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Fondaparinux 💊
💡 Clinical tip: Consider Fondaparinux 2.5 mg SC OD for all patients with cardiac-sounding chest pain. ⚠️ May need to withhold on the day of angiography - always take senior/haematology advice.
📖 About
Always check the BNF link here.
- 💊 Synthetic pentasaccharide anticoagulant.
- 🧬 Inhibits activated factor Xa via binding to antithrombin.
- 📊 More predictable anticoagulant effect than UFH.
⚡ Mechanism of Action
- 🎯 Direct Factor Xa inhibitor (via ATIII binding).
- ⬇️ Prevents thrombin generation and clot propagation.
- ✅ Predictable pharmacokinetics → fixed dosing without routine monitoring.
🩺 Indications & Dosing (verify with BNF/datasheet)
💊 Dosing – Fondaparinux
| Indication | Details |
|---|---|
| 🛡️ VTE Prophylaxis | Fondaparinux 2.5 mg SC OD (often evening dose, e.g. 6 pm) |
| ❤️ ACS – NSTEMI / Unstable Angina |
Fondaparinux 2.5 mg SC OD (≤8 days)
⚠️ Stop before CABG; restart ≥48 h post-op |
| ❤️ ACS – STEMI |
Fondaparinux 2.5 mg IV (loading), then 2.5 mg SC OD (≤8 days)
⚠️ Withhold before CABG; restart ≥48 h post-op |
| 💉 Acute DVT / PE |
Fondaparinux
• 5 mg SC OD if <50 kg • 7.5 mg SC OD if 50–100 kg • 10 mg SC OD if >100 kg Duration ≥5 days (until INR >2 for 24 h if bridging to warfarin) |
| 🩸 Superficial Vein Thrombosis |
Fondaparinux 2.5 mg SC OD
Duration usually 30–45 days |
⚠️ Interactions
- See BNF – ↑ bleeding risk with antiplatelets, anticoagulants, NSAIDs.
⚠️ Cautions
- 📉 Anaemia or active haemorrhage.
- 👵 Elderly and low body weight → higher bleeding risk.
- ⚠️ Reduce dose in renal impairment (contraindicated if CrCl <30 mL/min).
📊 Monitoring
- Routine anti-Factor Xa activity monitoring not required.
- Consider in pregnancy, extremes of weight, or severe renal impairment.
🚫 Contraindications
- Active major bleeding.
- Severe renal impairment (CrCl <30 mL/min).
- Known hypersensitivity.
💥 Side Effects
- 🩸 Bleeding (most significant risk).
- ⬇️ Anaemia.
- 🤢 Nausea, vomiting.
- Rare: thrombocytopenia, allergic skin reactions.
📑 References
| The content on this website is provided for educational and informational purposes only to support exam preparation (e.g., MLA, MRCP, USMLE) and learning. This is NOT medical advice, diagnosis, treatment, or professional guidance. It does not replace consultation with a qualified healthcare professional, official guidelines (e.g., NICE, GMC, BNF), or supervised clinical practice. Always verify information with current, authoritative sources. Makindo and its contributors accept no liability for any reliance on this content, including errors, omissions, or any resulting harm, loss, or consequences. By using this site, you agree to these terms. |
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