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| {{CMG}} | | __NOTOC__ |
| | {{Fondaparinux}} |
| | {{CMG}}; {{AE}} {{AZ}} |
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| ==Major Interactions== | | ==Drug Interactions== |
| {{refbegin|3}}
| | In clinical studies performed with ARIXTRA: |
| * [[Abbokinase]]
| | :*The concomitant use of oral anticoagulants (warfarin), platelet inhibitors ([[acetylsalicylic acid]]), NSAIDs (piroxicam), and digoxin did not significantly affect the pharmacokinetics/pharmacodynamics of fondaparinux sodium. In addition, ARIXTRA neither influenced the pharmacodynamics of warfarin, acetylsalicylic acid, [[piroxicam]], and [[digoxin]], nor the pharmacokinetics of digoxin at steady state. |
| * [[Abbokinase Open-Cath]]
| | :*Agents that may enhance the risk of hemorrhage '''should be discontinued''' prior to initiation of therapy with ARIXTRA unless these agents are essential. If co-administration is necessary, '''monitor patients closely for hemorrhage'''. [See Warnings and Precautions (5.1).] |
| * [[abciximab]]
| |
| * [[Acetylsalicylic Acid]]
| |
| * [[Acova]]
| |
| * [[Activase]]
| |
| * [[Actron]]
| |
| * [[Acuprin 81]]
| |
| * [[Advil]]
| |
| * [[Advil Childrens]]
| |
| * [[Advil Junior Strength]]
| |
| * [[Advil Liquigel]]
| |
| * [[Advil Migraine]]
| |
| * [[Advil Pediatric]]
| |
| * [[Aflaxen]]
| |
| * [[Aggrastat]]
| |
| * [[Agrylin]]
| |
| * [[Aleve]]
| |
| * [[Aleve Caplet]]
| |
| * [[Aleve Easy Open Arthritis]]
| |
| * [[Aleve Gelcap]]
| |
| * [[alteplase]]
| |
| * [[Amigesic]]
| |
| * [[Anaflex]]
| |
| * [[anagrelide]]
| |
| * [[Anaprox]]
| |
| * [[Anaprox-DS]]
| |
| * [[Angiomax]]
| |
| * [[anisindione]]
| |
| * [[anistreplase]]
| |
| * [[Ansaid]]
| |
| * [[antithrombin III]]
| |
| * [[Anturane]]
| |
| * [[Aptivus]]
| |
| * [[ardeparin]]
| |
| * [[argatroban]]
| |
| * [[Argesic-SA]]
| |
| * [[Arthritis Pain]]
| |
| * [[Arthropan]]
| |
| * [[ASA]]
| |
| * [[Ascriptin Enteric]]
| |
| * [[Aspergum Cherry]]
| |
| * [[Aspergum Orginal]]
| |
| * [[Aspir-Low]]
| |
| * [[aspirin]]
| |
| * [[aspirin extended release]]
| |
| * [[Aspirin Lite Coat]]
| |
| * [[Aspirin Litecoat]]
| |
| * [[Aspirin Low Strength]]
| |
| * [[Aspirtab]]
| |
| * [[Atnativ]]
| |
| * [[Bayer Aspirin]]
| |
| * [[Bayer Aspirin Regimen]]
| |
| * [[Bayer Aspirin Sugar Free]]
| |
| * [[Bayer Aspirin with Calcium]]
| |
| * [[Bayer Childrens Aspirin]] | |
| * [[Bayer Low Strength]]
| |
| * [[Bayer Plus]]
| |
| * [[Bayer Select Backache Pain Formula]]
| |
| * [[Bexxar Dosimetric]]
| |
| * [[Bexxar I 131 Dosimetric]]
| |
| * [[Bexxar I 131 Therapeutic]]
| |
| * [[BexxarTherapeutic]]
| |
| * [[bivalirudin]]
| |
| * [[bromfenac]]
| |
| * [[Buffered Aspirin]]
| |
| * [[Bufferin]]
| |
| * [[Bufferin Arthritis Strength]]
| |
| * [[Bufferin Extra Strength]]
| |
| * [[Buffex]]
| |
| * [[Cataflam]]
| |
| * [[Cathflo Activase]]
| |
| * [[Childrens Ibuprofen Berry]]
| |
| * [[choline salicylate]]
| |
| * [[cilostazol]]
| |
| * [[Clexane]]
| |
| * [[Clexane Forte]]
| |
| * [[Clinoril]]
| |
| * [[clopidogrel]]
| |
