Fondaparinux administration

Acute DVT and PE treatment In patients with acute symptomatic DVT and in patients with acute symptomatic PE, the recommended dosage of fondaparinux is 5 mg (body weight less than 50 kg), 7.5 mg (body weight 50 to 100 kg), or 10 mg (body weight greater than 100 kg) by subcutaneous injection once daily. Continue fondaparinux treatment for at least 5 days until a therapeutic oral anticoagulant effect is established (international normalized ratio [INR] 2 to 3). Initiate concomitant treatment with warfarin as soon as possible, usually within 72 hours. The usual duration of administration of fondaparinux is 5 to 9 days. 

DVT prophylaxis In patients undergoing hip fracture surgery, hip replacement surgery, or knee replacement surgery, the recommended dose is 2.5 mg subcutaneously once daily. After hemostasis has been established, give the initial dose 6 to 8 hours after surgery. The usual duration of administration is 5 to 9 days. Admixture incompatibilities Do not mix fondaparinux with other injections or infusions. 

Distribution - IV or subcutaneous administration distributes mainly in blood and only to a minor extent in extravascular fluid. Apparent volume of distribution is 7 to 11 L. Fondaparinux is highly (at least 94%) and specifically bound to ATIII. 

The following points should be considered in all patients receiving heparin Platelet counts should be performed frequently thrombocytopenia appearing in a time frame consistent with an immune response to heparin should be considered suspicious for HIT and any new thrombus occurring in a patient receiving heparin therapy should raise suspicion of HIT. Patients who develop HIT are treated by discontinuance of heparin and administration of a direct thrombin inhibitor or fondaparinux (see below). 

Primary prevention of venous thrombosis reduces the incidence of and mortality rate from pulmonary emboli. Heparin and warfarin may be used to prevent venous thrombosis. Subcutaneous administration of low-dose unfractionated heparin, low-molecular-weight heparin, or fondaparinux provides effective prophylaxis. Warfarin is also effective but requires laboratory monitoring of the prothrombin time. 

FONDAPARINUX ANTICOAGULANTS-PARENTERAL t risk of bleeding when heparins are given with fondaparinux Combined anticoagulant effect Manufacturers recommend avoiding co-administration... 

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