Limited Coverage Drugs - tinzaparin

During the COVID-19 pandemic, PharmaCare is waiving the requirement of warfarin as first line anticoagulant therapy. For Special Authority Requests during this time, please indicate COVID on the request form and note this change is temporary.

Generic Name / Strength / Form
Tinzaparin/ 2,500 IU (Anti-Xa)/0.25 mL / SYRINGE
Tinzaparin/ 3,500 IU (Anti-Xa)/0.35 mL / SYRINGE
Tinzaparin/ 4,500 IU (Anti-Xa)/0.45 mL / SYRINGE
Tinzaparin/ 8,000 IU (Anti-Xa)/0.4 mL / SYRINGE
Tinzaparin/ 10,000 IU (Anti-Xa)/0.5 mL / SYRINGE
Tinzaparin/ 12,000 IU (Anti-Xa)/0.6 mL / SYRINGE
Tinzaparin/ 14,000 IU (Anti-Xa)/0.7 mL / SYRINGE
Tinzaparin/ 16,000 IU (Anti-Xa)/0.8 mL / SYRINGE
Tinzaparin/ 18,000 IU (Anti-Xa)/0.9 mL / SYRINGE
Tinzaparin/ 10,000 IU (Anti-Xa)/ 2 mL / VIAL
Tinzaparin/ 20,000 IU (Anti-Xa)/ 2 mL / VIAL

Special Authority Criteria

Approval Period

Treatment of venous thromboembolism


For the treatment of:

patients with acute deep vein thrombosis or pulmonary embolus who continue to receive care after leaving an acute care (hospital) setting. This treatment bridges the time gap to achieve therapeutic INR on oral anticoagulants


patients with treatment failure on oral anticoagulant therapy (recurrence of one or more deep vein thromboses or pulmonary emboli in patients with therapeutic INR on oral anticoagulants)


patients, associated with cancer, who have failed, or who are unable to tolerate, oral therapy with warfarin

Up to 10 days’ supply



Up to 3 months, then



Up to 6 months

Prophylaxis of venous thromboembolism


For prevention in patients:

following elective total knee replacement surgery


following elective total hip replacement surgery


following orthopedic surgery for major trauma


with lupus anticoagulant syndrome, antiphospholipid syndrome, or thrombophilia


before, during or after pregnancy


Up to 14 days


Up to 35 days


Up to 10 days


Up to 3 months


Up to 4 weeks post-partum

Practitioner Exemptions

  • PharmaCare coverage will be provided for a patient who meets the Limited Coverage criteria, and whose prescription is written by an orthopedic surgeon who has entered into a Collaborative Prescribing Agreement.

  • Due to the individual nature of each Collaborative Prescribing Agreement, the Agreement must be signed by the prescriber and not his/her delegate.

Special Notes

  • The total duration of therapy includes the period during which doses are administered post-operatively in an acute care (hospital) setting, and the approval period is for the balance of the total duration after discharge (i.e., for outpatients only).

Special Authority Request Form(s)