. Before using tinzaparin, tell your doctor if are using or have recently used any of the following drugs:

• abciximab (ReoPro);

• argatroban (Acova);

• bivalirudin (Angiomax);

• cilostazol (Pletal);

• clopidogrel (Plavix);

• dipyridamole (Persantine);

• eptifibatide (Integrelin);

• heparin;

• lepirudin (Refludan);

• ticlopidine (Ticlid); or

• tirofiban (Aggrastat).

Certain medical conditions can increase your risk of bleeding or hemorrhage while using tinzaparin, such as:

• a bleeding or blood-clotting disorder, such as hemophilia;

• bacterial endocarditis (infection of the heart's inner layer);

• congestive heart failure;

• untreated or uncontrolled high blood pressure;

• liver failure;

• kidney disease;

• diabetes;

• Alzheimer's or Parkinson's disease;

• Huntington's disease; or

• recent surgery on your brain, spine, or eyes.

If you have any of these conditions, you may not be able to use tinzaparin, or you may need a dosage adjustment or special tests during treatment.

FDA pregnancy category B. This medication is not expected to be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. It is not known whether tinzaparin passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.