Which low-molecular-weight heparin is indicated for use with warfarin for the treatment of acute symptomatic deep vein thrombosis?

The correct answer is Tinzaparin, a low-molecular-weight heparin (LMWH) indicated for use alongside warfarin in the treatment of acute symptomatic deep vein thrombosis (DVT). Tinzaparin works by inhibiting factor Xa and factor IIa (thrombin), which helps to effectively reduce the risk of clot propagation during the initial stages of anticoagulation therapy.

In clinical practice, LMWHs like Tinzaparin are favored for bridging therapy because they have predictable pharmacokinetics, which allows for fixed dosing without routine monitoring of activated partial thromboplastin time (aPTT). This characteristic makes Tinzaparin particularly useful in outpatient settings, where close monitoring may not be feasible. The goal during this combination therapy is to provide immediate anticoagulation while warfarin is being titrated to achieve its therapeutic range.

While other options such as Nadroparin and Dalteparin are also LMWHs used for similar purposes, their approved indications may vary, and Tinzaparin has been noted for its specific usage in combination with warfarin for DVT treatment in some clinical guidelines. Fondaparinux, while an anticoagulant, is not classified as a low