Dosing & Uses
Dosage Forms & Strengths
prefilled syringe
- 2.5mg/0.5mL
- 5mg/0.4mL
- 7.5mg/0.6mL
- 10mg/0.8mL
Deep Vein Thrombosis/Acute Pulmonary Embolism
Treatment
- <50 kg: 5 mg SC once daily
- 50-100 kg: 7.5 mg SC once daily
- >100 kg: 10 mg SC once daily
- Administer for 5-9 days; up to 26 days administered in clinical trials
Prophylaxis
- >50 kg: 2.5 mg SC once daily for 5-9 days or up to 10 days following abdomonal surgery; for hip replacement, 11 days recommended and a minimum 10-14 days recommended for patients undergoing total hip or knee arthroplasty, or hip fracture surgery; administered for up to 35 days in some instances
VTE Prophylaxis With History of HIT (Off-label)
Prophylaxis of deep vein thrombosis (DVT) in patient with history of heparin-induced thrombocytopenia (HIT) until patient can switch to warfarin
2.5 mg SC once daily for 5-10 days
American College of Chest Physicians (ACCP) guidelines assign low evidence rating to treatment of HIT with fondaparinux and conclude that further studies evaluating its role in HIT treatment are needed
Administration
Administer initial dose 6-8 hours after surgery, once hemostasis has been established
SC administration is deep, alternating right and left anterior and posterior abdominal walls
Safety and efficacy not established
Because bleeding is increased in adults <50 kg, bleeding may be a particular safety concern in children
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Contraindicated (3)
- apixaban
fondaparinux and apixaban both increase anticoagulation. Contraindicated. Avoid concurrent use of rivaroxaban with other anticoagulants due to increased bleeding risk other than during therapeutic transition periods where patients should be observed closely. Monitor for signs/symptoms of blood loss.
- defibrotide
defibrotide increases effects of fondaparinux by pharmacodynamic synergism. Contraindicated. Coadministration of defibrotide is contraindicated with antithrombotic/fibrinolytic drugs. This does not include use for routine maintenance or reopening of central venous lines.
- mifepristone
mifepristone, fondaparinux. Other (see comment). Contraindicated. Comment: Mifepristone may lead to excessive post abortion bleeding in pts. on anticoagulant therapy.
Serious - Use Alternative (63)
- abciximab
fondaparinux, abciximab. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Enhanced risk of hemorrhage.
- amobarbital
amobarbital decreases effects of fondaparinux by increasing metabolism. Avoid or Use Alternate Drug.
- anagrelide
fondaparinux, anagrelide. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Enhanced risk of hemorrhage.
- antithrombin alfa
antithrombin alfa and fondaparinux both increase anticoagulation. Avoid or Use Alternate Drug.
- antithrombin III
antithrombin III and fondaparinux both increase anticoagulation. Avoid or Use Alternate Drug.
- argatroban
argatroban and fondaparinux both increase anticoagulation. Avoid or Use Alternate Drug.
- azithromycin
azithromycin increases effects of fondaparinux by decreasing metabolism. Avoid or Use Alternate Drug.
- bazedoxifene/conjugated estrogens
bazedoxifene/conjugated estrogens decreases effects of fondaparinux by pharmacodynamic antagonism. Contraindicated. Risk of thromboembolic disorders.
- bemiparin
bemiparin and fondaparinux both increase anticoagulation. Avoid or Use Alternate Drug.
- betrixaban
fondaparinux, betrixaban. Either increases levels of the other by anticoagulation. Contraindicated. Therapeutic duplication; may use temporarily when switching anticoagulants.
- bivalirudin
bivalirudin and fondaparinux both increase anticoagulation. Avoid or Use Alternate Drug.
- butabarbital
butabarbital decreases effects of fondaparinux by increasing metabolism. Avoid or Use Alternate Drug.
- butalbital
butalbital decreases effects of fondaparinux by increasing metabolism. Avoid or Use Alternate Drug.
- caplacizumab
caplacizumab, fondaparinux. Either increases effects of the other by anticoagulation. Avoid or Use Alternate Drug.
- cefamandole
cefamandole increases effects of fondaparinux by pharmacodynamic synergism. Avoid or Use Alternate Drug.
- cefazolin
cefazolin increases effects of fondaparinux by pharmacodynamic synergism. Avoid or Use Alternate Drug.
- cefdinir
cefdinir increases effects of fondaparinux by anticoagulation. Avoid or Use Alternate Drug. cephalosporins may decrease prothrombin activity.
- cefditoren
cefditoren will increase the level or effect of fondaparinux by anticoagulation. Avoid or Use Alternate Drug. cephalosporins may decrease prothrombin activity
- cefotetan
cefotetan increases effects of fondaparinux by anticoagulation. Avoid or Use Alternate Drug. cephalosporins may decrease prothrombin activity.
- cefoxitin
cefoxitin will increase the level or effect of fondaparinux by anticoagulation. Avoid or Use Alternate Drug. cephalosporins may decrease prothrombin activity
- cefpodoxime
cefpodoxime will increase the level or effect of fondaparinux by anticoagulation. Avoid or Use Alternate Drug. cephalosporins may decrease prothrombin activity
- ceftriaxone
ceftriaxone increases effects of fondaparinux by anticoagulation. Avoid or Use Alternate Drug. cephalosporins may decrease prothrombin activity.
- cefuroxime
cefuroxime will increase the level or effect of fondaparinux by anticoagulation. Avoid or Use Alternate Drug. cephalosporins may decrease prothrombin activity
- cilostazol
fondaparinux, cilostazol. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Enhanced risk of hemorrhage.
- clarithromycin
clarithromycin increases effects of fondaparinux by decreasing metabolism. Avoid or Use Alternate Drug.
- clopidogrel
fondaparinux, clopidogrel. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Enhanced risk of hemorrhage.
- conjugated estrogens
conjugated estrogens decreases effects of fondaparinux by pharmacodynamic antagonism. Contraindicated. Risk of thromboembolic disorders.
- dabigatran
dabigatran and fondaparinux both increase anticoagulation. Avoid or Use Alternate Drug. Both drugs have the potential to cause bleeding. Concomitant use may increase risk of bleeding.
- dalteparin
dalteparin and fondaparinux both increase anticoagulation. Avoid or Use Alternate Drug.
