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Fondaparinux

Aka: Fondaparinux, Arixtra

Mechanism
1. Heparin derivative
2. Binds activated factor X (Factor Xa)
Indications: Orthopedic Perioperative DVT Prophylaxis
1. Hip Fracture
2. Hip replacement
3. Knee replacement
Contraindications (due to bleeding risk)
1. Severe renal Impairment
2. Weight less than 110 pounds
Dosing
1. Prophylaxis: DVT
  1. Arixtra 2.5 mg SQ daily
2. Therapeutic: Bridging for DVT or PE to Warfarin
  1. Weight <50 Kg: 5 mg SQ daily
  2. Weight 50-100 Kg: 7.5 mg SQ daily
  3. Weight >100 Kg: 10 mg SQ daily
Complications
1. Bleeding
  1. Higher risk than Low Molecular Weight Heparin
2. Spinal thrombosis with risk of paralysis
  1. Associated with concurrent spinal anesthetic
Efficacy
1. Lower perioperative DVT and Thromboembolism Incidence in hip surgery
References
1. Eriksson (2001) N Engl J Med 345:1298-304
2. Turpie (2004) Chest 126:501-8

Medication Costs
Arixtra (on 2/9/2012 at DrugStore.com)
Arixtra 2.5mg/0.5ml Solution 0.5ml Syringe	#10 for $593.04	($59.30/unit)
Arixtra 7.5mg/0.6ml Solution 0.6ml Syringe	#1 for $140.09	($140.09/unit)
FPNotebook does not benefit financially from showing this medication data or their pharmacy links. This information is provided only to help medical providers and their patients see relative costs. Insurance plans negotiate lower medication prices with suppliers. Prices shown here are out of pocket, non-negotiated rates. See Needy Meds for financial assistance information.

fondaparinux (C1098510)
Definition (NCI)	A drug used to prevent blood clots from forming inside blood vessels in the leg. It is being studied in the prevention of blood clots in some cancer patients, including women having surgery for cancer of the reproductive tract. It is a type of anticoagulant.
Definition (NCI)	A drug used to prevent blood clots from forming inside blood vessels in the leg. It is being studied in the prevention of blood clots in some cancer patients, including women having surgery for cancer of the reproductive tract. It is a type of anticoagulant.
Definition (NCI)	A synthetic glucopyranoside with antithrombotic activity. Fondaparinux selectively binds to antithrombin III, thereby potentiating the innate neutralization of activated factor X (Factor Xa) by antithrombin. Neutralization of Factor Xa inhibits its activity and interrupts the blood coagulation cascade, thereby preventing thrombin formation and thrombus development.
Concepts	Carbohydrate (T118) , Pharmacologic Substance (T121)
MSH	C438268
SnomedCT	395236007
English	fondaparinux [Chemical/Ingredient], fondaparinux, Fondaparinux, Fondaparinux (product), FONDAPARINUX
Spanish	fondaparinux (producto), fondaparinux
Sources	Derived from the NIH UMLS (Unified Medical Language System)

Arixtra (C1099665)
Concepts	Carbohydrate (T118) , Pharmacologic Substance (T121)
MSH	C438268
English	Arixtra, arixtra, Sanofi Synthelabo brand of fondaparinux sodium, Sanofi brand of fondaparinux sodium
Sources	Derived from the NIH UMLS (Unified Medical Language System)

Family Practice Notebook

Patients should address specific medical concerns with their physicians.

Although access to this page is not restricted, the information found here is intended for use by medical providers.

This page was written by Scott Moses, MD, last revised on 3/22/2012 and last published on 5/14/2013.

This is one of 5887 pages in the Family Practice Notebook