Precautions
Similar to low molecular weight heparins, it is an indirect inhibitor of factor Xa, but it does not inhibit thrombin at all. Fondaparinux has a longer half-life than heparin and does not interact with platelets, both of which may be advantageous in certain settings.
Is fondaparinux an inhibitor of factor Xa?
Fondaparinux. Fondaparinux (trade name Arixtra) is an anticoagulant medication chemically related to low molecular weight heparins. It is marketed by GlaxoSmithKline. A generic version developed by Alchemia is marketed within the US by Dr. Reddy's Laboratories .
Is there a generic version of fondaparinux?
Testosterone may increase the anticoagulant activities of Fondaparinux. Testosterone cypionate may increase the anticoagulant activities of Fondaparinux. Testosterone enantate benzilic acid hydrazone may increase the anticoagulant activities of Fondaparinux. Testosterone enanthate may increase the anticoagulant activities of Fondaparinux.
What increases the anticoagulant activity of fondaparinux?
One potential advantage of fondaparinux over LMWH or unfractionated heparin is that the risk for heparin-induced thrombocytopenia (HIT) is substantially lower. Furthermore, there have been case reports of fondaparinux being used to anti-coagulate patients with established HIT as it has no affinity for PF4.
What are the advantages and disadvantages of fondaparinux over heparin?
Is there an antidote for fondaparinux?
Contrary to UFH or LMWHs, fondaparinux is not neutralized by protamine sulfate, and no antidote is available to counteract bleeding disorders associated with overdosing.
How do you reverse fondaparinux?
Fondaparinux. No specific antidote exists for fondaparinux reversal. Prohemostatic agents such as rFVIIa and activated PCC have been shown to reverse anticoagulant action of fondaparinux, although clinical data are largely limited to in vitro studies.
Which is used as antidote for heparin?
Expert opinion: Despite of the low therapeutic index, protamine is the only registered antidote of heparins. The toxicology of protamine depends on a complex interaction of the high molecular weight, a cationic peptide with the surfaces of the vasculature and blood cells.
What is the antidote to enoxaparin?
Neutralization of enoxaparin by protamine A second infusion of 0.5 mg protamine per 1 mg LOVENOX may be administered if the aPTT measured 2 to 4 hours after the first infusion remains prolonged. Particular care should be taken to avoid overdosage with protamine sulfate.
Does protamine reverse fondaparinux?
Protamine only partially neutralizes anti-factor Xa activity (~60%). Fondaparinux: Has only anti-Xa activity and protamine will have no significant effect. Very limited data to recommend these agents to reverse fondaparinux.
What drug reverses eliquis?
The FDA approved andexanet alfa (AndexXa) on May 3, 2018. It's the first and only antidote to reverse bleeding in people taking apixaban (Eliquis), rivaroxaban (Xarelto), or edoxaban (Savaysa). Another newer blood thinner — dabigatran (Pradaxa) — already has an approved antidote called idarucizumab (Praxbind).
What is the antidote for apixaban?
Coagulation factor Xa (recombinant), inactivated-zhzo (andexanet alfa; Andexxa – Portola) has received accelerated approval from the FDA for urgent reversal of the anticoagulant effect of the direct factor Xa inhibitors apixaban (Eliquis) and rivaroxaban (Xarelto).
What is the antidote of atropine?
The antidote to atropine is physostigmine or pilocarpine. A common mnemonic used to describe the physiologic manifestations of atropine overdose is: "hot as a hare, blind as a bat, dry as a bone, red as a beet, and mad as a hatter".
Is vitamin K the antidote for heparin?
Abstract. Individuals anticoagulated with warfarin or heparin are typically treated with specific antidotes such as vitamin K or protamine, respectively, if they bleed or require surgery.
What is vitamin K an antidote for?
Vitamin K is an effective antidote for poisoning with a vitamin K antagonist. 42,43. There are 2 distinct enzymatic activities capable of reducing vitamin K1 quinone to the hydroquinone form.
What is the antidote for heparin and enoxaparin?
Heparin can be neutral- ized by protamine, and warfarin anticoagulation can be reversed by vitamin K injections. Protamine can also partially reverse the effect of ATIII-dependent low–molecular weight heparins (LMWH) such as enoxaparin but has no corrective activity on shorter heparins (fondaparinux or idraparinux)5–7.
Which anticoagulant has a reversal agent?