| * [[Coumadin]]
| |
| * [[dalteparin]]
| |
| * [[danaparoid]]
| |
| * [[dasatinib]]
| |
| * [[Daypro]]
| |
| * [[desirudin]]
| |
| * [[dextran 1]]
| |
| * [[Dextran 40]]
| |
| * [[Dextran 40 in 0.9% Sodium Chloride]]
| |
| * [[Dextran 40 in 5% Dextrose]]
| |
| * [[Dextran 70 6% in 0.9% Sodium Chloride]]
| |
| * [[Dextran 70 6% in 5% Dextrose]]
| |
| * [[dextran high molecular weight]]
| |
| * [[dextran low molecular weight]]
| |
| * [[Dextran-HM]]
| |
| * [[diclofenac]]
| |
| * [[diclofenac potassium]]
| |
| * [[diclofenac sodium]]
| |
| * [[diclofenac sodium extended release]]
| |
| * [[dicumarol]]
| |
| * [[diflunisal]]
| |
| * [[dipyridamole]]
| |
| * [[Disalcid]]
| |
| * [[Doans Pills]]
| |
| * [[Doans Pills Extra Strength]]
| |
| * [[Dolobid]]
| |
| * [[drotrecogin]]
| |
| * [[drotrecogin alfa]]
| |
| * [[DurAct]]
| |
| * [[Easprin]]
| |
| * [[EC-Naprosyn]]
| |
| * [[Ecotrin]]
| |
| * [[Ecotrin Adult Low Strength]]
| |
| * [[Ecotrin Maximum Strength]]
| |
| * [[Empirin]]
| |
| * [[enoxaparin]]
| |
| * [[Entaprin]]
| |
| * [[Entercote]]
| |
| * [[eptifibatide]]
| |
| * [[etodolac]]
| |
| * [[etodolac extended release]]
| |
| * [[Extra Strength Bayer]]
| |
| * [[Fasprin]]
| |
| * [[Feldene]]
| |
| * [[fenoprofen]]
| |
| * [[flurbiprofen]]
| |
| * [[Fragmin]]
| |
| * [[Genacote]]
| |
| * [[Gennin-FC]]
| |
| * [[Genpril]]
| |
| * [[Genprin]]
| |
| * [[Gentran 40]]
| |
| * [[Gentran 40 with 0.9% Sodium Chloride]]
| |
| * [[Gentran 40 with 5% Dextrose]]
| |
| * [[Gentran 70]]
| |
| * [[Halfprin]]
| |
| * [[Haltran]]
| |
| * [[Hep-Lock]]
| |
| * [[Hep-Pak]]
| |
| * [[Hep-Pak CVC]]
| |
| * [[heparin]]
| |
| * [[Heparin Lock Flush]]
| |
| * [[Hyskon]]
| |
| * [[ibritumomab]]
| |
| * [[Ibu]]
| |
| * [[IBU-200]]
| |
| * [[Ibu-4]]
| |
| * [[Ibu-6]]
| |
| * [[Ibu-8]]
| |
| * [[Ibu-Tab]]
| |
| * [[ibuprofen]]
| |
| * [[Ibuprofen PMR]]
| |
| * [[iloprost]]
| |
| * [[In-111 Zevalin]]
| |
| * [[Indocin]]
| |
| * [[Indocin SR]]
| |
| * [[indomethacin]] | |
| * [[indomethacin extended release]]
| |
| * [[Innohep]]
| |
| * [[Integrilin]]
| |
| * [[iodine I 131 tositumomab]]
| |
| * [[Iprivask]]
| |
| * [[Jantoven]]
| |
| * [[Kabikinase]]
| |
| * [[ketoprofen]]
| |
| * [[ketoprofen extended release]]
| |
| * [[ketorolac]]
| |
| * [[Kinlytic]]
| |
| * [[Leader Naproxen Sodium]]
| |
| * [[lepirudin]]
| |
| * [[Litecoat Aspirin]]
| |
| * [[LMD with 0.9% Sodium Chloride]]
| |
| * [[LMD with 5% Dextrose]]
| |
| * [[Lodine]]
| |
| * [[Lodine XL]]
| |
| * [[Lovenox]]
| |
| * [[Lovenox HP]]
| |
| * [[Low Dose ASA]]
| |
| * [[Macrodex]]
| |
| * [[Magan]]
| |
| * [[magnesium salicylate]]
| |
| * [[Marthritic]]
| |
| * [[meclofenamate]]
| |
| * [[Meclomen]]
| |
| * [[mefenamic acid]]
| |
| * [[Menadol]]
| |
| * [[Midol Extended Relief]]
| |
| * [[Midol IB]]
| |
| * [[Midol Maximum Strength Cramp Formula]]
| |
| * [[Minitabs]]
| |
| * [[Miradon]]
| |
| * [[Mithracin]]
| |
| * [[Mobidin]]
| |
| * [[Mono-Gesic]]
| |
| * [[Motrin]]
| |
| * [[Motrin Childrens]]
| |
| * [[Motrin IB]]
| |
| * [[Motrin Infant Drops]]
| |
| * [[Motrin Junior Strength]]
| |
