Identification
NameFondaparinux sodium
Accession NumberDB00569  (APRD00500)
TypeSmall Molecule
GroupsApproved, Investigational
Description

Fondaparinux (Arixtra) is a synthetic pentasaccharide anticoagulant. 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 glycosaminoglycan heparin and heparan sulfate (HS). This monomeric sequence in heparin and HS is thought to form the high affinity binding site for the natural 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. Fondaparinux potentiates the neutralizing action of ATIII on activated Factor X 300-fold. Fondaparinux may be used: to prevent venous thromboembolism in patients who have undergone orthopedic surgery of the lower limbs (e.g. hip fracture, hip replacement and knee surgery); to prevent VTE in patients undergoing abdominal surgery who are are at high risk of thromboembolic complications; in the treatment of deep vein thrombosis (DVT) and pumonary embolism (PE); in the management of unstable angina (UA) and non-ST segment elevation myocardial infarction (NSTEMI); and in the management of ST segment elevation myocardial infarction (STEMI).

Structure
Thumb
Synonyms
Arixtra
Methyl O-2-deoxy-6-O-sulfo-2-(sulfoamino)-alpha-D-glucopyranosyl-(1-4)-O-beta-D-glucopyranuronosyl-(1-4)-O-2-deoxy-3,6-di-O-sulfo-2-(sulfoamino)-alpha-D-glucopyranosyl-(1-4)-O-2-O-sulfo-alpha-L-idopyranuronosyl-(1-4)-2-deoxy-6-O-sulfo-2-(sulfoamino)-alpha-D-glucopyranoside, decasodium salt
External IDs Not Available
Product Ingredients Not Available
Approved Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing End
ArixtraInjection, solution1.5 mg/0.3mlSubcutaneousAspen Pharma Trading Limited2002-03-21Not applicableEu
ArixtraInjection, solution10 mg/0.8mlSubcutaneousAspen Pharma Trading Limited2002-03-21Not applicableEu
ArixtraInjection, solution10 mg/0.8mlSubcutaneousAspen Pharma Trading Limited2002-03-21Not applicableEu
ArixtraInjection, solution10 mg/0.8mlSubcutaneousAspen Pharma Trading Limited2002-03-21Not applicableEu
ArixtraInjection, solution5 mg/0.4mlSubcutaneousAspen Pharma Trading Limited2002-03-21Not applicableEu
ArixtraInjection, solution2.5 mg/.5mLSubcutaneousGlaxosmithkline Inc2005-03-302016-10-31Us
ArixtraSolution2.5 mgIntravenous; SubcutaneousAspen Pharmacare Canada Inc.2002-07-19Not applicableCanada
ArixtraInjection, solution2.5 mg/0.5mlIntravenous; SubcutaneousAspen Pharma Trading Limited2002-03-21Not applicableEu
ArixtraInjection, solution10 mg/.8mLSubcutaneousGlaxosmithkline Inc2004-11-172016-09-30Us
ArixtraSolution10 mgSubcutaneousAspen Pharmacare Canada Inc.2008-04-17Not applicableCanada
ArixtraInjection, solution1.5 mg/0.3mlSubcutaneousAspen Pharma Trading Limited2002-03-21Not applicableEu
ArixtraInjection, solution5 mg/0.4mlSubcutaneousAspen Pharma Trading Limited2002-03-21Not applicableEu
ArixtraInjection, solution2.5 mg/0.5mlIntravenous; SubcutaneousAspen Pharma Trading Limited2002-03-21Not applicableEu
ArixtraInjection, solution10 mg/0.8mlSubcutaneousAspen Pharma Trading Limited2002-03-21Not applicableEu
ArixtraInjection, solution7.5 mg/0.6mlSubcutaneousAspen Pharma Trading Limited2002-03-21Not applicableEu
ArixtraInjection, solution10 mg/0.8mlSubcutaneousAspen Pharma Trading Limited2002-03-21Not applicableEu
ArixtraInjection, solution7.5 mg/0.6mlSubcutaneousAspen Pharma Trading Limited2002-03-21Not applicableEu
ArixtraInjection, solution1.5 mg/0.3mlSubcutaneousAspen Pharma Trading Limited2002-03-21Not applicableEu
ArixtraInjection, solution7.5 mg/.6mLSubcutaneousMylan Institutional2015-05-06Not applicableUs
ArixtraInjection, solution2.5 mg/0.5mlIntravenous; SubcutaneousAspen Pharma Trading Limited2002-03-21Not applicableEu
ArixtraInjection, solution1.5 mg/0.3mlSubcutaneousAspen Pharma Trading Limited2002-03-21Not applicableEu
ArixtraInjection, solution5 mg/0.4mlSubcutaneousAspen Pharma Trading Limited2002-03-21Not applicableEu
ArixtraInjection, solution2.5 mg/0.5mlIntravenous; SubcutaneousAspen Pharma Trading Limited2002-03-21Not applicableEu
ArixtraInjection, solution5 mg/0.4mlSubcutaneousAspen Pharma Trading Limited2002-03-21Not applicableEu
ArixtraInjection, solution10 mg/0.8mlSubcutaneousAspen Pharma Trading Limited2002-03-21Not applicableEu
ArixtraInjection, solution7.5 mg/0.6mlSubcutaneousAspen Pharma Trading Limited2002-03-21Not applicableEu
ArixtraInjection, solution5 mg/.4mLSubcutaneousGlaxosmithkline Inc2004-11-172016-11-30Us
ArixtraSolution7.5 mgSubcutaneousAspen Pharmacare Canada Inc.2008-04-17Not applicableCanada
ArixtraInjection, solution7.5 mg/.6mLSubcutaneousPhysicians Total Care, Inc.2004-11-17Not applicableUs
ArixtraInjection, solution7.5 mg/0.6mlSubcutaneousAspen Pharma Trading Limited2002-03-21Not applicableEu
ArixtraInjection, solution1.5 mg/0.3mlSubcutaneousAspen Pharma Trading Limited2002-03-21Not applicableEu
ArixtraInjection, solution2.5 mg/.5mLSubcutaneousMylan Institutional2015-05-06Not applicableUs
ArixtraInjection, solution10 mg/0.8mlSubcutaneousAspen Pharma Trading Limited2002-03-21Not applicableEu
ArixtraInjection, solution5 mg/0.4mlSubcutaneousAspen Pharma Trading Limited2002-03-21Not applicableEu
ArixtraInjection, solution10 mg/.8mLSubcutaneousMylan Institutional2015-05-06Not applicableUs
ArixtraInjection, solution2.5 mg/0.5mlIntravenous; SubcutaneousAspen Pharma Trading Limited2002-03-21Not applicableEu
ArixtraSolution5 mgSubcutaneousAspen Pharmacare Canada Inc.2008-04-17Not applicableCanada
ArixtraInjection, solution1.5 mg/0.3mlSubcutaneousAspen Pharma Trading Limited2002-03-21Not applicableEu
ArixtraInjection, solution5 mg/0.4mlSubcutaneousAspen Pharma Trading Limited2002-03-21Not applicableEu
ArixtraInjection, solution2.5 mg/0.5mlIntravenous; SubcutaneousAspen Pharma Trading Limited2002-03-21Not applicableEu
ArixtraInjection, solution7.5 mg/0.6mlSubcutaneousAspen Pharma Trading Limited2002-03-21Not applicableEu
ArixtraInjection, solution5 mg/0.4mlSubcutaneousAspen Pharma Trading Limited2002-03-21Not applicableEu
ArixtraInjection, solution7.5 mg/0.6mlSubcutaneousAspen Pharma Trading Limited2002-03-21Not applicableEu
ArixtraInjection, solution7.5 mg/.6mLSubcutaneousGlaxosmithkline Inc2004-11-172016-11-30Us
ArixtraInjection, solution5 mg/.4mLSubcutaneousMylan Institutional2015-08-07Not applicableUs
ArixtraInjection, solution2.5 mg/0.5mlIntravenous; SubcutaneousAspen Pharma Trading Limited2002-03-21Not applicableEu
ArixtraInjection, solution7.5 mg/0.6mlSubcutaneousAspen Pharma Trading Limited2002-03-21Not applicableEu
ArixtraInjection, solution1.5 mg/0.3mlSubcutaneousAspen Pharma Trading Limited2002-03-21Not applicableEu
Fondaparinux SodiumInjection, solution2.5 mg/.5mLSubcutaneousMylan Institutional2016-06-09Not applicableUs
Fondaparinux SodiumInjection, solution10 mg/.8mLSubcutaneousMylan Institutional2015-01-05Not applicableUs
Fondaparinux SodiumInjection, solution10 mg/.8mLSubcutaneousApotex Corporation2011-07-182017-04-15Us
Fondaparinux SodiumInjection, solution10 mg/.8mLSubcutaneousMylan Institutional2016-06-09Not applicableUs
Fondaparinux SodiumInjection, solution7.5 mg/.6mLSubcutaneousMylan Institutional2015-01-05Not applicableUs
Fondaparinux SodiumInjection, solution5 mg/.4mLSubcutaneousApotex Corporation2011-07-182017-04-15Us
Fondaparinux SodiumInjection, solution2.5 mg/.5mLSubcutaneousMylan Institutional2015-01-05Not applicableUs
Fondaparinux SodiumInjection, solution5 mg/.4mLSubcutaneousMylan Institutional2016-06-09Not applicableUs
Fondaparinux SodiumInjection, solution7.5 mg/.6mLSubcutaneousApotex Corporation2011-07-182017-04-15Us
Fondaparinux SodiumInjection, solution5 mg/.4mLSubcutaneousMylan Institutional2015-01-05Not applicableUs
Fondaparinux SodiumInjection, solution7.5 mg/.6mLSubcutaneousMylan Institutional2016-06-09Not applicableUs
Fondaparinux SodiumInjection, solution2.5 mg/.5mLSubcutaneousApotex Corporation2011-07-182017-04-15Us
Fondaparinux Sodium InjectionSolution5 mgSubcutaneousDr Reddy's LaboratoriesNot applicableNot applicableCanada
Fondaparinux Sodium InjectionSolution2.5 mgIntravenous; SubcutaneousDr Reddy's Laboratories2014-03-21Not applicableCanada
Fondaparinux Sodium InjectionSolution10 mgSubcutaneousDr Reddy's LaboratoriesNot applicableNot applicableCanada
Fondaparinux Sodium InjectionSolution7.5 mgSubcutaneousDr Reddy's Laboratories2014-03-21Not applicableCanada
Approved Generic Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing End
Fondaparinux SodiumInjection2.5 mg/.5mLSubcutaneousDr Reddy's Laboratories2011-07-14Not applicableUs
Fondaparinux SodiumInjection10 mg/.8mLSubcutaneousDr Reddy's Laboratories2011-07-14Not applicableUs
Fondaparinux SodiumInjection5 mg/.4mLSubcutaneousDr Reddy's Laboratories2011-07-14Not applicableUs
Fondaparinux SodiumInjection7.5 mg/.6mLSubcutaneousDr Reddy's Laboratories2011-07-14Not applicableUs
Approved Over the Counter ProductsNot Available
Unapproved/Other Products Not Available
International BrandsNot Available
Brand mixturesNot Available
Categories
UNIIX0Q6N9USOZ
CAS number114870-03-0
WeightAverage: 1730.097
Monoisotopic: 1728.786427203
Chemical FormulaC31H45N3Na10O49S8
InChI KeyXEKSTYNIJLDDAZ-JASSWCPGSA-F
InChI
InChI=1S/C31H53N3O49S8.10Na/c1-69-27-9(33-85(48,49)50)13(37)17(6(74-27)3-71-88(57,58)59)76-31-22(83-91(66,67)68)16(40)21(24(81-31)26(43)44)79-29-10(34-86(51,52)53)19(82-90(63,64)65)18(7(75-29)4-72-89(60,61)62)77-30-15(39)14(38)20(23(80-30)25(41)42)78-28-8(32-84(45,46)47)12(36)11(35)5(73-28)2-70-87(54,55)56;;;;;;;;;;/h5-24,27-40H,2-4H2,1H3,(H,41,42)(H,43,44)(H,45,46,47)(H,48,49,50)(H,51,52,53)(H,54,55,56)(H,57,58,59)(H,60,61,62)(H,63,64,65)(H,66,67,68);;;;;;;;;;/q;10*+1/p-8/t5-,6-,7-,8-,9-,10-,11-,12-,13-,14-,15-,16+,17-,18-,19-,20+,21+,22-,23+,24-,27+,28-,29-,30-,31-;;;;;;;;;;/m1........../s1
IUPAC Name
decasodium N-[(2S,3R,4R,5S,6R)-5-{[(2R,3R,4S,5S,6R)-6-carboxy-5-{[(2R,3R,4R,5R,6R)-5-{[(2R,3R,4R,5S,6S)-6-carboxy-5-{[(2R,3R,4R,5S,6R)-4,5-dihydroxy-3-(sulfonatoamino)-6-[(sulfonatooxy)methyl]oxan-2-yl]oxy}-3,4-dihydroxyoxan-2-yl]oxy}-3-(sulfonatoamino)-4-(sulfonatooxy)-6-[(sulfonatooxy)methyl]oxan-2-yl]oxy}-4-hydroxy-3-(sulfonatooxy)oxan-2-yl]oxy}-4-hydroxy-2-methoxy-6-[(sulfonatooxy)methyl]oxan-3-yl]sulfamate
SMILES
[Na+].[Na+].[Na+].[Na+].[Na+].[Na+].[Na+].[Na+].[Na+].[Na+].CO[[email protected]]1O[[email protected]](COS([O-])(=O)=O)[C@@H](O[C@@H]2O[[email protected]]([C@@H](O[[email protected]]3O[[email protected]](COS([O-])(=O)=O)[C@@H](O[C@@H]4O[C@@H]([C@@H](O[[email protected]]5O[[email protected]](COS([O-])(=O)=O)[C@@H](O)[[email protected]](O)[[email protected]]5NS([O-])(=O)=O)[[email protected]](O)[[email protected]]4O)C(O)=O)[[email protected]](OS([O-])(=O)=O)[[email protected]]3NS([O-])(=O)=O)[[email protected]](O)[[email protected]]2OS([O-])(=O)=O)C(O)=O)[[email protected]](O)[[email protected]]1NS([O-])(=O)=O
Pharmacology
Indication

