- FondaparinuxArixtraNo effect on thrombin; safe for use in HITS
Mechanism of Action
- Binds to and activates antithrombin III, which as a heparin-ATIII complex inactivates factor Xa.
- More potent (2-4x) than unfractionated heparin due to higher activation of antithrombin III
- Smaller molecules are able to bind only to factor Xa, with no effect on IIa
- Better bioavailability and more predictable response than heparin
- Prevention of venous thromboembolism (DVT / PE)
- Treatment of venous thromboembolism (DVT / PE)
- ST elevation myocardial infarction (STEMI)
- Bridging anticoagulation for initiation / withholding of warfarin
- Adverse Effects
- Elevated LFTs
- Thrombocytopaenia (less commonly than heparin)
- Not monitored in most cases, though anti-factor Xa levels may be taken.