- dipyridamole
fondaparinux, dipyridamole. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Enhanced risk of hemorrhage.
- enoxaparin
enoxaparin and fondaparinux both increase anticoagulation. Avoid or Use Alternate Drug.
- eptifibatide
fondaparinux, eptifibatide. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Enhanced risk of hemorrhage.
- erythromycin base
erythromycin base increases effects of fondaparinux by decreasing metabolism. Avoid or Use Alternate Drug.
- erythromycin ethylsuccinate
erythromycin ethylsuccinate increases effects of fondaparinux by decreasing metabolism. Avoid or Use Alternate Drug.
- erythromycin lactobionate
erythromycin lactobionate increases effects of fondaparinux by decreasing metabolism. Avoid or Use Alternate Drug.
- erythromycin stearate
erythromycin stearate increases effects of fondaparinux by decreasing metabolism. Avoid or Use Alternate Drug.
- estradiol
estradiol decreases effects of fondaparinux by pharmacodynamic antagonism. Contraindicated. Risk of thromboembolic disorders.
- estrogens conjugated synthetic
estrogens conjugated synthetic decreases effects of fondaparinux by pharmacodynamic antagonism. Contraindicated. Risk of thromboembolic disorders.
- estropipate
estropipate decreases effects of fondaparinux by pharmacodynamic antagonism. Contraindicated. Risk of thromboembolic disorders.
- Factor X, human
fondaparinux will decrease the level or effect of Factor X, human by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Based on the mechanism of action, Factor X is likely to be counteracted by direct and indirect Factor Xa inhibitors.
- heparin
fondaparinux and heparin both increase anticoagulation. Avoid or Use Alternate Drug.
- levonorgestrel intrauterine
levonorgestrel intrauterine, fondaparinux. Either decreases effects of the other by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Risk of thromboembolic disorders.
- levonorgestrel oral
levonorgestrel oral, fondaparinux. Either decreases effects of the other by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Risk of thromboembolic disorders.
- levothyroxine
levothyroxine increases effects of fondaparinux by pharmacodynamic synergism. Avoid or Use Alternate Drug.
- liothyronine
liothyronine increases effects of fondaparinux by pharmacodynamic synergism. Avoid or Use Alternate Drug.
- mestranol
mestranol decreases effects of fondaparinux by pharmacodynamic antagonism. Contraindicated. Risk of thromboembolic disorders.
- pentobarbital
pentobarbital decreases effects of fondaparinux by increasing metabolism. Avoid or Use Alternate Drug.
- phenindione
fondaparinux and phenindione both increase anticoagulation. Avoid or Use Alternate Drug.
- phenobarbital
phenobarbital decreases effects of fondaparinux by increasing metabolism. Avoid or Use Alternate Drug.
- primidone
primidone decreases effects of fondaparinux by increasing metabolism. Avoid or Use Alternate Drug.
- protamine
fondaparinux and protamine both increase anticoagulation. Avoid or Use Alternate Drug.
- quinine
quinine increases effects of fondaparinux by unknown mechanism. Avoid or Use Alternate Drug.
- rivaroxaban
rivaroxaban, fondaparinux. Either increases effects of the other by anticoagulation. Contraindicated. Avoid concurrent use of rivaroxaban with other anticoagulants due to increased bleeding risk other than during therapeutic transition periods where patients should be observed closely. Monitor for signs/symptoms of blood loss.
- roxithromycin
roxithromycin increases effects of fondaparinux by decreasing metabolism. Avoid or Use Alternate Drug.
- secobarbital
secobarbital decreases effects of fondaparinux by increasing metabolism. Avoid or Use Alternate Drug.
- sulfadiazine
sulfadiazine increases effects of fondaparinux by decreasing metabolism. Avoid or Use Alternate Drug.
sulfadiazine increases effects of fondaparinux by plasma protein binding competition. Avoid or Use Alternate Drug. - sulfamethoxazole
sulfamethoxazole increases effects of fondaparinux by decreasing metabolism. Avoid or Use Alternate Drug.
sulfamethoxazole increases effects of fondaparinux by plasma protein binding competition. Avoid or Use Alternate Drug. - sulfisoxazole
sulfisoxazole increases effects of fondaparinux by decreasing metabolism. Avoid or Use Alternate Drug.
sulfisoxazole increases effects of fondaparinux by plasma protein binding competition. Avoid or Use Alternate Drug. - thyroid desiccated
thyroid desiccated increases effects of fondaparinux by pharmacodynamic synergism. Avoid or Use Alternate Drug.
- tibolone
tibolone increases effects of fondaparinux by pharmacodynamic synergism. Avoid or Use Alternate Drug.
- ticlopidine
fondaparinux, ticlopidine. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Enhanced risk of hemorrhage.
- tirofiban
fondaparinux, tirofiban. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Enhanced risk of hemorrhage.
- warfarin
fondaparinux increases effects of warfarin by anticoagulation. Avoid or Use Alternate Drug. Avoid combined use once INR is established in the desired therapeutic range.
Monitor Closely (121)
- aceclofenac
fondaparinux and aceclofenac both increase anticoagulation. Modify Therapy/Monitor Closely.
- acemetacin
fondaparinux and acemetacin both increase anticoagulation. Modify Therapy/Monitor Closely.
- agrimony
fondaparinux and agrimony both increase anticoagulation. Modify Therapy/Monitor Closely.
- alfalfa
fondaparinux and alfalfa both increase anticoagulation. Modify Therapy/Monitor Closely.
- alteplase
fondaparinux and alteplase both increase anticoagulation. Modify Therapy/Monitor Closely.
- American ginseng
fondaparinux and American ginseng both increase anticoagulation. Modify Therapy/Monitor Closely.
- anamu
fondaparinux and anamu both increase anticoagulation. Use Caution/Monitor.
- aspirin
fondaparinux and aspirin both increase anticoagulation. Modify Therapy/Monitor Closely.
- aspirin rectal
fondaparinux and aspirin rectal both increase anticoagulation. Modify Therapy/Monitor Closely.
- aspirin/citric acid/sodium bicarbonate
fondaparinux and aspirin/citric acid/sodium bicarbonate both increase anticoagulation. Modify Therapy/Monitor Closely.