Approved for: (1) prophylaxis of VTE for up to one month post surgery in patients undergoing orthopedic surgery of the lower limbs such as hip fracture, hip replacement and knee surgery; (2) prophylaxis of VTE patients undergoing abdominal surgery who are at high risk of thromboembolic complications (e.g. patients undergoing abdominal cancer surgery); (3) treatment of acute DVT and PE; (4) management of UA and NSTEMI for the prevention of death and subsequent myocardial infarction (MI); and (5) management of STEMI for the prevention of death and myocardial reinfarction in patients who are managed with thrombolytics or who are initially to receive no form of reperfusion therapy. Fondaparinux should not be used as the sole anticoagulant during percutaneous coronary intervention (PCI) due to an increased risk of guiding catheter thrombosis.

Structured Indications
Pharmacodynamics

Fondaparinux binds specifically to the natural anticoagulant factor, ATIII. Binding to ATIII potentiates the neutralizing action of ATIII on Factor Xa 300-times. Neutralization of Factor Xa decreases the conversion of prothrombin to thrombin, which subsequently decreases the conversion of fibrinogen to fibrin (loose meshwork). The decrease in thrombin also decreases the activation of Factor XIII, which decreases the conversion of fibrin in its loose meshwork form to its stabilized meshwork form. Disruption of the coagulation cascade effectively decreases the formation of blood clots. Fondaparinux does not inactivate thrombin (activated Factor II). According to the manufacturer, fondaparinux has no known effect on platelet function. In studies comparing fondaparinux to enoxaparin, decreases in platelet levels were observed in similar numbers of patients from both groups (2-5%) (PMID 11794148, 12049860). At the recommended dose, Fondaparinux does not affect fibrinolytic activity or bleeding time. There is no antidote for fondaparinux. Monitoring of the anticoagulant activity of fondaparinux is not generally required. The anti-factor Xa assay may be used to monitor therapy in special populations such as those with renal impairment or who are pregnant. Complete blood count (CBC) and kidney function should be monitored during treatment.