| * [[Motrin Migraine Pain]]
| |
| * [[MST]]
| |
| * [[nabumetone]]
| |
| * [[Nalfon]]
| |
| * [[Naprelan '375']]
| |
| * [[Naprelan '500']]
| |
| * [[Naprosyn]]
| |
| * [[naproxen]]
| |
| * [[naproxen sodium]]
| |
| * [[Naproxen Sodium DS]]
| |
| * [[naproxen sodium extended release]]
| |
| * [[NeoProfen]]
| |
| * [[Normiflo]]
| |
| * [[Norwich Aspirin]]
| |
| * [[Nuprin]]
| |
| * [[Nuprin Backache Caplet]]
| |
| * [[Orgaran]]
| |
| * [[Orudis]]
| |
| * [[Orudis KT]]
| |
| * [[Oruvail]]
| |
| * [[oxaprozin]]
| |
| * [[Pediacare Fever]]
| |
| * [[Persantine]]
| |
| * [[Persantine IV]]
| |
| * [[phenyl salicylate]]
| |
| * [[phenylbutazone]]
| |
| * [[piroxicam]]
| |
| * [[Plavix]]
| |
| * [[Pletal]]
| |
| * [[plicamycin]]
| |
| * [[Ponstel]]
| |
| * [[Promit]]
| |
| * [[Q-Profen]]
| |
| * [[Refludan]]
| |
| * [[Relafen]]
| |
| * [[Reopro]]
| |
| * [[Retavase]]
| |
| * [[reteplase]]
| |
| * [[Rexolate]]
| |
| * [[Rheomacrodex]]
| |
| * [[Rufen]]
| |
| * [[Saleto-200]]
| |
| * [[Saleto-400]]
| |
| * [[Saleto-600]]
| |
| * [[Saleto-800]]
| |
| * [[Salflex]]
| |
| * [[salsalate]]
| |
| * [[Salsitab]]
| |
| * [[Sloprin]]
| |
| * [[sodium salicylate]]
| |
| * [[sodium thiosalicylate]]
| |
| * [[Sprycel]]
| |
| * [[St. Joseph Aspirin]]
| |
| * [[St. Joseph Aspirin Adult Chewable]]
| |
| * [[St. Joseph Aspirin Adult EC]]
| |
| * [[Stanback Analgesic]]
| |
| * [[Streptase]]
| |
| * [[streptokinase]]
| |
| * [[sulfinpyrazone]]
| |
| * [[sulindac]]
| |
| * [[temsirolimus]]
| |
| * [[tenecteplase]]
| |
| * [[Therapy Bayer]]
| |
| * [[Thrombate III]]
| |
| * [[Ticlid]]
| |
| * [[ticlopidine]]
| |
| * [[tinzaparin]]
| |
| * [[tipranavir]]
| |
| * [[tirofiban]]
| |
| * [[tissue plasminogen activator]]
| |
| * [[TNKase]]
| |
| * [[Tolectin]]
| |
| * [[Tolectin 600]]
| |
| * [[Tolectin DS]]
| |
| * [[tolmetin]]
| |
| * [[Toradol]]
| |
| * [[Toradol IM]]
| |
| * [[Toradol IV/IM]]
| |
| * [[Torisel]]
| |
| * [[tositumomab]]
| |
| * [[TPA]]
| |
| * [[Tri-Buffered Aspirin]]
| |
| * [[Tusal]]
| |
| * [[urokinase]]
| |
| * [[Ventavis]]
| |
| * [[Voltaren]]
| |
| * [[Voltaren-XR]]
| |
| * [[warfarin]]
| |
| * [[Xigris]]
| |
| * [[Y-90 Zevalin]]
| |
| * [[YSP Aspirin]]
| |
| * [[Zero-Order Release]]
| |
| * [[Zorprin]]
| |
| {{refend}}
| |
|
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|
| ==Moderate Interactions==
| | In an in vitro study in human liver microsomes: |
| {{refbegin|3}}
| | :*Inhibition of CYP2A6 hydroxylation of coumarin by fondaparinux (200 micromolar i.e., 350 mg/L) was 17 to 28%. Inhibition of the other isozymes evaluated (CYPs 1A2, 2C9, 2C19, 2D6, 3A4, and 3E1) was 0 to 16%. |
| * [[Acular]]
| | :*Since fondaparinux '''does not markedly inhibit CYP450s''' (CYP1A2, CYP2A6, CYP2C9, CYP2C19, CYP2D6, CYP2E1, or CYP3A4) in vitro, fondaparinux sodium is not expected to significantly interact with other drugs in vivo by inhibition of metabolism mediated by these isozymes. |
| * [[Acular LS]]
| |
| * [[Acular PF]]
| |
| * [[Anafranil]]
| |
| * [[ARI Sodium Iodide (I123) 1-12 MBq]] | |
| * [[ARI Sodium Iodide (I123) 100-750 MBq]]
