Arixtra (Fondaparinux)

Description

Arixtra (fondaparinux) is an injection available with a valid prescription for preventing blood clots in adults undergoing hip fracture surgery, hip or knee replacement surgery, or abdominal surgery. It may also be administered with warfarin for treating blood clots in the legs or lungs.

Arixtra is an anticoagulant, meaning it thins the blood to prevent or reduce blood clot formation.

Arixtra comes in 2.5 mg, 5 mg, 7.5 mg, or 10 mg single-dose, prefilled syringes.

Directions

Follow your doctor’s instructions on the proper use of Arixtra. You may refer to the medication guide that comes with your prescription for further product use information, including storage instructions.

Your Arixtra treatment regimen will be determined by your doctor based on your weight and medical condition. You or a caregiver should receive instructions on the proper preparation, administration, and disposal of Arixtra.

Arixtra is administered subcutaneously (underneath the skin) in the abdomen.

Any questions or concerns that arise may be referred to your doctor or pharmacist.

Ingredients

Fondaparinux sodium is the active ingredient in Arixtra blood thinner.

Sodium chloride and water for injection are the inactive ingredients included. Sodium hydroxide and/or hydrochloric acid for pH balance may also be included.

Contraindications

Arixtra injections should not be administered to patients who have any of the following:

• Kidney problems that are severe
• Major bleeding that is active
• Bacterial heart or heart valve infection
• Low platelets related to a positive in vitro test for anti-platelet antibody with use of fondaparinux sodium
• Weigh less than 50 kg (if Arixtra is needed for preventing blood clots)
• History of a severe hypersensitivity reaction to Arixtra (i.e., angioedema, anaphylaxis)

Cautions

Arixtra is associated with the following FDA Boxed Warning:

• Patients who receive low molecular weight heparins, heparinoids, or fondaparinux sodium with neuraxial anesthesia or when undergoing spinal puncture can develop epidural or spinal hematomas (accumulation of blood in the space that compresses the spinal cord) that may result in long-term or permanent paralysis. Evaluation of these risks should be performed when scheduling patients for spinal procedures. Factors that can increase these risks include:
• Indwelling epidural catheters
• Receiving medications that affect the clotting of blood, such as platelet inhibitors, non-steroidal anti-inflammatory drugs (NSAIDs), or other anticoagulants
• Have had traumatic or repeated epidural or spinal puncture
• Have had a spinal surgery or deformity
• Signs and symptoms of neurological effects should be monitored frequently. Immediate treatment is needed if neurological disturbances occur.
• Prior to receiving neuraxial intervention, evaluation of the benefits and risks should be performed in patients who are anticoagulated or will receive anticoagulants for blood clot prevention.

• Before Arixtra is initiated, discuss the following with your doctor:
• All the medications you take, including prescription and nonprescription medications
• Your allergies
• Any existing health concerns
• Your past medical history
• If you are pregnant or breastfeeding
• Arixtra contains the following warnings and precautions:
• Spinal or epidural hematomas that can cause long-term or permanent paralysis
• Risk of severe bleeding is increased in patients receiving Arixtra and have risk factors for bleeding
• Risk of bleeding is increased in patients weighing less than 50 kg and have kidney issues
• Decreased platelets
• Routine evaluation of serum creatinine, complete blood counts, and stool occult blood tests are recommended
• Dry natural rubber is contained in the syringe’s needle guard, which may cause allergic reactions in people who are allergic to latex

Side Effects

The most serious Arixtra side effect is bleeding issues. Patients may also experience other side effects. Contact your doctor right away if you have bothersome or persistent side effects.

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References

1. Arixtra. Morgantown, WV: Mylan Institutional LLC; 2020.
2. Arixtra. Dublin, Ireland: Viatris Healthcare Limited; European Medicines Agency; 2007.
3. Fondaparinux (Rx). Medscape.
4. Spinal Subdural or Epidural Hematoma. Rubin M: Merck Manual; 2023.

About Dr. Savannah Muncy (Page Author)

Dr. Muncy (PharmD) studied science and education as an undergraduate before attending the Appalachian College of Pharmacy where she completed her PharmD in three years. She is currently using her pharmacy and healthcare expertise to write medical content for clients all around the world. She is focused on delivering the most current, accurate, and engaging information to healthcare professionals and patients. Read More....