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Fondaparinux

 
Drug Info: Fondaparinux

Brand names: Arixtra™



Fondaparinux injection

What is fondaparinux injection?

FONDAPARINUX (Arixtra®) is commonly used after abdominal, knee replacement, hip replacement, or hip fracture surgeries to help prevent blood clotting. Fondaparinux can also be used to treat blood clots in the veins or lungs. Fondaparinux stops clots from forming or getting bigger, and lets the body naturally dissolve the clots. Fondaparinux is known as an anticoagulant, and is sometimes called a blood thinner. However, fondaparinux does not actually thin the blood, but decreases the ability of blood to form clots. Generic fondaparinux injections are not yet available.

What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:
• bleeding disorders, hemorrhage, or hemophilia
• brain tumor or aneurysm
• decreased kidney function
• diabetes
• high blood pressure
• infection of the heart or heart valves
• receiving injections of medications or vitamins
• liver disease
• previous stroke
• recent surgery or delivery of a baby
• ulcer in the stomach or intestine, diverticulitis, or other bowel disease
• undergoing treatments for cancer
• an unusual or allergic reaction to fondaparinux, heparin, low molecular weight heparins, other medicines, foods, dyes, or preservatives
• pregnant or trying to get pregnant
• breast-feeding

How should I use this medicine?

Fondaparinux is for injection under the skin. It is usually given by a health-care professional, or you or a family member may be trained on how to give the injections. If you are to give yourself injections, make sure you understand how to use the syringe, measure the dose if necessary, and give the injection, and how to dispose of used syringes and needles. Use the syringes only once, and throw away syringes and needles in a closed container to prevent accidental needle sticks. Use exactly as directed. Do not exceed the prescribed dose, and try not to miss doses.

To avoid bruising, do not rub the site where fondaparinux has been injected.

Contact your pediatrician or health care professional regarding the use of this medicine in children. Special care may be needed.

What if I miss a dose?

Usually you will receive fondaparinux in the hospital and this will not apply. However, if you are using fondaparinux at home and you miss a dose, use your next scheduled dose when it is due unless otherwise directed by your health care provider. Do not use double or extra doses.

What drug(s) may interact with fondaparinux?

• antiinflammatory drugs such as ibuprofen (Motrin®), naproxen (Aleve®), or ketoprofen (Orudis-KT®)
• aspirin and aspirin-like medicines
cilostazol
clopidogrel
dipyridamole
• fish oil (omega-3 fatty acids) supplements
• herbal products containing feverfew, garlic, ginger, gingko, or horse chestnut
ticlopidine
warfarin

Tell your prescriber or health care professional about all other medicines you are taking, including non-prescription medicines, nutritional supplements, or herbal products. Also tell your prescriber or health care professional if you are a frequent user of drinks with caffeine or alcohol, if you smoke, or if you use illegal drugs. These may affect the way your medicine works. Check with your health care professional before stopping or starting any of your medicines.

What should I watch for while taking fondaparinux?

In case of an accident or emergency, it is recommended that you place a notification in your wallet that you are receiving fondaparinux. The blood thinning effects of fondaparinux may last for 2 or 3 days after you stop receiving it.

Your condition will be monitored carefully while you are receiving fondaparinux. Notify your prescriber or health care professional and seek emergency treatment if you develop increased difficulty in breathing, chest pain, dizziness, shortness of breath, swelling in the legs or arms, abdominal pain, decreased vision, pain when walking, or pain and warmth of the arms or legs. These can be signs that your condition has worsened.

Monitor your skin closely for easy bruising or red spots, which can indicate bleeding. If you notice easy bruising or minor bleeding from the nose, gums/teeth, in your urine, or stool, contact your prescriber or health care professional immediately, these are indications that your medication needs adjustment or evaluation. Keep scheduled appointments with your prescriber or health care professional to check on your condition.

If you are going to have surgery, tell your prescriber or health care professional that you have received fondaparinux.

Do not take aspirin or aspirin-like products (ibuprofen, naproxen, or ketoprofen) while using fondaparinux unless directed to do so by your prescriber.

Be careful to avoid injury while you are using fondaparinux. Take special care brushing or flossing your teeth, shaving, cutting your fingernails or toenails, or when using sharp objects. Report any injuries to your prescriber or health care professional.

What side effects might I notice from receiving fondaparinux?