Mechanism of action

The antithrombotic activity of fondaparinux is the result of ATIII-mediated selective inhibition of Factor Xa. By selectively binding to ATIII, Fondaparinux potentiates (about 300 times) the neutralization of Factor Xa by ATIII. Neutralization of Factor Xa interrupts the blood coagulation cascade and thus inhibits thrombin formation and thrombus development. It is thought that fondaparinux is unlikely to induce thrombocytopenia via a heparin-induced thrombocytopenia (HIT)-like mechanism given its chemical structure (PMID 19825921). As a result, fondaparinux has been used as an alternative anticoagulant in heparin-induced thrombocytopenia (HIT) patients (PMID 19737996, 19432027, 18217156). However, it is important to note that rare cases of HIT have been reported in patients treated with fondaparinux (PMID 20351685, 20351686).

TargetKindPharmacological actionActionsOrganismUniProt ID
Antithrombin-IIIProteinyes
potentiator
HumanP01008 details
Coagulation factor XProteinyes
inhibitor
HumanP00742 details
Related Articles
Absorption

100% bioavailability when administered subcutaneously

Volume of distribution
  • 7 - 11 L (healthy adults), distributed primarily in blood
Protein binding

94% in vitro protein binding specifically to ATIII

Metabolism

Not metabolized

Route of elimination

In individuals with normal kidney function, fondaparinux is eliminated in urine mainly as unchanged drug.

Half life

17-21 hours

ClearanceNot Available
Toxicity

As with other anticoagulants, the main concern is increased bleed risk. The risk of hemorrhage may increase with decreased renal function, body mass less than 50 kg, and moderate to severe hepatic function.

