Fondaparinux

From Anvita Health Wiki

Contents 1 Introduction 2 Indications 3 Contraindications 4 Dosage 5 Adverse-effects 6 Mechanism-of-action 7 Notes 8 More General Terms 9 Additional Terms 10 Internet Database 11 References

Introduction

• Tradename: Arixtra.

Indications

• prophylaxis for deep vein thrombosis (DVT), especially after orthopedic surgery (hip & knee replacement) (appears to be more effective than enoxaparin)
• superficial venous thrombosis:

• diminishes incidence of DVT & PE but does not effect mortality [5]

• unstable angina, STEMI*, non-STEMI

• * not for use in association with PCI [4]

Contraindications

• severe renal impairment
• < 110 lbs in weight

Dosage

• 2.5 mg SC QD
• initiate 4-8 hours after surgery

Adverse-effects

• bleeding, including major bleeding (more common than with enoxaparin

Mechanism-of-action

• synthetic polysaccharide that inhibits factor VIIIa
• also binds to & inhibits factor Xa [3,5]
• inhibits thrombin formation

Notes

• Manufacturer: Organon/Sanofi

More General Terms

• polysaccharide (complex carbohydrate, glycan)
• anticoagulant
• enzyme inhibitor

Additional Terms

• Organization to Assess Strategies in Acute Ischemic Syndrome (OASIS) trial (OASIS-5, OASIS-6)

Internet Database

PubChem: 636380
PubChem: 123611

References

1. Journal Watch 21(24):196, 2001
2. Prescriber's Letter 9(2):S1 2002
3. Prescriber's Letter 9(3):14-15 2002
4. The Fifth Organization to Assess Strategies in Acute Ischemic Syndrome Investigators. Comparison of fondaparinux and enoxaparin in acute coronary syndromes. N Engl J Med 2006; 354:1464 PMID: [1]
   - The OASIS-6 Trial Group. Effect of fondaparinux on mortality and reinfarcion in patient with acute ST-segment elevation myocardial infarction. The OASIS-6 Randomized Trial. JAMA 2006; 295:1519 PMID: [2]
   - Califf RM Fondaparinux in ST-segment elevation myocardial infarction: The drug, the stategy, the environment, or all of the above. JAMA 2006; 295:1579 PMID: [3]
5. Decousus H et al. Fondaparinux for the treatment of superficial-vein thrombosis in the legs. N Engl J Med 2010 Sep 23; 363:1222 <PubMed> PMID: [4] <Internet> [5]
   - Goldman L and Ginsberg J. Superficial phlebitis and phase 3.5 trials. N Engl J Med 2010 Sep 23; 363:1278 <PubMed> PMID: [6] <Internet> [7]

fondaparinux (Arixtra)