Fondaparinux (Arixtra®)

Biochemistry

Fondaparinux sodium is an anticoagulant drug from the group of heparinoids that is preventing coagulation similar to heparin. It enhances the inhibitory activity of antithrombin. In contrast to conventional heparin and low molecular heparins, fondaparinux is a synthetic, homogenous agent. Fondaparinux is the shortest active polysaccharide. It consists of only 5 subunits. This pentasaccharide is considered to have a low allergenic risk and does not bind to platelet factor 4 (PF4). The dose is indicated as gravimetric mass, e.g. mg, unlike heparins where the activity of factor Xa inhibition is indicated.

Clinical significance

The following indications are indicated: Prophylaxis of venous thromboembolic events in adults undergoing major orthopaedic surgery and in adults undergoing abdominal surgery. It is used therapeutically in acute, symptomatic, spontaneous, superficial venous thrombosis of the lower extremities without concomitant deep vein thrombosis and in acute coronary syndrome (non-ST-elevating myocardial infarction (NSTEMI), unstable angina pectoris (UA), and transmural infarction (STEMI)).

Indication

• Monitoring anticoagulant therapy, if necessary
• Individual dose determination

Literature

1. Turpie AG, Eriksson BI, Lassen MR, Bauer KA. Fondaparinux, the first selective factor Xa inhibitor. Curr Opin Hematol. Sep 10(5):327-32, 2003.
2. Klaeffling C, Piechottka G, Daemgen-von Brevern G, et al. Development and clinical evaluation of two chromogenic substrate methods for monitoring fondaparinux sodium. Ther Drug Monit.;28(3):375–38, 2006.
3. Alban S. Pharmakologie der Heparine und direkten Antikoagulanzien Hämostaeologie 28: 400-420, 2008.