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Fondaparinux

 
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  •  
    Fondaparinux
    Arixtra 
     
    No 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.
  • Pharmacology
  • 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

Clinical Use

  • Indications
  • 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
  • Haemorrhage
  • Hypersensitivity
  • Elevated LFTs
  • Thrombocytopaenia (less commonly than heparin)

  • Monitoring

  • Not monitored in most cases, though anti-factor Xa levels may be taken.
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