Affected organisms
  • Humans and other mammals
Pathways
PathwayCategorySMPDB ID
Fondaparinux Action PathwayDrug actionSMP00273
Pharmacogenomic Effects/ADRs Not Available
Interactions
Drug Interactions
DrugInteractionDrug group
AbciximabAbciximab may increase the anticoagulant activities of Fondaparinux sodium.Approved
AceclofenacAceclofenac may increase the anticoagulant activities of Fondaparinux sodium.Approved
AcenocoumarolFondaparinux sodium may increase the anticoagulant activities of Acenocoumarol.Approved
Acetylsalicylic acidAcetylsalicylic acid may increase the anticoagulant activities of Fondaparinux sodium.Approved, Vet Approved
AdapaleneAdapalene may increase the anticoagulant activities of Fondaparinux sodium.Approved
AllylestrenolThe therapeutic efficacy of Fondaparinux sodium can be decreased when used in combination with Allylestrenol.Approved
AlprostadilAlprostadil may increase the anticoagulant activities of Fondaparinux sodium.Approved, Investigational
AlteplaseAlteplase may increase the anticoagulant activities of Fondaparinux sodium.Approved
Aminosalicylic AcidAminosalicylic Acid may increase the anticoagulant activities of Fondaparinux sodium.Approved
AnagrelideAnagrelide may increase the anticoagulant activities of Fondaparinux sodium.Approved
AncrodFondaparinux sodium may increase the anticoagulant activities of Ancrod.Investigational
AndrographolideHMPL-004 may increase the anticoagulant activities of Fondaparinux sodium.Investigational
AnisodamineAnisodamine may increase the anticoagulant activities of Fondaparinux sodium.Investigational
AnistreplaseAnistreplase may increase the anticoagulant activities of Fondaparinux sodium.Approved
AntipyrineAntipyrine may increase the anticoagulant activities of Fondaparinux sodium.Approved
Antithrombin III humanFondaparinux sodium may increase the anticoagulant activities of Antithrombin III human.Approved
ApixabanApixaban may increase the anticoagulant activities of Fondaparinux sodium.Approved
ApocyninAcetovanillone may increase the anticoagulant activities of Fondaparinux sodium.Investigational
ApremilastApremilast may increase the anticoagulant activities of Fondaparinux sodium.Approved, Investigational
ArdeparinArdeparin may increase the anticoagulant activities of Fondaparinux sodium.Approved, Withdrawn
ArgatrobanArgatroban may increase the anticoagulant activities of Fondaparinux sodium.Approved, Investigational
AzapropazoneAzapropazone may increase the anticoagulant activities of Fondaparinux sodium.Withdrawn
AzelastineAzelastine may increase the anticoagulant activities of Fondaparinux sodium.Approved
BalsalazideBalsalazide may increase the anticoagulant activities of Fondaparinux sodium.Approved, Investigational
BazedoxifeneBazedoxifene may decrease the anticoagulant activities of Fondaparinux sodium.Approved, Investigational
BecaplerminBecaplermin may increase the anticoagulant activities of Fondaparinux sodium.Approved, Investigational
BemiparinBemiparin may increase the anticoagulant activities of Fondaparinux sodium.Approved
BenoxaprofenBenoxaprofen may increase the anticoagulant activities of Fondaparinux sodium.Withdrawn
BeraprostBeraprost may increase the anticoagulant activities of Fondaparinux sodium.Investigational
Betulinic AcidBetulinic Acid may increase the anticoagulant activities of Fondaparinux sodium.Investigational
BivalirudinBivalirudin may increase the anticoagulant activities of Fondaparinux sodium.Approved, Investigational
BromfenacBromfenac may increase the anticoagulant activities of Fondaparinux sodium.Approved
BucillamineBucillamine may increase the anticoagulant activities of Fondaparinux sodium.Investigational
ButylphthalideButylphthalide may increase the anticoagulant activities of Fondaparinux sodium.Investigational
CangrelorCangrelor may increase the anticoagulant activities of Fondaparinux sodium.Approved
CarprofenCarprofen may increase the anticoagulant activities of Fondaparinux sodium.Approved, Vet Approved, Withdrawn
CastanospermineCastanospermine may increase the anticoagulant activities of Fondaparinux sodium.Experimental
CelecoxibCelecoxib may increase the anticoagulant activities of Fondaparinux sodium.Approved, Investigational
CertoparinFondaparinux sodium may increase the anticoagulant activities of Certoparin.Approved
ChloroquineChloroquine may increase the anticoagulant activities of Fondaparinux sodium.Approved, Vet Approved
ChlorotrianiseneChlorotrianisene may decrease the anticoagulant activities of Fondaparinux sodium.Withdrawn
Choline magnesium trisalicylateTrisalicylate-choline may increase the anticoagulant activities of Fondaparinux sodium.Approved
CilostazolCilostazol may increase the anticoagulant activities of Fondaparinux sodium.Approved
Citric AcidFondaparinux sodium may increase the anticoagulant activities of Citric Acid.Nutraceutical, Vet Approved
ClonixinClonixin may increase the anticoagulant activities of Fondaparinux sodium.Approved
ClopidogrelClopidogrel may increase the anticoagulant activities of Fondaparinux sodium.Approved, Nutraceutical
Conjugated estrogensConjugated Equine Estrogens may decrease the anticoagulant activities of Fondaparinux sodium.Approved
CurcuminCurcumin may increase the anticoagulant activities of Fondaparinux sodium.Investigational
Dabigatran etexilateDabigatran etexilate may increase the anticoagulant activities of Fondaparinux sodium.Approved
DalteparinFondaparinux sodium may increase the anticoagulant activities of Dalteparin.Approved
DarexabanFondaparinux sodium may increase the anticoagulant activities of Ym150.Investigational
DasatinibDasatinib may increase the anticoagulant activities of Fondaparinux sodium.Approved, Investigational
DeferasiroxThe risk or severity of adverse effects can be increased when Fondaparinux sodium is combined with Deferasirox.Approved, Investigational
DefibrotideDefibrotide may increase the anticoagulant activities of Fondaparinux sodium.Approved, Investigational
Deoxycholic AcidThe risk or severity of adverse effects can be increased when Fondaparinux sodium is combined with Deoxycholic Acid.Approved
DesirudinFondaparinux sodium may increase the anticoagulant activities of Desirudin.Approved
DesmoteplaseDesmoteplase may increase the anticoagulant activities of Fondaparinux sodium.Investigational
DesogestrelThe therapeutic efficacy of Fondaparinux sodium can be decreased when used in combination with Desogestrel.Approved
DextranFondaparinux sodium may increase the anticoagulant activities of Dextran.Approved, Vet Approved
Dextran 40Fondaparinux sodium may increase the anticoagulant activities of Dextran 40.Approved
DiclofenacDiclofenac may increase the anticoagulant activities of Fondaparinux sodium.Approved, Vet Approved
DicoumarolDicoumarol may increase the anticoagulant activities of Fondaparinux sodium.Approved
DienestrolDienestrol may decrease the anticoagulant activities of Fondaparinux sodium.Approved
DienogestThe therapeutic efficacy of Fondaparinux sodium can be decreased when used in combination with Dienogest.Approved
DiethylstilbestrolDiethylstilbestrol may decrease the anticoagulant activities of Fondaparinux sodium.Approved
DiflunisalDiflunisal may increase the anticoagulant activities of Fondaparinux sodium.Approved
DipyridamoleDipyridamole may increase the anticoagulant activities of Fondaparinux sodium.Approved
DitazoleDitazole may increase the anticoagulant activities of Fondaparinux sodium.Approved, Withdrawn
DrospirenoneThe therapeutic efficacy of Fondaparinux sodium can be decreased when used in combination with Drospirenone.Approved
Drotrecogin alfaDrotrecogin alfa may increase the anticoagulant activities of Fondaparinux sodium.Approved, Investigational, Withdrawn
DroxicamDroxicam may increase the anticoagulant activities of Fondaparinux sodium.Approved
DuvelisibDuvelisib may increase the anticoagulant activities of Fondaparinux sodium.Investigational
DydrogesteroneThe therapeutic efficacy of Fondaparinux sodium can be decreased when used in combination with Dydrogesterone.Approved, Withdrawn
E-6201E6201 may increase the anticoagulant activities of Fondaparinux sodium.Investigational
EbselenEbselen may increase the anticoagulant activities of Fondaparinux sodium.Investigational
Edetic AcidFondaparinux sodium may increase the anticoagulant activities of Edetic Acid.Approved, Vet Approved
EdoxabanEdoxaban may increase the anticoagulant activities of Fondaparinux sodium.Approved
EnoxaparinFondaparinux sodium may increase the anticoagulant activities of Enoxaparin.Approved
EpinastineEpinastine may increase the anticoagulant activities of Fondaparinux sodium.Approved, Investigational
EpirizoleEpirizole may increase the anticoagulant activities of Fondaparinux sodium.Approved