Side effects that you should report to your prescriber or health care professional as soon as possible:
Rare or uncommon:
• signs and symptoms of bleeding such as back or stomach pain, black, tarry stools, blood in the urine, or coughing up blood
• difficulty breathing
• dizziness or fainting spells
• heavy menstrual bleeding
More frequent:
• bleeding from the injection site
• fever
• unusual bruising or bleeding: bleeding gums, red spots on the skin, nosebleeds

Side effects that usually do not require medical attention (report to your prescriber or health care professional if they continue or are bothersome):
• pain or irritation at the injection site
• skin rash, itching

Where can I keep my medicine?

Keep out of the reach of children.

Store at room temperature between 15 and 30 degrees C (59—86 degrees F); do not freeze. Throw away any unused medicine after the expiration date.

Make sure you receive a puncture-resistant container to dispose of the needles and syringes once you have finished with them. Do not reuse these items. Return the container to your prescriber or health care professional for proper disposal.

Last updated: 7/1/2002

Important Disclaimer: The drug information provided here is for educational purposes only. It is intended to supplement, not substitute for, the diagnosis, treatment and advice of a medical professional. This drug information does not cover all possible uses, precautions, side effects and interactions. It should not be construed to indicate that this or any drug is safe for you. Consult your medical professional for guidance before using any prescription or over the counter drugs.

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Wikipedia: Fondaparinux
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Fondaparinux
Systematic (IUPAC) name
2-deoxy-6-O-sulfo-2-(sulfoamino)-α-D-glucopyranosyl-(1→

4)-O-β-D-glucopyranuronosyl-(1→4)-O-2-deoxy-3,6-di-O-sulfo-2- (sulfoamino)-α-D-glucopyranosyl-(1→4)-O-2-O-sulfo-α-L-idopyranouronosyl-(1→ 4)-O-methyl-2-deoxy-6-O-sulfo-2-(sulfoamino)-α-D-glucopyranoside, decasodium salt.

Identifiers
CAS number 114870-03-0
ATC code B01AX05
PubChem 636380
DrugBank APRD00500
Chemical data
Formula C31H43N3Na10O49S8 
Mol. mass 1726.77 g/mol
Pharmacokinetic data
Bioavailability N/A
Protein binding 94%
Metabolism renally excreted unchanged
Half life 17-21 hours
Excretion  ?
Therapeutic considerations
Licence data

EU EMEA:linkUS FDA:link

Pregnancy cat.

?

Legal status

POM(UK) -only(US)

Routes subcutaneous

Fondaparinux (Arixtra) is an anticoagulant medication.

It is marketed by GlaxoSmithKline.

Contents

Structure and mechanism

Fondaparinux is a synthetic pentasaccharide as evident by its chemical structure on the right. 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). Within heparin and heparan sulfate this monomeric sequence is thought to form the high affinity binding site for the anti-coagulant factor antithrombin III (ATIII). Binding of heparin/HS to ATIII has been shown to increase the anti-coagulant activity of antithrombin III 1000 fold.

Administration

Fondaparinux is given subcutaneously daily. 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.

Comparison to other agents

One potential advantage of fondaparinux over LMWH or unfractionated heparin is that the risk for heparin-induced thrombocytopenia is substantially lower. Furthermore, there have been case reports of fondaparinux being used to anticoagulate patients with established HIT as it has no affinity to PF-4. However, its renal excretion precludes its use in patients with renal dysfunction.

Unlike direct factor Xa inhibitors, it mediates its effects indirectly through antithrombin III, but unlike heparin, it is selective for factor Xa.[1]

Uses

Fondaparinux is similar to enoxaparin in reducing the risk of ischemic events at nine days, but it substantially reduces major bleeding and improves long term mortality and morbidity.[2]

It has been investigated for use in conjunction with streptokinase.[3]

Chemical structure

Abbreviations

  • GlcNS(6S) = 2-deoxy-6-O-sulfo-2-(sulfoamino)-α-D-glucopyranoside
  • GlcA = β-D-glucopyranuronosyl
  • GlcNS(3S,6S) = 2-deoxy-3,6-di-O-sulfo-2-(sulfoamino)-α-D-glucopyranosyl
  • IdoA(2S) = 2-O-sulfo-α-L-idopyranuronosyl
  • GlcNS(6S)OMe = methyl-O-2-deoxy-6-O-sulfo-2-(sulfoamino)-α-D-glucopyranoside
Fondaparinux

References

External links


 
 
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Fondaparinux injection
Inyección de fondaparinux
Fondaparinux Sodium Solution for injection

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Drug Info. Gold Standard. Copyright © 2008 by Gold Standard. All rights reserved.  Read more
Wikipedia. This article is licensed under the Creative Commons Attribution/Share-Alike License. It uses material from the Wikipedia article "Fondaparinux" Read more