Antithrombotic (selective factor Xa inhibitor)
Injectable anticoagulant indicated for prophylaxis of deep vein thrombosis in patients undergoing major orthopedic surgery (hip fracture, hip and knee replacement) and at-risk abdominal surgery, and for treatment of acute DVT and acute pulmonary embolism.
Also known as: Arixtra, fondaparinux sodium
DailyMed approved label (Fondaparinux Sodium Injection, Zydus; setID dffbf7c9-495e-4a33-ac76-57b52f014fc2).
DailyMed approved label (Fondaparinux Sodium Injection, Zydus; setID dffbf7c9-495e-4a33-ac76-57b52f014fc2).
No documented drug–drug interactions for this medicine.
Fondaparinux is given subcutaneously; food does not affect its pharmacokinetics.
May be administered regardless of meals.
DailyMed approved label (Fondaparinux Sodium Injection, Zydus; setID dffbf7c9-495e-4a33-ac76-57b52f014fc2).
No relevant pharmacokinetic interaction; excessive alcohol can increase the risk of falls/bleeding in anticoagulated patients.
Moderate alcohol intake during treatment.
DailyMed approved label (Fondaparinux Sodium Injection, Zydus; setID dffbf7c9-495e-4a33-ac76-57b52f014fc2).
Fondaparinux is renally eliminated and is contraindicated at CrCl < 30 ml/min.
Do not use at CrCl < 30 ml/min; assess renal function before starting.
EMC-UK (MHRA) — approved Fondaparinux SmPC: https://www.medicines.org.uk/emc/product/3340/smpc
Data on fondaparinux in pregnancy are limited; use only if the benefit outweighs the risk.
Avoid in pregnancy unless strictly necessary.
Excretion into breast milk is unknown; use with caution.
In women of childbearing age, rule out pregnancy before starting.
EMC-UK (MHRA) — approved Fondaparinux SmPC: https://www.medicines.org.uk/emc/product/3340/smpc
Clinical and educational support tool. The information does not replace a medical prescription or the opinion of a qualified healthcare professional.
Antithrombotic activity results from antithrombin III-mediated selective inhibition of factor Xa: by selectively binding ATIII, it potentiates (~300-fold) the neutralization of factor Xa, interrupting the coagulation cascade and inhibiting thrombin formation. It does not inactivate thrombin nor affect platelet function.
Synthetic pentasaccharide that selectively binds antithrombin III (ATIII), potentiating factor Xa neutralization; pharmacodynamics are monitored by anti-Xa activity calibrated with fondaparinux.
Absolute bioavailability of 100% after subcutaneous administration; plasma peaks ~2–3 hours after dosing.
Predominantly renal excretion of unchanged drug; no significant hepatic metabolism.
Elimination half-life of 17–21 hours (allowing once-daily administration).
Medicines from the same therapeutic group (ATC classification) or the same pharmacological class.
