NHS Greater Glasgow & Clyde Area Drug and Therapeutics Committee
Greater Glasgow and Clyde Medicines
Medicines Update

LMWH in patients with solid tumours

SMC have accepted tinzaparin for extended treatment of symptomatic venous thromboembolism and prevention of its recurrence, in patients with solid tumours. NHSGGC specialists advise that dalteparin should remain our LMWH of choice in cancer patients with VTE. The NHSGGC clinical guideline  notes that responsibility for ongoing monitoring and completion of anticoagulant therapy rests with the doctor managing the patient's cancer: this may be the oncologist or specialist physician, palliative care consultant or GP. This individual should be identified and consulted on the treatment plan prior to discharge from the acute team. Prescribers are reminded that the treatment plan, which should be detailed within the discharge letter, includes a dose reduction for dalteparin after one month.