Arixtra

— THERAPEUTIC CATEGORIES —
  • Miscellaneous hematological agents

Arixtra Generic Name & Formulations

General Description

Fondaparinux sodium 2.5mg/0.5mL, 5mg/0.4mL. 7.5mg/0.6mL, 10mg/0.8mL; soln for SC inj; preservative free.

Pharmacological Class

Factor Xa inhibitor.

How Supplied

Prefilled syringes 2.5mg, 7.5mg, 10mg—2, 10; 5mg—10

Manufacturer

Arixtra Indications

Indications

Prophylaxis of DVT in patients undergoing hip fracture surgery, or hip or knee replacement, or abdominal surgery with risk of thromboembolic complications. With warfarin: Treatment of acute pulmonary embolism (PE) (initiate in hospital), or treatment of acute DVT.

Arixtra Dosage and Administration

Adult

Give by SC inj. Prophylaxis: Once hemostasis is achieved, give 1st dose no earlier than 6–8hrs post-op. 2.5mg once daily for 5–9 days. Hip or knee replacement: max 11 days. Hip fracture: give for up to 24 more days (max 32 days). Abdominal: max 10 days. Treatment: (<50kg): 5mg; (50–100kg): 7.5mg; (>100kg): 10mg; for all: give once daily for at least 5 days and until INR= 2–3; usually 5–9 days; max 26 days; start warfarin usually within 72hrs.

Children

Not established.

Arixtra Contraindications

Contraindications

Severe renal impairment (CrCl <30mL/min). Active major bleeding. Bacterial endocarditis. Thrombocytopenia associated with (+) in vitro test for antiplatelet antibody in presence of fondaparinux. Also for prophylaxis: body weight <50kg.

Arixtra Boxed Warnings

Boxed Warning

Spinal/epidural hematomas.

Arixtra Warnings/Precautions

Warnings/Precautions

See full labeling. Increased risk of spinal/epidural hematoma in anticoagulated patients receiving neuraxial anesthesia or undergoing spinal puncture (esp. post-op indwelling epidural use); monitor for signs/symptoms of neurological impairment. Increased risk of hemorrhage in those with bleeding disorders, acute ulcerative or angiodysplastic GI disease, hemorrhagic stroke, uncontrolled hypertension, diabetic retinopathy, recent brain, spinal, or eye surgery. Increased risk of bleeding in renal impairment and in those with low body weight (<50kg). Assess hepatic and renal function periodically; discontinue if severe renal impairment develops. Monitor closely for thrombocytopenia. Obtain CBCs, platelets, serum creatinine level, stool occult blood tests during therapy; discontinue if platelets <100,000 per mm3 or major bleeding occurs. Not interchangeable (unit-for-unit) with heparin or low molecular weight heparins. Latex allergy. Elderly. Neonates. Pregnancy. Labor & delivery. Nursing mothers.

Arixtra Pharmacokinetics

See Literature

Arixtra Interactions

Interactions

Caution with drugs that affect hemostasis (eg, warfarin, platelet inhibitors, NSAIDs). Avoid drugs that increase risk of hemorrhage (eg, Vit. K antagonists); if co-admin necessary, monitor closely for bleeding.

Arixtra Adverse Reactions

Adverse Reactions

Bleeding, thrombocytopenia, local reactions (rash, pruritus, hematoma, pain), anemia, insomnia, increased wound drainage, hypokalemia, dizziness, hypotension, confusion, bullous eruption, post-op hemorrhage, purpura, elevated ALT/AST.

Arixtra Clinical Trials

See Literature

Arixtra Note

Not Applicable

Arixtra Patient Counseling

See Literature