- azapropazone
azapropazone increases effects of fondaparinux by plasma protein binding competition. Use Caution/Monitor.
- azathioprine
azathioprine decreases effects of fondaparinux by unknown mechanism. Use Caution/Monitor.
- azficel-T
azficel-T, fondaparinux. Other (see comment). Use Caution/Monitor. Comment: Coadministration with anticoagulants or antiplatelets may increase bruising or bleeding at biopsy and/or injection sites; concomitant use not recommended. Decisions regarding continued use or cessation of anticoagulants or antiplatelets should be made by a physician.
- budesonide
budesonide, fondaparinux. Other (see comment). Use Caution/Monitor. Comment: Corticosteroids may decrease anticoagulant effects by increasing blood coagulability; conversely, they may impair vascular integrity, thus increasing bleeding risk. Monitor INR closely.
- capecitabine
capecitabine increases effects of fondaparinux by unspecified interaction mechanism. Use Caution/Monitor.
- carbamazepine
carbamazepine decreases levels of fondaparinux by increasing metabolism. Use Caution/Monitor.
- celecoxib
fondaparinux and celecoxib both increase anticoagulation. Modify Therapy/Monitor Closely.
- chitosan
chitosan increases effects of fondaparinux by Other (see comment). Use Caution/Monitor. Comment: Chitosan can decrease GI absorption of vitamin K, enhancing anticoagulant effects.
- choline magnesium trisalicylate
fondaparinux and choline magnesium trisalicylate both increase anticoagulation. Modify Therapy/Monitor Closely.
- cinnamon
fondaparinux and cinnamon both increase anticoagulation. Modify Therapy/Monitor Closely.
- citalopram
citalopram increases effects of fondaparinux by pharmacodynamic synergism. Use Caution/Monitor. Combination may increase risk of bleeding.
- collagenase clostridium histolyticum
fondaparinux increases toxicity of collagenase clostridium histolyticum by anticoagulation. Use Caution/Monitor. Collagenase clostridium histolyticum has high incidence of ecchymosis/contusion at injection site; avoid concomitant anticoagulants (except for low-dose aspirin, ie, up to 150 mg/day).
- conjugated estrogens, vaginal
conjugated estrogens, vaginal decreases effects of fondaparinux by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Risk of thromboembolic disorders.
- cordyceps
fondaparinux and cordyceps both increase anticoagulation. Modify Therapy/Monitor Closely.
- cornsilk
cornsilk decreases effects of fondaparinux by pharmacodynamic antagonism. Use Caution/Monitor. Cornsilk contains vitamin K; consume a consistent amount daily.
- cortisone
cortisone, fondaparinux. Other (see comment). Use Caution/Monitor. Comment: Corticosteroids may decrease anticoagulant effects by increasing blood coagulability; conversely, they may impair vascular integrity, thus increasing bleeding risk. Monitor INR closely.
- cyclophosphamide
cyclophosphamide increases effects of fondaparinux by unknown mechanism. Use Caution/Monitor. Due to potential thrombocytopenic effects of cyclophosphamide, an additive risk of bleeding may be seen in patients receiving concomitant anticoagulants.
- danshen
fondaparinux and danshen both increase anticoagulation. Use Caution/Monitor.
- deferasirox
deferasirox, fondaparinux. Other (see comment). Use Caution/Monitor. Comment: Gastric ulceration and GI bleeding have been reported in patients taking deferasirox, use caution when coadministering with other drugs known to increase the risk of peptic ulcers or gastric hemorrhage including anticoagulants.
- deflazacort
deflazacort, fondaparinux. Other (see comment). Use Caution/Monitor. Comment: Corticosteroids may decrease anticoagulant effects by increasing blood coagulability; conversely, they may impair vascular integrity, thus increasing bleeding risk. Monitor INR closely.
- devil's claw
fondaparinux and devil's claw both increase anticoagulation. Use Caution/Monitor.
- dexamethasone
dexamethasone, fondaparinux. Other (see comment). Use Caution/Monitor. Comment: Corticosteroids may decrease anticoagulant effects by increasing blood coagulability; conversely, they may impair vascular integrity, thus increasing bleeding risk. Monitor INR closely.
- dichlorphenamide
dichlorphenamide and fondaparinux both decrease serum potassium. Use Caution/Monitor.
- diclofenac
fondaparinux and diclofenac both increase anticoagulation. Modify Therapy/Monitor Closely.
- diflunisal
fondaparinux and diflunisal both increase anticoagulation. Modify Therapy/Monitor Closely.
diflunisal increases effects of fondaparinux by plasma protein binding competition. Use Caution/Monitor. - dong quai
fondaparinux and dong quai both increase anticoagulation. Modify Therapy/Monitor Closely.
- epoprostenol
fondaparinux and epoprostenol both increase anticoagulation. Modify Therapy/Monitor Closely.
- escitalopram
escitalopram increases effects of fondaparinux by anticoagulation. Use Caution/Monitor. SSRIs may inhibit platelet aggregation, thus increase bleeding risk when coadministered with anticoagulants.
- ethanol
ethanol increases effects of fondaparinux by unknown mechanism. Use Caution/Monitor. Acute EtOH intoxication.
- ethotoin
fondaparinux increases levels of ethotoin by unknown mechanism. Use Caution/Monitor.
ethotoin, fondaparinux. Other (see comment). Use Caution/Monitor. Comment: Hydantoin anticonvulsants increase anticoagulant effects at first, then decrease those effects with continued use (2+ wks). There are multiple mechanisms involved, including enzyme induction, plasma protein binding site competition, and additive effects on prothrombin time. - etodolac
fondaparinux and etodolac both increase anticoagulation. Modify Therapy/Monitor Closely.
- fenbufen
fondaparinux and fenbufen both increase anticoagulation. Modify Therapy/Monitor Closely.
- fennel
fondaparinux and fennel both increase anticoagulation. Modify Therapy/Monitor Closely.
- fenoprofen
fondaparinux and fenoprofen both increase anticoagulation. Modify Therapy/Monitor Closely.
- feverfew
fondaparinux and feverfew both increase anticoagulation. Modify Therapy/Monitor Closely.
- fish oil
fish oil, fondaparinux. Other (see comment). Use Caution/Monitor. Comment: Patients taking fish oil and an anticoagulant or other drug affecting coagulation should be monitored periodically due to potential increased risk of bleeding. .
