Table 4.

Clinical uses of fondaparinux

Drug	Indications	Dosing, timing, duration	Monitoring	Precautions
Fondaparinux (Arixtra™)	Treatment of VTE [2, 10] Treatment is for 5–9 days; continue treatment until a therapeutic oral anticoagulant effect is established	<50 kg: 5 mg SC daily 50–100 kg: 7.5 mg SC daily >100 mg kg: 10 mg SC daily [2, 10]	CBC Serum creatinine Signs and symptoms of bleeding Anti-Xa level in patients with significant renal impairment, those experiencing bleeding or abnormal coagulation parameters, pregnant patients, obese or low-weight patients, and children Hepatic function	Indwelling epidural catheter Recent spinal or ophthalmologic surgery History of recent major bleed (gastrointestinal, intracranial, etc.) Congenital or acquired bleeding disorders
		Renal impairment CrCl 50–80 mL/min—25 % reduction in total clearance; consider empiric dosage reduction CrCl 30–50 mL/min—40 % reduction in total clearance; consider empiric dosage reduction CrCl less than 30 mL/min—contraindicated
	Treatment of STEMI and NSTEMIa	2.5 mg SC daily
	Prophylaxis of VTE in major surgery and acute medically illa	2.5 mg SC daily

VTE venous thromboembolism, SC subcutaneous, CrCl creatinine clearance using the Cockroft–Gault Equation, CBC complete blood count, STEMI ST-elevation myocardial infarction, NSTEMI non-ST-elevation myocardial infarction

^aIndicates off label use of medication