Tinzaparin (multi-dose vial solution for injection)
Specialist use off label in paediatrics ONLY for prophylaxis or treatment of thromboembolic disorders in long term/Homecare patients with no necessity to remain in hospital (refer to Southampton Children's Hospital guidelines).
Not for use in adults (enoxaparin is LMWH of choice at UHS for adults).
Multidose vials contain 10mg/ml of the preservative benzyl alcohol: may cause toxic and anaphylactoid reactions in infants and children up to 3 years old. Where possible use alternative CIVAS enoxaparin syringes in neonates.
for thromboprophylaxis when history of heparin-induced thrombocytopenia only when danaparoid is unobtainable
as an adjunct to thrombolysis with tenecteplase in STEMI
for superficial thrombophlebitis
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Dalteparin (Fragmin®) (injection)
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Suitable for prescribing by all in both primary and secondary care.
Specialist recommended but suitable for continuation in primary care.
Specialist initiated but suitable for continuation in primary care.
Specialist initiated and for continuation in primary care under a locally approved shared care guideline.
Suitable for prescribing in specialist settings (secondary care) only.
Secondary care medicines to be used under specialised commissioning arrangements only.
For primary care, either via FP10 or supplied through specialist services. These products may be stocked by hospital
pharmacies only for supply to primary care units/wards or for continuing supplies for patients admitted on therapy.