- fish oil triglycerides
fish oil triglycerides will increase the level or effect of fondaparinux by anticoagulation. Use Caution/Monitor. Prolonged bleeding reported in patients taking antiplatelet agents or anticoagulants and oral omega-3 fatty acids. Periodically monitor bleeding time in patients receiving fish oil triglycerides and concomitant antiplatelet agents or anticoagulants.
- fludrocortisone
fludrocortisone, fondaparinux. Other (see comment). Use Caution/Monitor. Comment: Corticosteroids may decrease anticoagulant effects by increasing blood coagulability; conversely, they may impair vascular integrity, thus increasing bleeding risk. Monitor INR closely.
- fluorouracil
fluorouracil increases effects of fondaparinux by unspecified interaction mechanism. Use Caution/Monitor. Due to the thrombocytopenic effects of fluorouracil, an additive risk of bleeding may be seen in patients receiving concomitant anticoagulants.
- fluoxetine
fluoxetine increases effects of fondaparinux by anticoagulation. Use Caution/Monitor. SSRIs may inhibit platelet aggregation, thus increase bleeding risk when coadministered with anticoagulants.
- flurbiprofen
fondaparinux and flurbiprofen both increase anticoagulation. Modify Therapy/Monitor Closely.
- fluvoxamine
fluvoxamine will increase the level or effect of fondaparinux by anticoagulation. Use Caution/Monitor. SSRIs may inhibit platelet aggregation, which may increase bleeding risk when coadministered with anticoabulants
- forskolin
fondaparinux and forskolin both increase anticoagulation. Modify Therapy/Monitor Closely.
- fosphenytoin
fondaparinux increases levels of fosphenytoin by unknown mechanism. Use Caution/Monitor.
fosphenytoin, fondaparinux. Other (see comment). Use Caution/Monitor. Comment: Hydantoin anticonvulsants increase anticoagulant effects at first, then decrease those effects with continued use (2+ wks). There are multiple mechanisms involved, including enzyme induction, plasma protein binding site competition, and additive effects on prothrombin time. - garlic
fondaparinux and garlic both increase anticoagulation. Modify Therapy/Monitor Closely.
- gemcitabine
gemcitabine increases effects of fondaparinux by unspecified interaction mechanism. Use Caution/Monitor. Due to the thrombocytopenic effects of gemcitabine, an additive risk of bleeding may be seen in patients receiving concomitant anticoagulants.
- ginger
fondaparinux and ginger both increase anticoagulation. Modify Therapy/Monitor Closely.
- ginkgo biloba
fondaparinux and ginkgo biloba both increase anticoagulation. Modify Therapy/Monitor Closely.
- glucagon intranasal
glucagon intranasal increases effects of fondaparinux by unknown mechanism. Use Caution/Monitor.
- green tea
green tea, fondaparinux. Other (see comment). Use Caution/Monitor. Comment: Combination may increase risk of bleeding, caution is advised.
- hemin
fondaparinux, hemin. Either increases effects of the other by anticoagulation. Use Caution/Monitor. Hemin degradation product (ie, hematin) may produce coagulopathy (eg, thrombocytopenia, platelet degranulation) and cause mild anticoagulant effects.
- horse chestnut seed
fondaparinux and horse chestnut seed both increase anticoagulation. Modify Therapy/Monitor Closely.
- hydrocortisone
hydrocortisone, fondaparinux. Other (see comment). Use Caution/Monitor. Comment: Corticosteroids may decrease anticoagulant effects by increasing blood coagulability; conversely, they may impair vascular integrity, thus increasing bleeding risk. Monitor INR closely.
- ibrutinib
ibrutinib, fondaparinux. Either increases effects of the other by anticoagulation. Use Caution/Monitor. Ibrutinib may potentiate the effects of anticoagulant agents such as warfarin may increase the risk of bleeding; monitor for signs of bleeding.
- ibuprofen
fondaparinux and ibuprofen both increase anticoagulation. Modify Therapy/Monitor Closely.
- ibuprofen IV
fondaparinux and ibuprofen IV both increase anticoagulation. Modify Therapy/Monitor Closely.
- icosapent
icosapent, fondaparinux. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Icosapent may prolong bleeding time; monitor periodically if coadministered with other drugs that affect bleeding.
- indomethacin
fondaparinux and indomethacin both increase anticoagulation. Modify Therapy/Monitor Closely.
- iodine (radioactive)
iodine (radioactive) decreases effects of fondaparinux by pharmacodynamic antagonism. Use Caution/Monitor.
- ketoprofen
fondaparinux and ketoprofen both increase anticoagulation. Modify Therapy/Monitor Closely.
- ketorolac
fondaparinux and ketorolac both increase anticoagulation. Modify Therapy/Monitor Closely.
- ketorolac intranasal
fondaparinux and ketorolac intranasal both increase anticoagulation. Modify Therapy/Monitor Closely.
- lofepramine
lofepramine increases levels of fondaparinux by decreasing metabolism. Use Caution/Monitor.
- lornoxicam
fondaparinux and lornoxicam both increase anticoagulation. Modify Therapy/Monitor Closely.
- meclofenamate
fondaparinux and meclofenamate both increase anticoagulation. Modify Therapy/Monitor Closely.
- mefenamic acid
fondaparinux and mefenamic acid both increase anticoagulation. Modify Therapy/Monitor Closely.
- melatonin
melatonin increases effects of fondaparinux by anticoagulation. Use Caution/Monitor. Melatonin may decrease prothrombin time.
- meloxicam
fondaparinux and meloxicam both increase anticoagulation. Modify Therapy/Monitor Closely.
- methimazole
methimazole decreases effects of fondaparinux by pharmacodynamic antagonism. Use Caution/Monitor.
- methylprednisolone
methylprednisolone, fondaparinux. Other (see comment). Use Caution/Monitor. Comment: Corticosteroids may decrease anticoagulant effects by increasing blood coagulability; conversely, they may impair vascular integrity, thus increasing bleeding risk. Monitor INR closely.
- mistletoe
fondaparinux increases and mistletoe decreases anticoagulation. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.
- nabumetone
fondaparinux and nabumetone both increase anticoagulation. Modify Therapy/Monitor Closely.