EpoprostenolEpoprostenol may increase the anticoagulant activities of Fondaparinux sodium.Approved
EptifibatideEptifibatide may increase the anticoagulant activities of Fondaparinux sodium.Approved, Investigational
EquolS Equol may decrease the anticoagulant activities of Fondaparinux sodium.Investigational
EstradiolEstradiol may decrease the anticoagulant activities of Fondaparinux sodium.Approved, Investigational, Vet Approved
EstriolEstriol may decrease the anticoagulant activities of Fondaparinux sodium.Approved, Vet Approved
EstroneEstrone may decrease the anticoagulant activities of Fondaparinux sodium.Approved
EtanerceptEtanercept may increase the anticoagulant activities of Fondaparinux sodium.Approved, Investigational
Ethinyl EstradiolEthinyl Estradiol may decrease the anticoagulant activities of Fondaparinux sodium.Approved
Ethyl biscoumacetateFondaparinux sodium may increase the anticoagulant activities of Ethyl biscoumacetate.Withdrawn
Ethynodiol diacetateThe therapeutic efficacy of Fondaparinux sodium can be decreased when used in combination with Ethynodiol diacetate.Approved
EtodolacEtodolac may increase the anticoagulant activities of Fondaparinux sodium.Approved, Investigational, Vet Approved
EtofenamateEtofenamate may increase the anticoagulant activities of Fondaparinux sodium.Approved
EtonogestrelThe therapeutic efficacy of Fondaparinux sodium can be decreased when used in combination with Etonogestrel.Approved, Investigational
EtoricoxibEtoricoxib may increase the anticoagulant activities of Fondaparinux sodium.Approved, Investigational
FenbufenFenbufen may increase the anticoagulant activities of Fondaparinux sodium.Approved
FenoprofenFenoprofen may increase the anticoagulant activities of Fondaparinux sodium.Approved
FibrinolysinPlasmin may increase the anticoagulant activities of Fondaparinux sodium.Investigational
FloctafenineFloctafenine may increase the anticoagulant activities of Fondaparinux sodium.Approved, Withdrawn
FluindioneFondaparinux sodium may increase the anticoagulant activities of Fluindione.Investigational
FlurbiprofenFlurbiprofen may increase the anticoagulant activities of Fondaparinux sodium.Approved, Investigational
FondaparinuxFondaparinux sodium may increase the anticoagulant activities of Fondaparinux.Investigational
GabexateFondaparinux sodium may increase the anticoagulant activities of Gabexate.Investigational
GenisteinGenistein may decrease the anticoagulant activities of Fondaparinux sodium.Investigational
GestodeneThe therapeutic efficacy of Fondaparinux sodium can be decreased when used in combination with Gestodene.Approved
GestrinoneThe therapeutic efficacy of Fondaparinux sodium can be decreased when used in combination with Gestrinone.Approved
HeminHemin may increase the anticoagulant activities of Fondaparinux sodium.Approved
HeparinFondaparinux sodium may increase the anticoagulant activities of Heparin.Approved, Investigational
HexestrolHexestrol may decrease the anticoagulant activities of Fondaparinux sodium.Withdrawn
HigenamineHigenamine may increase the anticoagulant activities of Fondaparinux sodium.Investigational
Hydroxyprogesterone caproateThe therapeutic efficacy of Fondaparinux sodium can be decreased when used in combination with Hydroxyprogesterone caproate.Approved
Ibritumomab tiuxetanThe risk or severity of adverse effects can be increased when Fondaparinux sodium is combined with Ibritumomab tiuxetan.Approved
IbrutinibThe risk or severity of adverse effects can be increased when Ibrutinib is combined with Fondaparinux sodium.Approved
IbudilastIbudilast may increase the anticoagulant activities of Fondaparinux sodium.Approved, Investigational
IbuprofenIbuprofen may increase the anticoagulant activities of Fondaparinux sodium.Approved
IbuproxamIbuproxam may increase the anticoagulant activities of Fondaparinux sodium.Withdrawn
IcatibantIcatibant may increase the anticoagulant activities of Fondaparinux sodium.Approved
Icosapent ethylIcosapent ethyl may increase the anticoagulant activities of Fondaparinux sodium.Approved, Nutraceutical
IfenprodilIfenprodil may increase the anticoagulant activities of Fondaparinux sodium.Approved, Withdrawn
IloprostIloprost may increase the anticoagulant activities of Fondaparinux sodium.Approved, Investigational
IndobufenIndobufen may increase the anticoagulant activities of Fondaparinux sodium.Investigational
IndomethacinIndomethacin may increase the anticoagulant activities of Fondaparinux sodium.Approved, Investigational
IndoprofenIndoprofen may increase the anticoagulant activities of Fondaparinux sodium.Withdrawn
IsoxicamIsoxicam may increase the anticoagulant activities of Fondaparinux sodium.Withdrawn
KebuzoneKebuzone may increase the anticoagulant activities of Fondaparinux sodium.Experimental
KetanserinKetanserin may increase the anticoagulant activities of Fondaparinux sodium.Investigational
KetoprofenKetoprofen may increase the anticoagulant activities of Fondaparinux sodium.Approved, Vet Approved
KetorolacKetorolac may increase the anticoagulant activities of Fondaparinux sodium.Approved
LeflunomideLeflunomide may increase the anticoagulant activities of Fondaparinux sodium.Approved, Investigational
LepirudinLepirudin may increase the anticoagulant activities of Fondaparinux sodium.Approved
LevonorgestrelThe therapeutic efficacy of Fondaparinux sodium can be decreased when used in combination with Levonorgestrel.Approved, Investigational
LimaprostThe risk or severity of adverse effects can be increased when Limaprost is combined with Fondaparinux sodium.Approved
LisofyllineLisofylline may increase the anticoagulant activities of Fondaparinux sodium.Investigational
LornoxicamLornoxicam may increase the anticoagulant activities of Fondaparinux sodium.Approved
LoxoprofenLoxoprofen may increase the anticoagulant activities of Fondaparinux sodium.Approved
LumiracoxibLumiracoxib may increase the anticoagulant activities of Fondaparinux sodium.Approved, Investigational
LynestrenolThe therapeutic efficacy of Fondaparinux sodium can be decreased when used in combination with Lynestrenol.Investigational
Magnesium salicylateMagnesium salicylate may increase the anticoagulant activities of Fondaparinux sodium.Approved
MasoprocolMasoprocol may increase the anticoagulant activities of Fondaparinux sodium.Approved
Meclofenamic acidMeclofenamic acid may increase the anticoagulant activities of Fondaparinux sodium.Approved, Vet Approved
MedrogestoneThe therapeutic efficacy of Fondaparinux sodium can be decreased when used in combination with Medrogestone.Approved
Medroxyprogesterone acetateThe therapeutic efficacy of Fondaparinux sodium can be decreased when used in combination with Medroxyprogesterone acetate.Approved, Investigational
Mefenamic acidMefenamic acid may increase the anticoagulant activities of Fondaparinux sodium.Approved
Megestrol acetateThe therapeutic efficacy of Fondaparinux sodium can be decreased when used in combination with Megestrol acetate.Approved, Vet Approved
MeloxicamMeloxicam may increase the anticoagulant activities of Fondaparinux sodium.Approved, Vet Approved
MesalazineMesalazine may increase the anticoagulant activities of Fondaparinux sodium.Approved
MestranolMestranol may decrease the anticoagulant activities of Fondaparinux sodium.Approved
MetamizoleMetamizole may increase the anticoagulant activities of Fondaparinux sodium.Withdrawn
MethallenestrilMethallenestril may decrease the anticoagulant activities of Fondaparinux sodium.Experimental
MilrinoneMilrinone may increase the anticoagulant activities of Fondaparinux sodium.Approved
MizoribineMizoribine may increase the anticoagulant activities of Fondaparinux sodium.Investigational
Mycophenolate mofetilMycophenolate mofetil may increase the anticoagulant activities of Fondaparinux sodium.Approved, Investigational
Mycophenolic acidMycophenolic acid may increase the anticoagulant activities of Fondaparinux sodium.Approved
NabumetoneNabumetone may increase the anticoagulant activities of Fondaparinux sodium.Approved
NadroparinFondaparinux sodium may increase the anticoagulant activities of Nadroparin.Approved
NafamostatNafamostat may increase the anticoagulant activities of Fondaparinux sodium.Approved, Investigational
NaftifineNaftifine may increase the anticoagulant activities of Fondaparinux sodium.Approved
NaftopidilNaftopidil may increase the anticoagulant activities of Fondaparinux sodium.Investigational
NaproxenNaproxen may increase the anticoagulant activities of Fondaparinux sodium.Approved, Vet Approved
NCX 4016NCX 4016 may increase the anticoagulant activities of Fondaparinux sodium.Investigational
NepafenacNepafenac may increase the anticoagulant activities of Fondaparinux sodium.Approved
