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

⚠️ 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

• BNF: Fondaparinux