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 |