Niflumic AcidNiflumic Acid may increase the anticoagulant activities of Fondaparinux sodium.Approved
NimesulideNimesulide may increase the anticoagulant activities of Fondaparinux sodium.Approved, Withdrawn
NintedanibThe risk or severity of adverse effects can be increased when Fondaparinux sodium is combined with Nintedanib.Approved
NitroaspirinNitroaspirin may increase the anticoagulant activities of Fondaparinux sodium.Investigational
NorethisteroneThe therapeutic efficacy of Fondaparinux sodium can be decreased when used in combination with Norethisterone.Approved
ObinutuzumabThe risk or severity of adverse effects can be increased when Fondaparinux sodium is combined with Obinutuzumab.Approved
OlopatadineOlopatadine may increase the anticoagulant activities of Fondaparinux sodium.Approved
OlsalazineOlsalazine may increase the anticoagulant activities of Fondaparinux sodium.Approved
Omacetaxine mepesuccinateThe risk or severity of adverse effects can be increased when Fondaparinux sodium is combined with Omacetaxine mepesuccinate.Approved
Omega-3 fatty acidsOmega-3 fatty acids may increase the anticoagulant activities of Fondaparinux sodium.Approved, Nutraceutical
OxaprozinOxaprozin may increase the anticoagulant activities of Fondaparinux sodium.Approved
OxyphenbutazoneOxyphenbutazone may increase the anticoagulant activities of Fondaparinux sodium.Withdrawn
OzagrelKct 0809 may increase the anticoagulant activities of Fondaparinux sodium.Investigational
ParecoxibParecoxib may increase the anticoagulant activities of Fondaparinux sodium.Approved
ParnaparinParnaparin may increase the anticoagulant activities of Fondaparinux sodium.Approved
Pentosan PolysulfatePentosan Polysulfate may increase the anticoagulant activities of Fondaparinux sodium.Approved
PentoxifyllinePentoxifylline may increase the anticoagulant activities of Fondaparinux sodium.Approved, Investigational
PhenindionePhenindione may increase the anticoagulant activities of Fondaparinux sodium.Approved
PhenprocoumonFondaparinux sodium may increase the anticoagulant activities of Phenprocoumon.Approved
PhenylbutazonePhenylbutazone may increase the anticoagulant activities of Fondaparinux sodium.Approved, Vet Approved
PimecrolimusPimecrolimus may increase the anticoagulant activities of Fondaparinux sodium.Approved, Investigational
PirfenidonePirfenidone may increase the anticoagulant activities of Fondaparinux sodium.Investigational
PiroxicamPiroxicam may increase the anticoagulant activities of Fondaparinux sodium.Approved, Investigational
PrasugrelPrasugrel may increase the anticoagulant activities of Fondaparinux sodium.Approved
ProgesteroneThe therapeutic efficacy of Fondaparinux sodium can be decreased when used in combination with Progesterone.Approved, Vet Approved
PromestrienePromestriene may decrease the anticoagulant activities of Fondaparinux sodium.Investigational
PropacetamolPropacetamol may increase the anticoagulant activities of Fondaparinux sodium.Approved
Protein S humanFondaparinux sodium may increase the anticoagulant activities of Protein S human.Approved
PTC299PTC299 may increase the anticoagulant activities of Fondaparinux sodium.Investigational
QuinestrolQuinestrol may decrease the anticoagulant activities of Fondaparinux sodium.Approved
RamatrobanRamatroban may increase the anticoagulant activities of Fondaparinux sodium.Investigational
ResveratrolResveratrol may increase the anticoagulant activities of Fondaparinux sodium.Experimental, Investigational
ReteplaseReteplase may increase the anticoagulant activities of Fondaparinux sodium.Approved
ReviparinFondaparinux sodium may increase the anticoagulant activities of Reviparin.Approved
RidogrelRidogrel may increase the anticoagulant activities of Fondaparinux sodium.Approved
RivaroxabanFondaparinux sodium may increase the anticoagulant activities of Rivaroxaban.Approved
RofecoxibRofecoxib may increase the anticoagulant activities of Fondaparinux sodium.Investigational, Withdrawn
RosiglitazoneRosiglitazone may increase the anticoagulant activities of Fondaparinux sodium.Approved, Investigational
SalicylamideSalicylamide may increase the anticoagulant activities of Fondaparinux sodium.Approved
Salicylic acidSalicylic acid may increase the anticoagulant activities of Fondaparinux sodium.Approved, Vet Approved
SalsalateSalsalate may increase the anticoagulant activities of Fondaparinux sodium.Approved
SecoisolariciresinolSecoisolariciresinol may decrease the anticoagulant activities of Fondaparinux sodium.Investigational
SelexipagSelexipag may increase the anticoagulant activities of Fondaparinux sodium.Approved
SevofluraneSevoflurane may increase the anticoagulant activities of Fondaparinux sodium.Approved, Vet Approved
SRT501SRT501 may increase the anticoagulant activities of Fondaparinux sodium.Investigational
StreptokinaseStreptokinase may increase the anticoagulant activities of Fondaparinux sodium.Approved
SugammadexSugammadex may increase the anticoagulant activities of Fondaparinux sodium.Approved
SulfasalazineSulfasalazine may increase the anticoagulant activities of Fondaparinux sodium.Approved
SulindacSulindac may increase the anticoagulant activities of Fondaparinux sodium.Approved
SulodexideFondaparinux sodium may increase the anticoagulant activities of Sulodexide.Approved, Investigational
SuprofenSuprofen may increase the anticoagulant activities of Fondaparinux sodium.Approved, Withdrawn
Synthetic Conjugated Estrogens, ASynthetic Conjugated Estrogens, A may decrease the anticoagulant activities of Fondaparinux sodium.Approved
Synthetic Conjugated Estrogens, BSynthetic Conjugated Estrogens, B may decrease the anticoagulant activities of Fondaparinux sodium.Approved
TenecteplaseTenecteplase may increase the anticoagulant activities of Fondaparinux sodium.Approved
TenoxicamTenoxicam may increase the anticoagulant activities of Fondaparinux sodium.Approved
TeriflunomideTeriflunomide may increase the anticoagulant activities of Fondaparinux sodium.Approved
TesmilifeneTesmilifene may increase the anticoagulant activities of Fondaparinux sodium.Investigational
Tiaprofenic acidTiaprofenic acid may increase the anticoagulant activities of Fondaparinux sodium.Approved
TiboloneTibolone may increase the anticoagulant activities of Fondaparinux sodium.Approved
TicagrelorTicagrelor may increase the anticoagulant activities of Fondaparinux sodium.Approved
TiclopidineTiclopidine may increase the anticoagulant activities of Fondaparinux sodium.Approved
TinoridineTinoridine may increase the anticoagulant activities of Fondaparinux sodium.Investigational
TinzaparinTinzaparin may increase the anticoagulant activities of Fondaparinux sodium.Approved
TipranavirTipranavir may increase the anticoagulant activities of Fondaparinux sodium.Approved, Investigational
TirofibanTirofiban may increase the anticoagulant activities of Fondaparinux sodium.Approved
Tolfenamic AcidTolfenamic Acid may increase the anticoagulant activities of Fondaparinux sodium.Approved
TolmetinTolmetin may increase the anticoagulant activities of Fondaparinux sodium.Approved
TositumomabThe risk or severity of adverse effects can be increased when Fondaparinux sodium is combined with Tositumomab.Approved
TranilastTranilast may increase the anticoagulant activities of Fondaparinux sodium.Approved, Investigational
TrapidilTrapidil may increase the anticoagulant activities of Fondaparinux sodium.Approved
TreprostinilTreprostinil may increase the anticoagulant activities of Fondaparinux sodium.Approved, Investigational
TriflusalTriflusal may increase the anticoagulant activities of Fondaparinux sodium.Approved
UrokinaseUrokinase may increase the anticoagulant activities of Fondaparinux sodium.Approved, Investigational, Withdrawn
ValdecoxibValdecoxib may increase the anticoagulant activities of Fondaparinux sodium.Investigational, Withdrawn
Vitamin EVitamin E may increase the anticoagulant activities of Fondaparinux sodium.Approved, Nutraceutical, Vet Approved
VorapaxarThe risk or severity of adverse effects can be increased when Vorapaxar is combined with Fondaparinux sodium.Approved
WarfarinFondaparinux sodium may increase the anticoagulant activities of Warfarin.Approved
XimelagatranFondaparinux sodium may increase the anticoagulant activities of Ximelagatran.Approved, Investigational, Withdrawn
ZaltoprofenZaltoprofen may increase the anticoagulant activities of Fondaparinux sodium.Approved
ZileutonZileuton may increase the anticoagulant activities of Fondaparinux sodium.Approved, Investigational, Withdrawn
ZomepiracZomepirac may increase the anticoagulant activities of Fondaparinux sodium.Withdrawn
Food InteractionsNot Available
References
Synthesis Reference

