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Generic Name: fondaparinux (injectable) (fawn da PEH rih nox)
Brand Names: Arixtra

What is fondaparinux?

Fondaparinux is an anticoagulant (blood thinner). Fondaparinux prevents the formation of blood clots.

Fondaparinux is used to prevent blood clot formation.

Fondaparinux may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about fondaparinux?

There is a risk of bleeding in the spinal or epidural space, possibly resulting in paralysis, when fondaparinux is used along with spinal or epidural anesthesia or spinal puncture. This risk may be increased by the use of indwelling epidural catheters or by the concomitant use of drugs that affect blood clotting.

What should I discuss with my healthcare provider before using fondaparinux?

• weigh less than 110 pounds (50 kilograms);

• have kidney disease;

• have active bleeding;

• have a low level of platelets in the blood;

• have bacterial endocarditis (infection of the heart).

Before using fondaparinux, tell your doctor if you have:

• high blood pressure;

• a bleeding or blood clotting disorder;

• a prosthetic heart valve;

• need to have (or have recently had) surgery or another invasive procedure;

• stomach bleeding or ulcers;

• eye problems due to diabetes;

• a history of a low level of platelets in the blood during treatment with heparin; or

• liver disease.

You may not be able to use fondaparinux, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.

How should I use fondaparinux?

Use fondaparinux exactly as directed by your doctor. If you do not understand these directions, ask your doctor, nurse, or pharmacist to explain them to you.

Fondaparinux is administered as a subcutaneous (under the skin) injection.

Fondaparinux may be administered by a healthcare professional. If fondaparinux is being administered at home, your doctor or nurse will give you detailed instructions on how to inject fondaparinux. It should be injected into the fatty tissue of the stomach. Follow your doctor's instructions.

Do not use any medication that is discolored or that has particles in it.

To inject fondaparinux using the prefilled syringe and automatic needle protection system:

• Sit or lie down before receiving an injection.

• Using an alcohol swab, wipe the skin where the injection will be given. Remove the plunger cap and needle guard from the prefilled syringe.

• To prevent the loss of medication do not expel the air bubble before administering the injection.

• Pinch a fold of skin and insert the needle at a 90 degree angle completely into the fold. Continue to pinch the skin until the injection is complete.

• Push the plunger rod firmly with your thumb as far as it will go. After injecting the contents of the syringe, release the plunger. The needle will automatically withdraw from the skin and retract into the security sleeve.

• The white indicator appears above the blue upper body or a soft click sound can be heard to assure the syringe has worked.

• To lessen bruising, do not rub the area after injecting the medication. Rotate the injection site as directed by your doctor.

Dispose of all needles and syringes in an appropriate, puncture-resistant disposal container.

Your doctor may want you to have blood tests or other medical evaluations during treatment with fondaparinux to monitor progress and side effects.

What happens if I miss a dose?

Use the missed dose as soon as you remember. However, if it is almost time for the next dose, skip the dose you missed and use only the next regularly scheduled dose. Do not use a double dose of this medication.

Notify your doctor if you miss a dose of fondaparinux.

What happens if I overdose?

Symptoms of an overdose include nosebleeds; black, bloody, or tarry stools; blood in the urine; and increased bruising or bleeding.

What should I avoid while using fondaparinux?

Tell your doctor and dentist that you are using fondaparinux. Treatment with the medication may need to be stopped for a short time if surgery is needed.

Fondaparinux side effects

• an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives);

• prolonged or unexplained bleeding;

• pain, warmth, or redness in an arm or leg, or difficulty breathing, which could indicate a blood clot;

• excessive bruising or paleness;

• black, bloody, or tarry stools; blood in the urine; sudden severe headache; or sudden severe stomach pain; or

• ulceration (open wound) at injection site.

Other less serious side effects may be more likely to occur. Continue to use fondaparinux and notify your doctor if you experience

• minor bleeding, rash, or itching at the injection site;

• fever;

• insomnia;

• constipation;

• nausea or vomiting; or

• swelling or water retention.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect fondaparinux?

There is a risk of bleeding in the spinal or epidural space, possibly resulting in paralysis, when fondaparinux is used along with spinal or epidural anesthesia or spinal puncture. This risk may be increased by the use of indwelling epidural catheters or by the concomitant use of drugs that affect blood clotting.

• aspirin,

• a salicylate (aspirin-related drugs) such as magnesium and/or choline salicylate (Magan, Doan's, Bayer Select Backache Pain Formula, Mobidin, Arthropan, Trilisate, Tricosal) and salsalate (Disalcid);

• ibuprofen (Motrin, Advil, Nuprin, and others), ketoprofen (Orudis KT, Orudis, Oruvail), naproxen (Aleve, Naprosyn, Anaprox, and others), indomethacin (Indocin), diclofenac (Cataflam, Voltaren), diflunisal (Dolobid), etodolac (Lodine), fenoprofen (Nalfon), flurbiprofen (Ansaid), ketorolac (Toradol), nabumetone (Relafen), oxaprozin (Daypro), piroxicam (Feldene), sulindac (Clinoril), tolmetin (Tolectin), or any other nonsteroidal anti-inflammatory medication;

• heparin;

• ardeparin (Normiflo), danaparoid (Orgaran), dalteparin (Fragmin), enoxaparin (Lovenox), tinzaparin (Innohep)

• warfarin (Coumadin);

• aspirin and dipyridamole (Aggrenox);

• ticlopidine (Ticlid) or clopidogrel (Plavix); or

• dipyridamole (Persantine).

The drugs listed above may increase the effects of fondaparinux, which could be dangerous. You may not be able to use fondaparinux, or you may require a dosage adjustment or special monitoring during treatment if you are taking any of the medicines listed above.

Tell your doctor and dentist that you are using fondaparinux. Treatment with the medication may need to be stopped for a short time if surgery is needed.

Drugs other than those listed here may also interact with fondaparinux. Talk to your doctor and pharmacist before using any prescription or over-the-counter medicines, including herbal products.

Where can I get more information?

• Your pharmacist has additional information about fondaparinux written for health professionals that you may read.

What does my medication look like?

Fondaparinux is available with a prescription under the brand name Arixtra. Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you.

• Arixtra 2.5 mg per 0.5 mL-single dose prefilled syringe

• Arixtra 5 mg per 0.4 mL-single dose prefilled syringe

• Arixtra 7.5 mg per 0.6 mL-single dose prefilled syringe

• Arixtra 10 mg per 0.8 mL-single dose prefilled syringe

• Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
• Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.