Abciximab
Severe
Database
Clinical effect not specified
Source: DDInter
Drug reference
Fondaparinux
Synthetic selective factor Xa inhibitor (pentasaccharide) · Anticoagulant
Also known as Fondaparinux sodium
START
Prophylaxis 2.5 mg SC daily; VTE treatment weight-based 5/7.5/10 mg SC daily; ACS 2.5 mg daily
TYPICAL MAX
10 mg/day (treatment, >100 kg)
STOP IF
Active major bleeding; appropriate timing around neuraxial procedures; CrCl <30 (treatment)
WATCH
Renal function/weight (dose & contraindication), bleeding/Hb, platelets, neuraxial timing; no antidote
CDSCO approvedSchedule HATC B01AX05
KDIGO 2024 + manufacturer label
- ONSET
- 2h · anti-Xa onset
- PEAK
- 2h · Cmax (SC)
- t½
- 19h · plasma t½
- DURATION
- 1d · once-daily
EXCRETION
Renal — excreted unchanged (not metabolised)
route + CYP
INTERACTIONS
12 major
SEVERE in our sources
PREGNANCY
Use only if clearly needed — limited data (LMWH preferred); does not cross placenta significantly
FDA category + note
Top interactionssee all 12 →
- AbciximabSevereDatabaseDDInter
- AcalabrutinibSevereDatabaseDDInter
- AlteplaseSevereDatabaseDDInter
- AnagrelideSevereDatabaseDDInter
Available in India
12 branded formulations. Look up specific brands in the Drugs workspace.
Mechanism
Synthetic antithrombin-binding pentasaccharide that selectively potentiates antithrombin-mediated inhibition of factor Xa (no direct thrombin/IIa effect), interrupting coagulation amplification.
Indications
VTE prophylaxis (orthopaedic/abdominal surgery, medical patients)Treatment of DVT and pulmonary embolism (with vitamin K antagonist transition)Acute coronary syndrome (UA/NSTEMI; STEMI selected)Suspected heparin-induced thrombocytopenia anticoagulation (off-label, no cross-reactivity)
Dosing
- Adult
- VTE prophylaxis: 2.5 mg SC once daily. VTE treatment: weight-based 5 mg (<50 kg) / 7.5 mg (50–100 kg) / 10 mg (>100 kg) SC once daily. ACS: 2.5 mg SC once daily.
- Pediatric
- Not established.
- Renal adjustment
- CrCl 30–50: use with caution (consider reduced prophylaxis frequency). CrCl <30: contraindicated for treatment; avoid prophylaxis.
- Hepatic adjustment
- No specific adjustment (severe hepatic — caution, bleeding).
- Geriatric
- Higher bleeding risk; assess renal function/weight.
- Max dose
- 10 mg/day (treatment, >100 kg); 2.5 mg/day prophylaxis/ACS
Pharmacokinetics
Onset
Anti-Xa within ~2 h
Peak effect
Cmax ~2 h (SC)
Duration
Once daily
Half-life
~17–21 h (longer in renal impairment/elderly)
Bioavailability
SC ~100%
Protein binding
High (specific to antithrombin)
Metabolism
Not metabolised
Excretion
Renal — excreted unchanged
Contraindications
- Severe renal impairment (CrCl <30 mL/min — accumulation/bleeding)
- Active major bleeding
- Bacterial endocarditis
- Body weight <50 kg for surgical prophylaxis (higher bleeding)
- Hypersensitivity to fondaparinux
Side effects
Common
Bleeding/bruisingAnaemiaInjection-site reactionsThrombocytopenia (mild)
Serious
- Major haemorrhage incl. intracranial
- Spinal/epidural haematoma with neuraxial anaesthesia (boxed)
- Severe thrombocytopenia
- No specific reversal agent (consider rFVIIa for life-threatening bleed)
Pregnancy & lactation
Pregnancy
Use only if clearly needed — limited data (LMWH preferred); does not cross placenta significantly
Lactation
Limited data; minimal infant oral absorption — caution
Drug interactions
Acalabrutinib
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Alteplase
Severe
Database
Clinical effect not specified
Source: DDInter
Anagrelide
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Anisindione
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Anistreplase
Severe
Database
Clinical effect not specified
Source: DDInter
Antithrombin Alfa
Severe
Database
Clinical effect not specified
Source: DDInter
Antithrombin Iii Human
Severe
Database
Clinical effect not specified
Source: DDInter
Apixaban
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Ardeparin
Severe
Database
Clinical effect not specified
Source: DDInter
Argatroban
Severe
Database
.
Source: DDInter
Aspirin
Severe
Database
Drug interaction classified as: synergy.
Source: DDInter
Related guidelines
Venous thromboembolism prophylaxis
ASH · Haematology · 2018
Acute coronary syndrome
CSI · Cardiology · 2022
Acute coronary syndrome in chronic kidney disease
CSI · Cardiology · 2020
Primary PCI for acute coronary syndrome
ESC · Cardiology · 2026
Preoperative cardiac evaluation for non-cardiac surgery
AHA · Cardiology · 2025
Ask House about Fondaparinux
Continue into a citation-backed clinical answer with the drug context already attached.
Sources: KD Tripathi 7e, Goodman & Gilman 14e, Harrison 22e·Verified: 2026-05-19 · House clinical team·Cockpit curated: 2026-05-19