Generic Name and Formulations:
Fondaparinux sodium 2.5mg/0.5mL, 5mg/0.4mL. 7.5mg/0.6mL, 10mg/0.8mL; soln for SC inj; preservative free.
Indications for ARIXTRA:
Prophylaxis of DVT in patients undergoing hip fracture surgery, or hip or knee replacement, or abdominal surgery with risk of thromboembolic complications. With warfarin: Treatment of acute pulmonary embolism (PE) (initiate in hospital), or treatment of acute DVT.
Give by SC inj. Prophylaxis: Once hemostasis is achieved, give 1st dose no earlier than 6–8hrs post-op. 2.5mg once daily for 5–9 days. Hip or knee replacement: max 11 days. Hip fracture: give for up to 24 more days (max 32 days). Abdominal: max 10 days. Treatment: (<50kg): 5mg; (50–100kg): 7.5mg; (>100kg): 10mg; for all: give once daily for at least 5 days and until INR= 2–3; usually 5–9 days; max 26 days; start warfarin usually within 72hrs.
Severe renal impairment (CrCl <30mL/min). Active major bleeding. Bacterial endocarditis. Thrombocytopenia associated with (+) in vitro test for antiplatelet antibody in presence of fondaparinux. Also for prophylaxis: body weight <50kg.
See full labeling. Increased risk of spinal/epidural hematoma in anticoagulated patients receiving neuraxial anesthesia or undergoing spinal puncture (esp. post-op indwelling epidural use); monitor for signs/symptoms of neurological impairment. Increased risk of hemorrhage in those with bleeding disorders, acute ulcerative or angiodysplastic GI disease, hemorrhagic stroke, uncontrolled hypertension, diabetic retinopathy, recent brain, spinal, or eye surgery. Increased risk of bleeding in renal impairment and in those with low body weight (<50kg). Assess hepatic and renal function periodically; discontinue if severe renal impairment develops. Monitor closely for thrombocytopenia. Obtain CBCs, platelets, serum creatinine level, stool occult blood tests during therapy; discontinue if platelets <100,000 per mm3 or major bleeding occurs. Not interchangeable (unit-for-unit) with heparin or low molecular weight heparins. Latex allergy. Elderly. Neonates. Pregnancy. Labor & delivery. Nursing mothers.
Caution with drugs that affect hemostasis (eg, warfarin, platelet inhibitors, NSAIDs). Avoid drugs that increase risk of hemorrhage (eg, Vit. K antagonists); if co-admin necessary, monitor closely for bleeding.
Factor Xa inhibitor.
Bleeding, thrombocytopenia, local reactions (rash, pruritus, hematoma, pain), anemia, insomnia, increased wound drainage, hypokalemia, dizziness, hypotension, confusion, bullous eruption, post-op hemorrhage, purpura, elevated ALT/AST.
Prefilled syringes 2.5mg, 7.5mg, 10mg—2, 10; 5mg—10
Neurology Advisor Articles
- Clarifying Cardiovascular Risk in Migraine
- Parkinson Disease Symptom Fluctuations Well-Managed With Adaptive Deep Brain Stimulation
- More Evidence Supports Benefits of Cannabidiol for Treatment-Resistant Epilepsy
- Monthly Erenumab Reduces Frequency of Episodic Migraine
- Reduced Risk for Multiple Sclerosis Linked to Greater Sun Exposure
- Tamsulosin Associated With Dementia Risk in Older Patients With BPH
- FDA Approves Blood Test to Assess Concussion
- Gait Difficulty in Parkinson Disease May Be Associated With More Progressive Disease Course
- Tau PET a Useful Biomarker for Alzheimer Disease Risk and Progression
- Multiple Sclerosis Drug Zinbryta Withdrawn From the Market
- Incidence of Delayed Traumatic Intracranial Hemorrhage Low in Older Adults With Blunt Head Trauma
- Older Epilepsy Patients More Likely to Experience AED, Non-AED Drug Interaction
- Female Gender, Natalizumab Exposure Associated With Increased Lymphopenia Risk in FNG-Treated MS
- Accelerated Cognitive Decline Associated With Retinopathy
- Treatment Effects Often Exaggerated in Early Clinical Studies