Drug Action
Fondaparinux sodium is a synthetic pentasaccharide that inhibits activated factor X.
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Drug reference
Fondaparinux sodium is a synthetic pentasaccharide that inhibits activated factor X.
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Prophylaxis of venous thromboembolism in patients after undergoing major orthopaedic surgery of the hip or leg, or abdominal surgery ▶BY SUBCUTANEOUS INJECTION ▶Adult: Initially 2.5 mg, dose to be given 6 hours after surgery, then 2.5 mg once daily Prophylaxis of venous thromboembolism in medical patients immobilised because of acute illness ▶BY SUBCUTANEOUS INJECTION ▶Adult: 2.5 mg once daily Treatment of superficial-vein thrombosis ▶BY SUBCUTANEOUS INJECTION ▶Adult (body-weight 50 kg and above): 2.5 mg once daily for at least 30 days (max. 45 days if high risk of thromboembolic complications), treatment should be stopped 24 hours before surgery and restarted at least 6 hours post operatively Treatment of unstable angina and non-ST-segment elevation myocardial infarction ▶BY SUBCUTANEOUS INJECTION ▶Adult: 2.5 mg once daily for up to 8 days (or until hospital discharge if sooner), treatment should be stopped 24 hours before coronary artery bypass graft surgery (where possible) and restarted 48 hours post operatively Treatment of ST-segment elevation myocardial infarction ▶INITIALLY BY INTRAVENOUS INJECTION, OR BY INTRAVENOUS INFUSION ▶Adult: Initially 2.5 mg daily for the first day, then (by subcutaneous injection) 2.5 mg once daily for up to 8 days (or until hospital discharge if sooner), treatment should be stopped 24 hours before coronary artery bypass graft surgery (where possible) and restarted 48 hours post operatively Treatment of deep-vein thrombosis and pulmonary embolism ▶BY SUBCUTANEOUS INJECTION ▶Adult (body-weight up to 50 kg): 5 mg every 24 hours, an oral anticoagulant (usually warfarin) is started at the same time as fondaparinux (fondaparinux should be continued for at least 5 days and until INR 2 for at least 24 hours) ▶Adult (body-weight 50–100 kg): 7.5 mg every 24 hours, an oral anticoagulant (usually warfarin) is started at the same time as fondaparinux (fondaparinux should be continued for at least 5 days and until INR 2 for at least 24 hours) ▶Adult (body-weight 101 kg and above): 10 mg every 24 hours, an oral anticoagulant (usually warfarin) is started at the same time as fondaparinux (fondaparinux should be continued for at least 5 days and until INR 2 for at least 24 hours)
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Active bleeding. bacterial endocarditis
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Active gastro-intestinal ulcer disease. bleeding disorders. brain surgery. elderly patients. low body- weight. ophthalmic surgery. recent intracranial haemorrhage. risk of catheter thrombus during percutaneous coronary intervention. spinal or epidural anaesthesia (risk of spinal haematoma—avoid if using treatment doses). spinal surgery
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→Appendix 1: fondaparinux
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▶Common or very common Anaemia. haemorrhage ▶Uncommon Chest pain. coagulation disorder. dyspnoea. fever. hepatic function abnormal. nausea. oedema. platelet abnormalities. skin reactions. thrombocytopenia. vomiting. wound secretion ▶Rare or very rare Anxiety. confusion. constipation. cough . diarrhoea. dizziness. drowsiness. fatigue. gastritis. gastrointestinal discomfort. genital oedema. headache. hyperbilirubinaemia. hypersensitivity. hypokalaemia. hypotension. leg pain. post procedural infection. syncope . vasodilation. vertigo
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Manufacturer advises avoid unless potential benefit outweighs possible risk—no information available.
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Present in milk in animal studies— manufacturer advises avoid.
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▶When used for Venous thromboembolism, unstable angina, non-ST- segment elevation myocardial infarction and ST-segment elevation myocardial infarction Manufacturer advises caution in severe impairment (increased risk of bleeding complications). ▶When used for Superficial-vein thrombosis Manufacturer advises avoid in severe impairment (no information available).
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Increased risk of bleeding in renal impairment. ▶When used for treatment of acute coronary syndromes or prophylaxis of venous thromboembolism and treatment of superficial-vein thrombosis Avoid if eGFR less than 20 mL/minute/1.73 m2. ▶When used for treatment of venous thromboembolism Use with caution if eGFR 30–50 mL/minute/1.73 m2, avoid if eGFR less than 30 mL/minute/1.73 m2. Dose adjustments ▶When used for prophylaxis of venous thromboembolism and treatment of superficial-vein thrombosis Reduce dose to 1.5 mg daily if eGFR 20–50 mL/minute/1.73 m2.
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For intravenous infusion (Arixtra ®), give intermittently in Sodium chloride 0.9%. For ST-segment elevation myocardial infarction, add requisite dose to 25-50 mL infusion fluid and give over 1- 2 minutes.
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There can be variation in the licensing of different medicines containing the same drug. Solution for injection ▶Fondaparinux sodium (Non-proprietary) Fondaparinux sodium 5 mg per 1 ml Fondaparinux sodium 2.5mg/0.5ml solution for injection pre-filled syringes | 10 pre-filled disposable injection P £62.79 DT = £62.79 Fondaparinux sodium 12.5 mg per 1 ml Fondaparinux sodium 5mg/0.4ml solution for injection pre-filled syringes | 10 pre-filled disposable injection P £110.70 DT = £116.53 Fondaparinux sodium 10mg/0.8ml solution for injection pre-filled syringes | 10 pre-filled disposable injection P £110.70 DT = £116.53 Fondaparinux sodium 7.5mg/0.6ml solution for injection pre-filled syringes | 10 pre-filled disposable injection P £110.70 DT = £116.53 ▶Arixtra (Aspen Pharma Trading Ltd) Fondaparinux sodium 5 mg per 1 ml Arixtra 2.5mg/0.5ml solution for injection pre-filled syringes | 10 pre-filled disposable injection P £62.79 DT = £62.79 (Hospital only) Arixtra 1.5mg/0.3ml solution for injection pre-filled syringes | 10 pre- filled disposable injection P £62.79 DT = £62.79 (Hospital only) Fondaparinux sodium 12.5 mg per 1 ml Arixtra 7.5mg/0.6ml solution for injection pre-filled syringes | 10 pre-filled disposable injection P £116.53 DT = £116.53 (Hospital only) Arixtra 5mg/0.4ml solution for injection pre-filled syringes | 10 pre- filled disposable injection P £116.53 DT = £116.53 (Hospital only) Arixtra 10mg/0.8ml solution for injection pre-filled syringes | 10 pre- filled disposable injection P £116.53 DT = £116.53 (Hospital only)
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Initially 2.5 mg, dose to be given 6 hours after
First-line fragment. Read the complete Indications and Dose section above.
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2.5 mg once daily
First-line fragment. Read the complete Indications and Dose section above.
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2.5 mg once daily
First-line fragment. Read the complete Indications and Dose section above.
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2.5 mg once daily for up to 8 days (or until
First-line fragment. Read the complete Indications and Dose section above.
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Initially 2.5 mg daily for the first day, then (by
First-line fragment. Read the complete Indications and Dose section above.
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5 mg every 24 hours, an
First-line fragment. Read the complete Indications and Dose section above.
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7.5 mg every 24 hours, an
First-line fragment. Read the complete Indications and Dose section above.
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10 mg every
First-line fragment. Read the complete Indications and Dose section above.
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