Jean-Francois Branellec, Christian Morello, Pierre Potier, Patrick Trouilleux, Petrus Marcus Bastiaansen, Henricus Cornelis Claassen, "Highly pure fondaparinux sodium composition, process for preparing said composition and pharmaceutical compositions containing it as active principle." U.S. Patent US20050020536, issued January 27, 2005.

US20050020536
General References
  1. Eriksson BI, Bauer KA, Lassen MR, Turpie AG: Fondaparinux compared with enoxaparin for the prevention of venous thromboembolism after hip-fracture surgery. N Engl J Med. 2001 Nov 1;345(18):1298-304. [PubMed:11794148 ]
  2. Turpie AG, Bauer KA, Eriksson BI, Lassen MR: Postoperative fondaparinux versus postoperative enoxaparin for prevention of venous thromboembolism after elective hip-replacement surgery: a randomised double-blind trial. Lancet. 2002 May 18;359(9319):1721-6. [PubMed:12049860 ]
  3. Lassen MR, Bauer KA, Eriksson BI, Turpie AG: Postoperative fondaparinux versus preoperative enoxaparin for prevention of venous thromboembolism in elective hip-replacement surgery: a randomised double-blind comparison. Lancet. 2002 May 18;359(9319):1715-20. [PubMed:12049858 ]
  4. Bauer KA, Eriksson BI, Lassen MR, Turpie AG: Fondaparinux compared with enoxaparin for the prevention of venous thromboembolism after elective major knee surgery. N Engl J Med. 2001 Nov 1;345(18):1305-10. [PubMed:11794149 ]
  5. Agnelli G, Bergqvist D, Cohen AT, Gallus AS, Gent M: Randomized clinical trial of postoperative fondaparinux versus perioperative dalteparin for prevention of venous thromboembolism in high-risk abdominal surgery. Br J Surg. 2005 Oct;92(10):1212-20. [PubMed:16175516 ]
  6. Buller HR, Davidson BL, Decousus H, Gallus A, Gent M, Piovella F, Prins MH, Raskob G, Segers AE, Cariou R, Leeuwenkamp O, Lensing AW: Fondaparinux or enoxaparin for the initial treatment of symptomatic deep venous thrombosis: a randomized trial. Ann Intern Med. 2004 Jun 1;140(11):867-73. [PubMed:15172900 ]
  7. Buller HR, Davidson BL, Decousus H, Gallus A, Gent M, Piovella F, Prins MH, Raskob G, van den Berg-Segers AE, Cariou R, Leeuwenkamp O, Lensing AW: Subcutaneous fondaparinux versus intravenous unfractionated heparin in the initial treatment of pulmonary embolism. N Engl J Med. 2003 Oct 30;349(18):1695-702. [PubMed:14585937 ]
  8. Yusuf S, Mehta SR, Chrolavicius S, Afzal R, Pogue J, Granger CB, Budaj A, Peters RJ, Bassand JP, Wallentin L, Joyner C, Fox KA: Comparison of fondaparinux and enoxaparin in acute coronary syndromes. N Engl J Med. 2006 Apr 6;354(14):1464-76. Epub 2006 Mar 14. [PubMed:16537663 ]
  9. Bassand JP, Richard-Lordereau I, Cadroy Y: Efficacy and safety of fondaparinux in patients with acute coronary syndromes. Expert Rev Cardiovasc Ther. 2007 Nov;5(6):1013-26. [PubMed:18035917 ]
  10. Steg PG, Jolly SS, Mehta SR, Afzal R, Xavier D, Rupprecht HJ, Lopez-Sendon JL, Budaj A, Diaz R, Avezum A, Widimsky P, Rao SV, Chrolavicius S, Meeks B, Joyner C, Pogue J, Yusuf S: Low-dose vs standard-dose unfractionated heparin for percutaneous coronary intervention in acute coronary syndromes treated with fondaparinux: the FUTURA/OASIS-8 randomized trial. JAMA. 2010 Sep 22;304(12):1339-49. doi: 10.1001/jama.2010.1320. Epub 2010 Aug 31. [PubMed:20805623 ]
  11. Yusuf S, Mehta SR, Chrolavicius S, Afzal R, Pogue J, Granger CB, Budaj A, Peters RJ, Bassand JP, Wallentin L, Joyner C, Fox KA: Effects of fondaparinux on mortality and reinfarction in patients with acute ST-segment elevation myocardial infarction: the OASIS-6 randomized trial. JAMA. 2006 Apr 5;295(13):1519-30. Epub 2006 Mar 14. [PubMed:16537725 ]
  12. Kuo KH, Kovacs MJ: Successful treatment of heparin induced thrombocytopenia (HIT) with fondaparinux. Thromb Haemost. 2005 May;93(5):999-1000. [PubMed:15886823 ]
  13. Ortel TL: Heparin-induced thrombocytopenia: when a low platelet count is a mandate for anticoagulation. Hematology Am Soc Hematol Educ Program. 2009:225-32. doi: 10.1182/asheducation-2009.1.225. [PubMed:20008202 ]
  14. Moser M, Bode C: New antithrombotic agents in acute coronary syndromes. Curr Opin Cardiol. 2009 Jul;24(4):313-7. doi: 10.1097/HCO.0b013e32832bd350. [PubMed:19395952 ]
  15. Hirsh J, Bauer KA, Donati MB, Gould M, Samama MM, Weitz JI: Parenteral anticoagulants: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest. 2008 Jun;133(6 Suppl):141S-159S. doi: 10.1378/chest.08-0689. [PubMed:18574264 ]
  16. Geerts WH, Bergqvist D, Pineo GF, Heit JA, Samama CM, Lassen MR, Colwell CW: Prevention of venous thromboembolism: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest. 2008 Jun;133(6 Suppl):381S-453S. doi: 10.1378/chest.08-0656. [PubMed:18574271 ]
  17. Kearon C, Kahn SR, Agnelli G, Goldhaber S, Raskob GE, Comerota AJ: Antithrombotic therapy for venous thromboembolic disease: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest. 2008 Jun;133(6 Suppl):454S-545S. doi: 10.1378/chest.08-0658. [PubMed:18574272 ]
  18. Anderson JL, Adams CD, Antman EM, Bridges CR, Califf RM, Casey DE Jr, Chavey WE 2nd, Fesmire FM, Hochman JS, Levin TN, Lincoff AM, Peterson ED, Theroux P, Wenger NK, Wright RS, Smith SC Jr, Jacobs AK, Adams CD, Anderson JL, Antman EM, Halperin JL, Hunt SA, Krumholz HM, Kushner FG, Lytle BW, Nishimura R, Ornato JP, Page RL, Riegel B: ACC/AHA 2007 guidelines for the management of patients with unstable angina/non-ST-Elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines for the Management of Patients With Unstable Angina/Non-ST-Elevation Myocardial Infarction) developed in collaboration with the American College of Emergency Physicians, the Society for Cardiovascular Angiography and Interventions, and the Society of Thoracic Surgeons endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation and the Society for Academic Emergency Medicine. J Am Coll Cardiol. 2007 Aug 14;50(7):e1-e157. [PubMed:17692738 ]
  19. Goodman SG, Menon V, Cannon CP, Steg G, Ohman EM, Harrington RA: Acute ST-segment elevation myocardial infarction: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest. 2008 Jun;133(6 Suppl):708S-775S. doi: 10.1378/chest.08-0665. [PubMed:18574277 ]
  20. Warkentin TE, Greinacher A, Koster A, Lincoff AM: Treatment and prevention of heparin-induced thrombocytopenia: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest. 2008 Jun;133(6 Suppl):340S-380S. doi: 10.1378/chest.08-0677. [PubMed:18574270 ]
  21. Harrington RA, Becker RC, Cannon CP, Gutterman D, Lincoff AM, Popma JJ, Steg G, Guyatt GH, Goodman SG: Antithrombotic therapy for non-ST-segment elevation acute coronary syndromes: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest. 2008 Jun;133(6 Suppl):670S-707S. doi: 10.1378/chest.08-0691. [PubMed:18574276 ]
External Links
ATC CodesNot Available
AHFS Codes
  • 20:12.04.92
PDB Entries
FDA labelDownload (289 KB)
MSDSNot Available
Clinical Trials
Clinical Trials
PhaseStatusPurposeConditionsCount
1CompletedTreatmentImpaired Renal Function1
1CompletedTreatmentCardiac surgery, heparin-induced thrombocytopenia and thrombosis syndrome / Thrombosis1
1WithdrawnTreatmentOvarian Carcinoma1
2CompletedPreventionProphylaxis of Pulmonary embolism / Thrombosis, Venous1
2CompletedTreatmentCancer, Ovarian / Cervical Cancers / Endometrial Cancers / Fallopian Tube Cancer / Sarcomas / Thromboembolism / Vaginal Cancers / Vulvar Cancers1
2TerminatedTreatmentCardiac surgery, heparin-induced thrombocytopenia and thrombosis syndrome1
2WithdrawnTreatmentCoronary Heart Disease (CHD) / Myocardial Infarction (MI)1
2, 3CompletedPreventionVenous Thromboembolism1
2, 3Unknown StatusPreventionDeep Vein Thrombosis (DVT) / Prophylaxis of Pulmonary embolism1
3CompletedPreventionAbdominal Surgeries / Deep Vein Thrombosis (DVT) / General Surgery / Prophylaxis of Pulmonary embolism / Thromboembolism / Thrombosis, Venous / Venous Thromboembolism1
3CompletedPreventionHip Replacement Surgery / Knee Replacement / Thromboembolism1
3CompletedPreventionThrombosis, Venous1
3CompletedPreventionVenous Thromboembolism1
3CompletedTreatmentAcute Deep Vein Thrombosis / Thrombosis, Venous1
3CompletedTreatmentAcute Pulmonary Thromboembolism / Prophylaxis of Pulmonary embolism1
3CompletedTreatmentSuperficial Vein Thrombosis1
3TerminatedPreventionThrombosis, Venous1
3TerminatedPreventionVenous Thromboembolism1
3TerminatedTreatmentCancers / Thromboembolism1
4Active Not RecruitingPreventionMedical Patients / Thrombocytopenias1
4CompletedPreventionVenous Thromboembolism1
4CompletedTreatmentPrimary Total Hip and Knee Arthroplasty1
4TerminatedPreventionImpaired Renal Function / Medical Patients1
4Unknown StatusTreatmentKnee Replacement Surgery1
4WithdrawnTreatmentCardiac surgery, heparin-induced thrombocytopenia and thrombosis syndrome1
Not AvailableCompletedNot AvailableAtaxia2
Not AvailableCompletedNot AvailableCardiovascular Disease (CVD)2
Not AvailableCompletedNot AvailableThrombosis, Venous1
Not AvailableCompletedPreventionNeoplasms, Esophageal / Neoplasms, Lung / Venous Thromboembolism1
Not AvailableRecruitingNot AvailableUnsuspected Pulmonary Embolism1
Not AvailableRecruitingTreatmentBlood Clots / Cancers / Deep Vein Thrombosis (DVT) / Prophylaxis of Pulmonary embolism / Venous Thromboembolism1
Not AvailableTerminatedTreatmentPatients With Acute Renal Failure / Renal Failure1
Not AvailableUnknown StatusTreatmentProphylaxis of Pulmonary embolism1
Not AvailableWithdrawnNot AvailableProphylaxis of Pulmonary embolism1
Not AvailableWithdrawnBasic ScienceKidney Diseases1
Pharmacoeconomics
Manufacturers
  • Glaxosmithkline
Packagers
Dosage forms
FormRouteStrength
Injection, solutionIntravenous; Subcutaneous2.5 mg/0.5ml
Injection, solutionSubcutaneous1.5 mg/0.3ml
Injection, solutionSubcutaneous10 mg/.8mL
Injection, solutionSubcutaneous10 mg/0.8ml
Injection, solutionSubcutaneous2.5 mg/.5mL
Injection, solutionSubcutaneous5 mg/.4mL
Injection, solutionSubcutaneous5 mg/0.4ml
Injection, solutionSubcutaneous7.5 mg/0.6ml
Injection, solutionSubcutaneous7.5 mg/.6mL
InjectionSubcutaneous10 mg/.8mL
InjectionSubcutaneous2.5 mg/.5mL
InjectionSubcutaneous5 mg/.4mL
InjectionSubcutaneous7.5 mg/.6mL
SolutionIntravenous; Subcutaneous2.5 mg
SolutionSubcutaneous10 mg
SolutionSubcutaneous5 mg
SolutionSubcutaneous7.5 mg
Prices
Unit descriptionCostUnit
Arixtra 7.5 mg/0.6ml Solution 0.6ml Syringe148.62USD syringe
Arixtra 2.5 mg/0.5ml Solution 0.5ml Syringe63.15USD syringe
Arixtra (0.5 Ml Syringe) 2.5 mg/syr Syringe17.38USD syringe
DrugBank does not sell nor buy drugs. Pricing information is supplied for informational purposes only.
PatentsNot Available
Properties
StateSolid
Experimental Properties
PropertyValueSource
logP0.4Not Available
Predicted Properties
PropertyValueSource
logP-10ChemAxon
pKa (Strongest Acidic)-3ChemAxon
Physiological Charge-10ChemAxon
Hydrogen Acceptor Count44ChemAxon
Hydrogen Donor Count11ChemAxon
Polar Surface Area828.12 Å2ChemAxon
Rotatable Bond Count27ChemAxon
Refractivity246.87 m3·mol-1ChemAxon
Polarizability119.2 Å3ChemAxon
Number of Rings5ChemAxon
Bioavailability0ChemAxon
Rule of FiveNoChemAxon
Ghose FilterNoChemAxon
Veber's RuleNoChemAxon
MDDR-like RuleYesChemAxon
Predicted ADMET features
PropertyValueProbability
Human Intestinal Absorption-0.9857
Blood Brain Barrier-0.8953
Caco-2 permeable-0.6312
P-glycoprotein substrateNon-substrate0.6876
P-glycoprotein inhibitor INon-inhibitor0.6169
P-glycoprotein inhibitor IINon-inhibitor0.9493
Renal organic cation transporterNon-inhibitor0.9327
CYP450 2C9 substrateNon-substrate0.8037
CYP450 2D6 substrateNon-substrate0.8179
CYP450 3A4 substrateNon-substrate0.5537
CYP450 1A2 substrateNon-inhibitor0.7505
CYP450 2C9 inhibitorNon-inhibitor0.7664
CYP450 2D6 inhibitorNon-inhibitor0.8799
CYP450 2C19 inhibitorNon-inhibitor0.757
CYP450 3A4 inhibitorNon-inhibitor0.9208
CYP450 inhibitory promiscuityLow CYP Inhibitory Promiscuity0.9172
Ames testNon AMES toxic0.5944
CarcinogenicityNon-carcinogens0.763
BiodegradationNot ready biodegradable0.8922
Rat acute toxicity2.4465 LD50, mol/kg Not applicable
hERG inhibition (predictor I)Weak inhibitor0.8431
hERG inhibition (predictor II)Non-inhibitor0.6468
ADMET data is predicted using admetSAR, a free tool for evaluating chemical ADMET properties. (23092397 )
Spectra
Mass Spec (NIST)Not Available
SpectraNot Available
Taxonomy
DescriptionThis compound belongs to the class of chemical entities known as oligosaccharide sulfates. These are carbohydrates containing between 3 and 9 sugar units, one of which bear one or more sulfate groups.
KingdomChemical entities
Super ClassOrganic compounds
ClassOrganic oxygen compounds
Sub ClassOrganooxygen compounds
Direct ParentOligosaccharide sulfates
Alternative ParentsFatty acyl glycosides / O-glucuronides / O-glycosyl compounds / Alkyl sulfates / Dicarboxylic acids and derivatives / Sulfuric acid monoesters / Sulfuric acid monoamides / Oxanes / Pyrans / Secondary alcohols
SubstituentsOligosaccharide sulfate / Fatty acyl glycoside / 1-o-glucuronide / O-glucuronide / Glucuronic acid or derivatives / Glycosyl compound / O-glycosyl compound / Dicarboxylic acid or derivatives / Sulfuric acid monoamide / Oxane
Molecular FrameworkAliphatic heteromonocyclic compounds
External Descriptorsorganic sodium salt (CHEBI:31632 )