- naproxen
fondaparinux and naproxen both increase anticoagulation. Modify Therapy/Monitor Closely.
- nettle
fondaparinux increases and nettle decreases anticoagulation. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.
- omega 3 carboxylic acids
omega 3 carboxylic acids, fondaparinux. Other (see comment). Use Caution/Monitor. Comment: Patients taking omega-3 acids and an anticoagulant or other drug affecting coagulation should be monitored periodically due to potential increased risk of bleeding.
- omega 3 fatty acids
omega 3 fatty acids, fondaparinux. Other (see comment). Use Caution/Monitor. Comment: Patients taking omega-3-fatty acids and an anticoagulant or other drug affecting coagulation should be monitored periodically due to potential increased risk of bleeding. .
- oxaprozin
fondaparinux and oxaprozin both increase anticoagulation. Modify Therapy/Monitor Closely.
- panax ginseng
fondaparinux and panax ginseng both increase anticoagulation. Modify Therapy/Monitor Closely.
- parecoxib
fondaparinux and parecoxib both increase anticoagulation. Modify Therapy/Monitor Closely.
- paroxetine
paroxetine increases effects of fondaparinux by anticoagulation. Use Caution/Monitor. SSRIs may inhibit platelet aggregation, thus increase bleeding risk when coadministered with anticoagulants.
- pau d'arco
fondaparinux and pau d'arco both increase anticoagulation. Modify Therapy/Monitor Closely.
- pegaspargase
pegaspargase increases effects of fondaparinux by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of bleeding events.
- phenytoin
fondaparinux increases levels of phenytoin by unknown mechanism. Use Caution/Monitor.
phenytoin, fondaparinux. Other (see comment). Use Caution/Monitor. Comment: Hydantoin anticonvulsants increase anticoagulant effects at first, then decrease those effects with continued use (2+ wks). There are multiple mechanisms involved, including enzyme induction, plasma protein binding site competition, and additive effects on prothrombin time. - phytoestrogens
fondaparinux and phytoestrogens both increase anticoagulation. Modify Therapy/Monitor Closely.
- piroxicam
fondaparinux and piroxicam both increase anticoagulation. Modify Therapy/Monitor Closely.
- porfimer
fondaparinux decreases effects of porfimer by pharmacodynamic antagonism. Use Caution/Monitor.
- prasugrel
fondaparinux, prasugrel. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Enhanced risk of hemorrhage.
- prednisolone
prednisolone, fondaparinux. Other (see comment). Use Caution/Monitor. Comment: Corticosteroids may decrease anticoagulant effects by increasing blood coagulability; conversely, they may impair vascular integrity, thus increasing bleeding risk. Monitor INR closely.
- prednisone
prednisone, fondaparinux. Other (see comment). Use Caution/Monitor. Comment: Corticosteroids may decrease anticoagulant effects by increasing blood coagulability; conversely, they may impair vascular integrity, thus increasing bleeding risk. Monitor INR closely.
- propafenone
propafenone increases effects of fondaparinux by decreasing metabolism. Use Caution/Monitor.
- propylthiouracil
propylthiouracil decreases effects of fondaparinux by pharmacodynamic antagonism. Use Caution/Monitor.
- reishi
fondaparinux and reishi both increase anticoagulation. Modify Therapy/Monitor Closely.
- reteplase
fondaparinux and reteplase both increase anticoagulation. Modify Therapy/Monitor Closely.
- rifabutin
rifabutin decreases levels of fondaparinux by increasing metabolism. Use Caution/Monitor.
- salicylates (non-asa)
fondaparinux and salicylates (non-asa) both increase anticoagulation. Modify Therapy/Monitor Closely.
- salsalate
fondaparinux and salsalate both increase anticoagulation. Modify Therapy/Monitor Closely.
- saw palmetto
saw palmetto increases toxicity of fondaparinux by unspecified interaction mechanism. Use Caution/Monitor. May increase risk of bleeding.
- sertraline
sertraline increases effects of fondaparinux by pharmacodynamic synergism. Use Caution/Monitor. Combination may increase risk of bleeding.
- Siberian ginseng
fondaparinux and Siberian ginseng both increase anticoagulation. Modify Therapy/Monitor Closely.
- sulfasalazine
fondaparinux and sulfasalazine both increase anticoagulation. Modify Therapy/Monitor Closely.
- sulindac
fondaparinux and sulindac both increase anticoagulation. Modify Therapy/Monitor Closely.
- tenecteplase
fondaparinux and tenecteplase both increase anticoagulation. Modify Therapy/Monitor Closely.
- ticagrelor
ticagrelor, fondaparinux. Either increases effects of the other by anticoagulation. Use Caution/Monitor. Increased risk of bleeding during concomitant use of medications that increase potential for bleeding.
- tipranavir
tipranavir increases effects of fondaparinux by pharmacodynamic synergism. Use Caution/Monitor. Tipranavir has mild antiplatelet activity that may incr bleeding risk.
- tolfenamic acid
fondaparinux and tolfenamic acid both increase anticoagulation. Modify Therapy/Monitor Closely.
- tolmetin
fondaparinux and tolmetin both increase anticoagulation. Modify Therapy/Monitor Closely.
- triamcinolone acetonide injectable suspension
triamcinolone acetonide injectable suspension, fondaparinux. Other (see comment). Use Caution/Monitor. Comment: Corticosteroids may decrease anticoagulant effects by increasing blood coagulability; conversely, they may impair vascular integrity, thus increasing bleeding risk. Monitor INR closely.
- triclofos
triclofos increases effects of fondaparinux by unspecified interaction mechanism. Use Caution/Monitor.
- vorapaxar
fondaparinux, vorapaxar. Either increases effects of the other by anticoagulation. Use Caution/Monitor. Coadministration of anticoagulants, antiplatelets, or other drug affecting coagulation should be monitored periodically due to potential increased risk of bleeding.
- vortioxetine
vortioxetine and fondaparinux both increase anticoagulation. Use Caution/Monitor.
- zanubrutinib
fondaparinux, zanubrutinib. Either increases effects of the other by anticoagulation. Modify Therapy/Monitor Closely. Zanubrutinib-induced cytopenias increases risk of hemorrhage. Coadministration of zanubritinib with antiplatelets or anticoagulants may further increase this risk.
