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Fondaparinux
Aka: Fondaparinux, Arixtra
- Mechanism
- Heparin derivative
- Binds activated factor X (Factor Xa)
- Indications: Orthopedic Perioperative DVT Prophylaxis
- Hip Fracture
- Hip replacement
- Knee replacement
- Contraindications (due to bleeding risk)
- Severe renal Impairment
- Weight less than 110 pounds
- Dosing
- Prophylaxis: DVT
- Arixtra 2.5 mg SQ daily
- Therapeutic: Bridging for DVT or PE to Warfarin
- Weight <50 Kg: 5 mg SQ daily
- Weight 50-100 Kg: 7.5 mg SQ daily
- Weight >100 Kg: 10 mg SQ daily
- Complications
- Bleeding
- Higher risk than Low Molecular Weight Heparin
- Spinal thrombosis with risk of paralysis
- Associated with concurrent spinal anesthetic
- Efficacy
- Lower perioperative DVT and thromboembolism Incidence in hip surgery
- References
- Eriksson (2001) N Engl J Med 345:1298-304
- Turpie (2004) Chest 126:501-8