Reversal agents are used to counter the effects of anticoagulants in life-threatening situations of uncontrolled bleeding. Vitamin K is the reversal agent for warfarin, and FDA recently approved the first reversal agent for the class of “new anticoagulant drugs,” Praxbind (idrucizumab).
When do you stop taking fondaparinux?
Depending on the patient's renal function, fondaparinux should be discontinued 36 to 42 hours before any procedure that carries the risk of hemorrhage, or before spinal anesthesia (Table 1) (8).
What is the difference between fondaparinux and enoxaparin?
Fondaparinux is a factor Xa inhibitor and does not inhibit thrombin (IIa) [8]. Enoxaparin on the other hand, binds to antithrombin to form a complex molecule that can irreversibly inactivate clotting factor Xa and it has less activity against thrombin [9]. This is how these two anticoagulants work.
Does fondaparinux increase INR?
At the 2.5 mg dose, Arixtra does not affect routine coagulation tests such as activated partial thromboplastin time (aPTT), activated clotting time (ACT) or prothrombin time (PT)/International Normalised Ratio (INR) tests in plasma, or bleeding time.
Can you bridge with fondaparinux?
Fondaparinux may provide an option of bridging for such patients, but further clinical investigations are warranted to identify the role of this agent for the prophylaxis of thrombus formation in patients with MVR.
Before Taking This Medicine
You should not use this medicine if you have ever had a severe allergic reaction to fondaparinux, or if you have: 1. active or uncontrolled bleedin...
How Should I Use Fondaparinux?
Fondaparinux is usually given every day until your bleeding condition improves. Follow all directions on your prescription label. Do not use this m...
What Happens If I Miss A Dose?
Use the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to m...
What Happens If I Overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Overdose can cause excessive bleeding.
What Should I Avoid While Using Fondaparinux?
Avoid activities that may increase your risk of bleeding or injury. Use extra care to prevent bleeding while shaving or brushing your teeth.
Fondaparinux Side Effects
Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.A...
What Other Drugs Will Affect Fondaparinux?
Tell your doctor about all your current medicines and any you start or stop using, especially other medicines used to treat or prevent blood clots...
Is Arixtra (fondaparinux) a heparin product?
No, Arixtra (fondaparinux) is not a type of heparin or low molecular weight heparin. Similar to heparin or heparin-like products, Arixtra (fondapar...
Does Arixtra (fondaparinux) affect INR (blood clotting time)?
No, Arixtra (fondaparinux) doesn't affect INR, which is a lab value monitored for people taking warfarin (Coumadin) to measure the speed at which b...
Does Arixtra (fondaparinux) contain pork?
No, Arixtra (fondaparinux) is not made from pork unlike heparin. It's a good injectable anticoagulant option for people who avoid pork for religiou...
Can I take Arixtra (fondaparinux) and warfarin (Coumadin) at the same time?
Yes, Arixtra (fondaparinux) and warfarin (Coumadin) can be taken at the same time for blood clot treatment for a short period of time when you are...
How do you reverse Arixtra (fondaparinux)?
Arixtra (fondaparinux) doesn't have a specific antidote like warfarin (Coumadin) and heparin, but healthcare providers can treat and manage serious...
What is Fondaparinux used for?
Overview TOP. Fondaparinux is used to prevent deep vein thrombosis, a condition in which harmful blood clots form in the blood vessels of the legs. These blood clots can travel to the lungs and can become lodged in the blood vessels of the lungs, causing a condition called pulmonary embolism.
What is Arixtra (fondaparinux)?
Arixtra (fondaparinux) is an anticoagulant (blood thinner). When you bleed, a protein complex called factor Xa is activated to help make a clot to stop the bleeding. Arixtra (fondaparinux) blocks this protein complex, which helps prevent blood clots from forming in your body.
What are the side effects of Arixtra (fondaparinux)?
With any medication, there are risks and benefits. Even if the medication is working, you may experience some unwanted side effects.
How much does Arixtra (fondaparinux) cost?
Unless there is a specific reason you need the brand, the generic medication will be a better value. For even more savings, use a GoodRx coupon and pay just a fraction of the retail price.
What is Arixtra blood thinner?
Arixtra (fondaparinux) is an injectable blood thinner that helps prevent blood clots from forming in the legs (deep vein thrombosis or DVT) or from traveling to your lungs (pulmonary embolism or PE). It doesn't require frequent blood tests like some other blood thinners, but it can be expensive.