Minor (18)
- acetaminophen
acetaminophen increases effects of fondaparinux by unknown mechanism. Minor/Significance Unknown.
- acetaminophen IV
acetaminophen IV increases effects of fondaparinux by unknown mechanism. Minor/Significance Unknown.
- acetaminophen rectal
acetaminophen rectal increases effects of fondaparinux by unknown mechanism. Minor/Significance Unknown.
- alprostadil intracavernous/urethral
alprostadil intracavernous/urethral increases effects of fondaparinux by pharmacodynamic synergism. Minor/Significance Unknown.
- ceftaroline
ceftaroline increases effects of fondaparinux by Other (see comment). Minor/Significance Unknown. Comment: Cephalosporins with a methylthiotetrazole (MTT) side ring (eg, cefotetan, cefoperazone) are more frequently associated with hypoprothrombinemic activity.
- chlorella
chlorella decreases effects of fondaparinux by pharmacodynamic antagonism. Minor/Significance Unknown. Theoretical, due to vitamin K content.
- demeclocycline
demeclocycline increases effects of fondaparinux by pharmacodynamic synergism. Minor/Significance Unknown.
- dexmethylphenidate
dexmethylphenidate increases effects of fondaparinux by decreasing metabolism. Minor/Significance Unknown.
- doxycycline
doxycycline increases effects of fondaparinux by pharmacodynamic synergism. Minor/Significance Unknown.
- glyburide
glyburide increases effects of fondaparinux by unspecified interaction mechanism. Minor/Significance Unknown.
- mineral oil
mineral oil decreases levels of fondaparinux by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- minocycline
minocycline increases effects of fondaparinux by pharmacodynamic synergism. Minor/Significance Unknown.
- oxytetracycline
oxytetracycline increases effects of fondaparinux by pharmacodynamic synergism. Minor/Significance Unknown.
- quinidine
quinidine increases effects of fondaparinux by decreasing metabolism. Minor/Significance Unknown.
- serdexmethylphenidate/dexmethylphenidate
serdexmethylphenidate/dexmethylphenidate increases effects of fondaparinux by decreasing metabolism. Minor/Significance Unknown.
- tetracycline
tetracycline increases effects of fondaparinux by pharmacodynamic synergism. Minor/Significance Unknown.
- verteporfin
fondaparinux decreases effects of verteporfin by pharmacodynamic antagonism. Minor/Significance Unknown.
- vitamin E
vitamin E, fondaparinux. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Vitamin E at RDA does not change INR in pts. on chronic warfarin therapy; megadoses (~10x RDA) may enhance anticoagulant effects in vitamin K deficient pts.
Adverse Effects
>10%
Anemia (1-20%)
Fever (4-14%)
Nausea (3-11%)
1-10%
Rash (7.5%)
Dizziness (4%)
Confusion (3%)
Constipation (5-9%)
Diarrhea (2-3%)
Edema (9%)
Headache (2-5%)
Hypokalemia (1-4%)
Hypotension (4%)
Insomnia (4-5%)
Purpura (4%)
Thrombocytopenia (3%)
Urinary retention (3%)
Urinary tract infection (2-4%)
Vomiting (1-6%)
Postmarketing Reports
Thrombocytopenia with thrombosis that manifested similarly to HIT
Serious allergic reactions, including angioedema and anaphylactoid or anaphylactic reactions
Spinal or epidural hematomas
Hemorrhage
Increase in bleeding risk with renal impairment
Increase in bleeding risk with body weight <50 Kg
Increase in aminotransferase levels
Warnings
Black Box Warnings
Epidural or spinal hematomas may occur in patients undergoing anticoagulation with low-molecular-weight heparins (LMWHs) or heparinoids who receive neuraxial (epidural or spinal) anesthesia or spinal puncture
These hematomas may result in long-term or permanent paralysis
Patients should be frequently monitored for signs and symptoms of neurologic impairment
If neurologic compromise is noted, urgent treatment is necessary
Physicians should weigh benefits against risk before embarking on neuraxial intervention in patients anticoagulated or scheduled to be anticoagulated for thromboprophylaxis
Optimal timing between the administration of LMWHs and neuraxial procedures is not known
Factors increasing risk of epidural or spinal hematomas
- Indwelling epidural catheters
- Concomitant use of other drugs that affect hemostasis (eg, nonsteroidal anti-inflammatory drugs [NSAIDs], platelet inhibitors, other anticoagulants)
- History of traumatic or repeated epidural or spinal punctures
- History of spinal deformity or spinal surgery
Contraindications
Severe renal impairment (CrCl <30 mL/min)
Body weight <50 kg (venous thromboembolism prophylaxis only)
Active major bleeding
Bacterial endocarditis
Thrombocytopenia with antiplatelet antibody in presence of fondaparinux
History of serious hypersensitivity reaction (eg, angioedema, anaphylactoid or anaphylactic reactions)
Cautions
Use with caution in the elderly (prolonged half-life in patients >75 years of age), peptic ulcer disease, bleeding disorder, recent stroke, recent surgery (brain, spinal cord, or eye), concurrent use of platelet inhibitors or anticoagulants, moderate renal impairment (CrCl 30-50 mL/min); may cause prolonged anticoagulation in patients with CrCl 30 to 50 mL/min
Discontinue if platelets <100,000/μL
Not for IM administration
Therapy increases risk of hemorrhage in patients at risk for bleeding, including conditions such as congenital or acquired bleeding disorders, active ulcerative and angiodysplastic gastrointestinal disease, hemorrhagic stroke, uncontrolled arterial hypertension, diabetic retinopathy, or shortly after brain, spinal, or ophthalmological surgery; cases of elevated aPTT temporally associated with bleeding events have been reported following administration of drug (with or without concomitant administration of other anticoagulants); do not administer agents that enhance risk of hemorrhage unless essential for management of underlying condition, such as vitamin K antagonists for treatment of VTE; if co-administration is essential, closely monitor patients for signs and symptoms of bleeding
