Hematology and Oncology Book



Aka: Fondaparinux, Arixtra
  1. Mechanism
    1. Heparin derivative
    2. Binds activated Factor X (Factor Xa)
  2. Indications: Orthopedic Perioperative DVT Prophylaxis
    1. Hip Fracture
    2. Hip replacement
    3. Knee replacement
  3. Pharmacokinetics
    1. Half-life: 17-21 hours
    2. Renal clearance 100%
  4. Contraindications (due to bleeding risk)
    1. Weight less than 110 pounds (relative contraindication, or use 5 mg dose)
    2. Renal Impairment
      1. Creatinine Clearance 30-50 mg/min
        1. Use with caution and consider 50% dose reduction
      2. Creatinine Clearance <30 mg/min
        1. Avoid use
  5. 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
  6. Complications
    1. Bleeding
      1. Higher risk than Low Molecular Weight Heparin
    2. Spinal thrombosis with risk of paralysis
      1. Associated with concurrent spinal Anesthetic
  7. Efficacy
    1. Lower perioperative DVT and ThromboembolismIncidence in hip surgery
  8. References
    1. Eriksson (2001) N Engl J Med 345:1298-304 [PubMed]
    2. Turpie (2004) Chest 126:501-8 [PubMed]
    3. Wilbur (2017) Am Fam Physician 95(5): 295-302 [PubMed]
Medication Costs
fondaparinux (on 8/17/2016 at Medicaid.Gov Pharmacy Drug pricing)
FONDAPARINUX 2.5 MG/0.5 ML SYR Generic $36.32 per ml
FONDAPARINUX 7.5 MG/0.6 ML SYR Generic $118.01 per ml
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_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
Derived from the NIH UMLS (Unified Medical Language System)

Arixtra (C1099665)

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

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