Can fondaparinux cause bleeding?
Blood tests will be needed to check for unwanted effects. Be sure to keep all appointments. Fondaparinux may cause bleeding problems. This risk is higher if you have a catheter in your back for pain medicine or anesthesia (sometimes called an "epidural"), or if you have kidney problems.
Where to inject Arixtra?
Inject Arixtra (fondaparinux) in your lower stomach, 2 inches below your belly button. Alternate the sites from left to right every day to avoid side effects at the injection site.
What is Fondaparinux?
Fondaparinux (trade name Arixtra) is an anticoagulant medication chemically related to low molecular weight heparins. It is marketed by GlaxoSmithKline. A generic version developed by Alchemia is marketed within the US by Dr. Reddy's Laboratories .
How many monomeric sugar units are in Fondaparinux?
Apart from the O-methyl group at the reducing end of the molecule, the identity and sequence of the five monomeric sugar units contained in fondaparinux is identical to a sequence of five monomeric sugar units that can be isolated after either chemical or enzymatic cleavage of the polymeric glycosaminoglycans heparin and heparan sulfate (HS).
Is Fondaparinux the same as enoxaparin?
Clinically, it is used for the prevention of deep vein thrombosis in patients who have had orthopedic surgery as well as for the treatment of deep vein thrombosis and pulmonary embolism . Fondaparinux is similar to enoxaparin in reducing the risk of ischemic events at nine days, but it substantially reduces major bleeding ...
Is fondaparinux better than LMWH?
One potential advantage of fondaparinux over LMWH or unfractionated heparin is that the risk for heparin-induced thrombocytopenia (HIT) is substantially lower. Furthermore, there have been case reports of fondaparinux being used to anti-coagulate patients with established HIT as it has no affinity for PF4.
What is Fondaparinux used for?
Summary. Fondaparinux is an anticoagulant used to prevent venous thromboembolism, to treat deep vein thrombosis, and to improve survival following myocardial infarction.
What is the mechanism of action of Fondaparinux?
Mechanism of action. The antithrombotic activity of fondaparinux is the result of ATIII-mediated selective inhibition of Factor Xa. By selectively binding to ATIII, Fondaparinux potentiates (about 300 times) the neutralization of Factor Xa by ATIII.
Does Fondaparinux inactivate thrombin?
Fondaparinux does not inactivate thrombin (activated Factor II). According to the manufacturer, fondaparinux has no known effect on platelet function. In studies comparing fondaparinux to enoxaparin, decreases in platelet levels were observed in similar numbers of patients from both groups (2-5%) 1, 2.
Which drug may increase the excretion rate of Fondaparinux?
Bromotheophylline. Bromotheophylline may increase the excretion rate of Fondaparinux which could result in a lower serum level and potentially a reduction in efficacy. Budesonide. Fondaparinux may decrease the excretion rate of Budesonide which could result in a higher serum level.
Does acetazolamide increase fondaparinux?
Acetazolamide may increase the excretion rate of Fondaparinux which could result in a lower serum level and potentially a reduction in efficacy. Acetylsalicylic acid. Acetylsalicylic acid may increase the anticoagulant activities of Fondaparinux. Aclidinium.
Can Fondaparinux be used as an anticoagulant?
Fondaparinux should not be used as the sole anticoagulant during percutaneous coronary intervention (PCI) due to an increased risk of guiding catheter thrombosis. Accelerate your drug discovery research with the industry’s only fully connected ADMET dataset, ideal for: Machine Learning. Data Science. Drug Discovery.
Does hydroxocobalamin lower Fondaparinux?
Hydroxocobalamin may decrease the excre tion rate of Fondaparinux which could result in a higher serum level. Hydroxyethyl Starch. Fondaparinux may decrease the excretion rate of Hydroxyethyl Starch which could result in a higher serum level.
Does fondaparinux interact with platelets?
Fondaparinux has a longer half-life than heparin and does not interact with platelets, both of which may be advantageous in certain settings. This topic review discusses the dosing and adverse effects associated with fondaparinux, including dosing in patients with renal insufficiency and management of bleeding.
Is Fondaparinux an inhibitor of thrombin?
Similar to low molecular weight heparins, it is an indirect inhibitor of factor Xa, but it does not inhibit thrombin at all. Fondaparinux has a longer half-life than heparin and does not interact with platelets, both of which may be advantageous in certain settings.