Do not use interchangeably with heparin or LMWHs
Thrombocytopenia with thrombosis reported with use; discontinue therapy if platelet count falls below 100,000/mm³
Risk of spinal or epidural hematomas if spinal puncture occurs (see Black Box Warnings)
Do not administer initial dose earlier than 6- 8 hours after surgery; administration earlier than 6 hours after surgery increases risk of major bleeding
Increased risk of bleeding in patients <50 kg; dosage reduction recommended
Not for administration as prophylactic for patients undergoing hip fracture, hip replacement, or knee replacement surgery and abdominal surgery
Pregnancy & Lactation
Pregnancy
Available data from published literature and postmarketing reports have not reported clear association with adverse developmental outcomes; fondaparinux sodium plasma concentrations obtained from four women treated during pregnancy and their newborn infants demonstrated low placental transfer of fondaparinux sodium; there are risks to mother associated with untreated venous thromboembolism in pregnancy and a risk of hemorrhage in the mother and fetus associated with use of anticoagulants
Pregnancy confers an increased risk for thromboembolism that is higher for women with underlying thromboembolic disease and certain high-risk pregnancy conditions; published data describe that women with a previous history of venous thrombosis are at high risk for recurrence during pregnancy
Fetal/neonatal adverse reactions
- Drug has been demonstrated to cross placenta in humans; use of anticoagulants, may increase risk of bleeding in the fetus and neonate; monitor neonates for bleeding
Labor or delivery
- All patients receiving anticoagulants, including pregnant women, are at risk for bleeding; use during labor or delivery in women who are receiving neuraxial anesthesia may result in epidural or spinal hematomas; pregnant women receiving therapy should be carefully monitored for evidence of bleeding or unexpected changes in coagulation parameters; consideration for use of a shorter acting anticoagulant should be specifically addressed as delivery approaches
Lactation
There are no data on presence in human milk, or effects on milk production; limited clinical data during lactation preclude a clear determination of risk of therapy to an infant during lactation; therefore, developmental and health benefits of breastfeeding should be considered along with mother’s clinical need for therapy and any potential adverse effects on breastfed infant from therapy or from underlying maternal condition
Pregnancy Categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available.Pharmacology
Mechanism of Action
Antithrombotic agent; inhibits factor Xa, which interrupts blood coagulation cascade and inhibits thrombin formation and thrombus development; generally does not increase prothrombin time (PT) or partial thromboplastin time (PTT)
Absorption
Bioavailability: 100%
Peak plasma time: 2-3 hr
Peak plasma concentration: 0.34-0.50 mg/L
Distribution
Protein bound: 94% (antithrombin III)
Vd: 7-11 L
Metabolism
Not established
Elimination
Half-life: 17-21 hr
Dialyzable: Yes
Excretion: Urine
Images
| BRAND | FORM. | UNIT PRICE | PILL IMAGE |
|---|---|---|---|
| Arixtra subcutaneous - | 10 mg/0.8 mL solution |  | |
| Arixtra subcutaneous - | 7.5 mg/0.6 mL solution |  | |
| Arixtra subcutaneous - | 5 mg/0.4 mL solution |  | |
| Arixtra subcutaneous - | 2.5 mg/0.5 mL solution |  | |
| fondaparinux subcutaneous - | 10 mg/0.8 mL solution |  | |
| fondaparinux subcutaneous - | 7.5 mg/0.6 mL solution |  | |
| fondaparinux subcutaneous - | 5 mg/0.4 mL solution |  | |
| fondaparinux subcutaneous - | 7.5 mg/0.6 mL solution |  | |
| fondaparinux subcutaneous - | 2.5 mg/0.5 mL solution |  | |
| fondaparinux subcutaneous - | 5 mg/0.4 mL solution |  | |
| fondaparinux subcutaneous - | 2.5 mg/0.5 mL solution |  | |
| fondaparinux subcutaneous - | 7.5 mg/0.6 mL solution |  | |
| fondaparinux subcutaneous - | 7.5 mg/0.6 mL solution |  | |
| fondaparinux subcutaneous - | 10 mg/0.8 mL solution |  | |
| fondaparinux subcutaneous - | 7.5 mg/0.6 mL solution |  | |
| fondaparinux subcutaneous - | 7.5 mg/0.6 mL solution |  | |
| fondaparinux subcutaneous - | 5 mg/0.4 mL solution |  | |
| fondaparinux subcutaneous - | 5 mg/0.4 mL solution |  | |
| fondaparinux subcutaneous - | 2.5 mg/0.5 mL solution |  | |
| fondaparinux subcutaneous - | 2.5 mg/0.5 mL solution |  | |
| fondaparinux subcutaneous - | 10 mg/0.8 mL solution |  | |
| fondaparinux subcutaneous - | 10 mg/0.8 mL solution |  | |
| fondaparinux subcutaneous - | 10 mg/0.8 mL solution |  | |
| fondaparinux subcutaneous - | 5 mg/0.4 mL solution |  | |
| fondaparinux subcutaneous - | 2.5 mg/0.5 mL solution |  | |
| fondaparinux subcutaneous - | 2.5 mg/0.5 mL solution |  | |
| fondaparinux subcutaneous - | 7.5 mg/0.6 mL solution |  | |
| fondaparinux subcutaneous - | 10 mg/0.8 mL solution |  | |
| fondaparinux subcutaneous - | 5 mg/0.4 mL solution |  | |
| fondaparinux subcutaneous - | 2.5 mg/0.5 mL solution |  | |
| fondaparinux subcutaneous - | 10 mg/0.8 mL solution |  | |
| fondaparinux subcutaneous - | 7.5 mg/0.6 mL solution |  | |
| fondaparinux subcutaneous - | 5 mg/0.4 mL solution |  | |
| fondaparinux subcutaneous - | 2.5 mg/0.5 mL solution |  | |
| fondaparinux subcutaneous - | 10 mg/0.8 mL solution |  | |
| fondaparinux subcutaneous - | 10 mg/0.8 mL solution |  | |
| fondaparinux subcutaneous - | 7.5 mg/0.6 mL solution |  | |
| fondaparinux subcutaneous - | 5 mg/0.4 mL solution |  |
Copyright © 2010 First DataBank, Inc.
