III. Indications
- Venous Thromboembolism (DVT, PE)
- Heparin Induced Thrombocytopenia (not FDA approved)
- Orthopedic Perioperative DVT Prophylaxis
- Hip Fracture
- Hip replacement
- Knee replacement
IV. Pharmacokinetics
- Half-Life: 17-21 hours
- Renal Clearance 100%
V. Contraindications (due to bleeding risk)
- Weight less than 110 pounds (relative contraindication, or use 5 mg dose)
- Renal Impairment
- Creatinine Clearance 30-50 mg/min
- Use with caution and consider 50% dose reduction
- Creatinine Clearance <30 mg/min
- Avoid use
- Creatinine Clearance 30-50 mg/min
VI. Dosing
-
DVT Prophylaxis
- Start 2.5 mg SQ daily at 6 to 8 hours post-surgery
- Continue for 5 to 9 days (extended up to 24 to 32 days following Hip Fracture surgery)
- Therapeutic Bridging for DVT or PE to Warfarin
- Continue until for at least 5 days and therapeutic INR
- Weight <50 Kg: 5 mg SQ daily
- Weight 50-100 Kg: 7.5 mg SQ daily
- Weight >100 Kg: 10 mg SQ daily
- Acute Heparin Induced Thrombocytopenia (not FDA approved)
- Same dosing as for therapeutic bridging
VII. Complications
- Bleeding
- Higher risk than Low Molecular Weight Heparin
- Spinal thrombosis with risk of paralysis
- Associated with concurrent spinal Anesthetic
VIII. Efficacy
- Lower perioperative DVT and ThromboembolismIncidence in hip surgery
IX. Safety
- Unknown Safety in Pregnancy
- Unknown Safety in Lactation
X. Resources
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Related Studies
| fondaparinux (on 9/20/2023 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| FONDAPARINUX 10 MG/0.8 ML SYR | Generic | $50.05 per ml |
| FONDAPARINUX 7.5 MG/0.6 ML SYR | Generic | $55.63 per ml |
Ontology: fondaparinux (C1098510)
| Definition (NCI_NCI-GLOSS) | 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 | Pharmacologic Substance (T121) , Carbohydrate (T118) |
| MSH | C438268 |
| SnomedCT | 395236007 |
| LNC | LP63637-0, MTHU025935 |
| English | fondaparinux [Chemical/Ingredient], FONDAPARINUX, fondaparinux, Fondaparinux, Fondaparinux (product) |
| Spanish | fondaparinux (producto), fondaparinux |
Ontology: Arixtra (C1099665)
| Concepts | Pharmacologic Substance (T121) , Carbohydrate (T118) |
| MSH | C438268 |
| English | Arixtra, arixtra, Sanofi Synthelabo brand of fondaparinux sodium, Sanofi brand of fondaparinux sodium |