Targets

Kind
Protein
Organism
Human
Pharmacological action
yes
Actions
potentiator
General Function:
Serine-type endopeptidase inhibitor activity
Specific Function:
Most important serine protease inhibitor in plasma that regulates the blood coagulation cascade. AT-III inhibits thrombin, matriptase-3/TMPRSS7, as well as factors IXa, Xa and XIa. Its inhibitory activity is greatly enhanced in the presence of heparin.
Gene Name:
SERPINC1
Uniprot ID:
P01008
Molecular Weight:
52601.935 Da
References
  1. Paolucci F, Clavies MC, Donat F, Necciari J: Fondaparinux sodium mechanism of action: identification of specific binding to purified and human plasma-derived proteins. Clin Pharmacokinet. 2002;41 Suppl 2:11-8. [PubMed:12383040 ]
  2. Cheng JW: Fondaparinux: a new antithrombotic agent. Clin Ther. 2002 Nov;24(11):1757-69; discussion 1719. [PubMed:12501872 ]
  3. Dager WE, Andersen J, Nutescu E: Special considerations with fondaparinux therapy: heparin-induced thrombocytopenia and wound healing. Pharmacotherapy. 2004 Jul;24(7 Pt 2):88S-94S. [PubMed:15317404 ]
  4. Donat F, Duret JP, Santoni A, Cariou R, Necciari J, Magnani H, de Greef R: The pharmacokinetics of fondaparinux sodium in healthy volunteers. Clin Pharmacokinet. 2002;41 Suppl 2:1-9. [PubMed:12383039 ]
Kind
Protein
Organism
Human
Pharmacological action
yes
Actions
inhibitor
General Function:
Serine-type endopeptidase activity
Specific Function:
Factor Xa is a vitamin K-dependent glycoprotein that converts prothrombin to thrombin in the presence of factor Va, calcium and phospholipid during blood clotting.
Gene Name:
F10
Uniprot ID:
P00742
Molecular Weight:
54731.255 Da
References
  1. Grouzi E, Kyriakou E, Panagou I, Spiliotopoulou I: Fondaparinux for the treatment of acute heparin-induced thrombocytopenia: a single-center experience. Clin Appl Thromb Hemost. 2010 Dec;16(6):663-7. doi: 10.1177/1076029609347900. Epub 2009 Oct 13. [PubMed:19825921 ]
Drug created on June 13, 2005 07:24 / Updated on July 18, 2017 16:50