Patient Handout
fondaparinux subcutaneous
FONDAPARINUX - INJECTION
(FON-da-PAR-in-ux)
COMMON BRAND NAME(S): Arixtra
WARNING: People using this medication may bleed near the spinal cord after certain spinal procedures. Bleeding in this area can cause paralysis that lasts a long time or could become permanent. Talk with your doctor about the benefits and risks before any spinal procedure. Your doctor may direct you to stop this medication for a certain amount of time before and after the procedure. Carefully follow your doctor's directions.The risk of bleeding may be higher if you have a deformed spine, or have had spinal procedures/surgery before (such as epidural catheter placement, difficult epidural/spinal puncture), or are taking other drugs that can cause bleeding/bruising (including antiplatelet drugs such as clopidogrel, "blood thinners" such as warfarin/rivaroxaban, nonsteroidal anti-inflammatory drugs-NSAIDs such as ibuprofen). Tell your doctor right away if you notice symptoms such as back pain, leg numbness/tingling/weakness, loss of control of the bowels or bladder (incontinence).
USES: Fondaparinux is used to treat serious blood clots in the legs and/or lungs. It is usually used with another "blood thinner" medication (warfarin). If untreated, blood clots can travel to the lungs, heart, or brain, causing serious (possibly fatal) breathing problems, heart attack, or stroke. This drug may also be used to prevent blood clots after certain surgeries with an increased risk of blood clots (such as hip fracture, abdominal, knee/hip replacement).Fondaparinux is known as a "blood thinner" (anticoagulant). It is a drug similar to heparin that works by blocking certain natural substances in the blood that cause clotting.
HOW TO USE: Read the Patient Information Leaflet if available from your pharmacist before you start using fondaparinux and each time you get a refill. If you have any questions, ask your doctor or pharmacist.This medication is given by injection under the skin of the stomach/abdomen as directed by your doctor, usually once daily. Do not inject into a muscle. The dosage and length of treatment are based on your medical condition and response to treatment. The dosage may also be based on your weight. Use this medication regularly to get the most benefit from it. To help you remember, use it at the same time each day.If you are using this medication at home, learn all preparation and usage instructions from your health care professional and the product package. Before using, check this product visually for particles or discoloration. If either is present, do not use the liquid. Do not mix any other medication in the same injection. Before injecting each dose, clean the injection site with rubbing alcohol. Change the injection site each time to lessen injury under the skin. To minimize bruising, do not rub the injection site after a shot. Learn how to store and discard medical supplies safely.When treating a blood clot, another "blood thinner" (warfarin) is usually started within 3 days after you start using fondaparinux. Your doctor will direct you to use both of these medications until the warfarin is working well. Do not stop either of these medications until your doctor directs you to stop.To prevent blood clots due to surgery, your doctor may direct you to start using this medication after surgery (such as 6 to 8 hours after knee/hip replacement surgery) and continue for several days. Follow your doctor's directions closely. Starting this medication too soon after surgery may increase the risk of serious bleeding.This medication may also be given by injection into a vein by a health care professional, as directed by your doctor.
SIDE EFFECTS: Pain, bruising, redness, and swelling at the injection site may occur. Headache, nausea, vomiting, swelling of the hands/feet, or fever may also occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: easy bleeding/bruising, dark urine, yellow eyes/skin.This medication may rarely cause serious bleeding. (See also Warning section.) Tell your doctor right away if you have any signs of serious bleeding, including: shortness of breath, coughing up blood, chest pain, cold/blue fingers or toes, unusual dizziness, fainting, fast/irregular heartbeat, joint/muscle pain, mental/mood changes (such as confusion), numbness/tingling, severe stomach/abdominal pain, bloody/black/tarry stools, red/pinkish urine, vomit that looks like coffee grounds.Get medical help right away if you have any very serious side effects, including: headache that is severe or doesn't go away, vision problems, weakness on one side of the body, trouble speaking, seizures, difficulty moving.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
PRECAUTIONS: See also Warning section.Before using fondaparinux, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients (such as dry natural rubber/latex in the needle cover on the prefilled syringe), which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using fondaparinux, tell your doctor or pharmacist your medical history, especially of: infection in the heart (bacterial endocarditis), current serious bleeding (such as bleeding ulcer), low platelet count because of antiplatelet antibody, bleeding/blood problems (such as low blood count/platelets), a past blood-clotting problem because of heparin (heparin-induced thrombocytopenia), a certain eye problem (diabetic retinopathy), high blood pressure, kidney disease, seizures, stomach/intestinal problems (such as recent ulcers, colitis), stroke, recent spinal procedures or puncture, spine problems (such as spinal deformity), recent surgery (especially on the eye, brain, or spine), low body weight (less than 50 kilograms/110 pounds).Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).Limit alcohol while taking this drug because it may increase the risk of stomach bleeding.To lower the chance of getting cut, bruised, or injured, use caution with sharp objects like razors and nail cutters, and avoid activities such as contact sports.Older adults may be more sensitive to the side effects of this drug, especially bleeding.During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor. If you become pregnant or think you may be pregnant, tell your doctor right away.It is unknown if this drug passes into breast milk. Consult your doctor before breast-feeding.
DRUG INTERACTIONS: See also Warning section.Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug include: mifepristone, other drugs that can cause bleeding/bruising (including antiplatelet drugs such as clopidogrel, NSAIDs such as ketorolac, "blood thinners" such as rivaroxaban).Check all prescription and nonprescription medicine labels carefully since many medications contain pain relievers/fever reducers (NSAIDs such as ibuprofen, naproxen, aspirin) which can increase the risk of bleeding when used with fondaparinux. However, if your doctor has directed you to take low-dose aspirin for heart attack or stroke prevention (usually 81-162 milligrams a day), you should continue taking it unless your doctor instructs you otherwise. Ask your doctor or pharmacist for more details.
OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: excessive bleeding and bruising.
NOTES: Do not share this medication with others.Lab and/or medical tests (such as complete blood count, kidney function) should be done while you are using this medication. Keep all medical and lab appointments. Consult your doctor for more details.
MISSED DOSE: If you miss a dose, use it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Use your next dose at the regular time. Do not double the dose to catch up.
STORAGE: Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.Each prefilled syringe can be used only once; discard any unused portion.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.
MEDICAL ALERT: Your condition can cause complications in a medical emergency. For information about enrolling in MedicAlert, call 1-888-633-4298 (US) or 1-800-668-1507 (Canada).
Information last revised November 2022. Copyright(c) 2023 First Databank, Inc.
IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.
Formulary
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Adding plans allows you to:
- View the formulary and any restrictions for each plan.
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