| |
| * [[bromfenac ophthalmic]]
| |
| * [[Celexa]]
| |
| * [[Ceprotin]]
| |
| * [[citalopram]]
| |
| * [[clomipramine]]
| |
| * [[Cymbalta]]
| |
| * [[desvenlafaxine]]
| |
| * [[dexfenfluramine]]
| |
| * [[diclofenac ophthalmic]]
| |
| * [[diclofenac topical]]
| |
| * [[dong quai]]
| |
| * [[duloxetine]]
| |
| * [[Effexor]]
| |
| * [[Effexor XR]]
| |
| * [[Elmiron]]
| |
| * [[escitalopram]]
| |
| * [[fenfluramine]]
| |
| * [[Flector Patch]]
| |
| * [[fluoxetine]]
| |
| * [[fluoxetine extended release]]
| |
| * [[flurbiprofen ophthalmic]]
| |
| * [[fluvoxamine]]
| |
| * [[fluvoxamine extended release]]
| |
| * [[garlic]] | |
| * [[Garlic Oil]]
| |
| * [[ginger]]
| |
| * [[Ginger Root]]
| |
| * [[Ginger(obs)]]
| |
| * [[gingko biloba]]
| |
| * [[ginseng]]
| |
| * [[hemin]]
| |
| * [[Hofels Ginger One A Day]]
| |
| * [[Iodotope]]
| |
| * [[ketorolac ophthalmic]]
| |
| * [[Lexapro]]
| |
| * [[Luvox]]
| |
| * [[Luvox CR]]
| |
| * [[Meridia]]
| |
| * [[nepafenac ophthalmic]]
| |
| * [[Nevanac]]
| |
| * [[Ocufen]]
| |
| * [[Panhematin]]
| |
| * [[paroxetine]]
| |
| * [[paroxetine extended release]]
| |
| * [[paroxetine mesylate]]
| |
| * [[Paxil]]
| |
| * [[Paxil CR]]
| |
| * [[pentosan polysulfate sodium]]
| |
| * [[Pexeva]]
| |
| * [[Pondimin]]
| |
| * [[Pristiq]]
| |
| * [[protein C]]
| |
| * [[Protexel]]
| |
| * [[Prozac]]
| |
| * [[Prozac Weekly]]
| |
| * [[Rapiflux]]
| |
| * [[Redux]]
| |
| * [[Remodulin]]
| |
| * [[Sarafem]]
| |
| * [[Selfemra]]
| |
| * [[sertraline]]
| |
| * [[sibutramine]]
| |
| * [[sodium iodide I-123]]
| |
| * [[sodium iodide-I-131]]
| |
| * [[Solaraze]]
| |
| * [[suprofen ophthalmic]]
| |
| * [[treprostinil]]
| |
| * [[venlafaxine]]
| |
| * [[venlafaxine extended release]]
| |
| * [[verteporfin]]
| |
| * [[Visudyne]]
| |
| * [[Voltaren Ophthalmic]]
| |
| * [[Voltaren Topical]]
| |
| * [[Xibrom]]
| |
| * [[zingiber]]
| |
| * [[Zoloft]]
| |
| {{refend}}
| |
| | |
| ==Minor Interactions==
| |
| {{refbegin|3}}
| |
| * [[capsaicin]]
| |
| * [[capsicum]]
| |
| * [[chamomile]]
| |
| * [[clove]]
| |
| * [[fenugreek]]
| |
| * [[feverfew]]
| |
| * [[matricaria]]
| |
| * [[turmeric]]
| |
| {{refend}}
| |
|
| |
|
| | '''Protein-Binding Displacement''' |
| | Since fondaparinux sodium does not bind significantly to plasma proteins other than ATIII, '''no drug interactions by protein-binding displacement''' are expected.<ref name="dailymed.nlm.nih.gov">{{Cite web | last = | first = | title = ARIXTRA (FONDAPARINUX SODIUM) INJECTION, SOLUTION [GLAXOSMITHKLINE LLC] | url =http://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=05bb2dd4-5fb5-4ec9-29a8-d200e62d1a8f | publisher = | date = | accessdate = }}</ref> |
|
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|
| | ==References== |
| | {{Reflist}} |
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| {{FDA}} | | {{FDA}} |
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| [[Category:Drugs]] | | [[Category:Drugs]] |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ahmed Zaghw, M.D. [2]
Drug Interactions
In clinical studies performed with ARIXTRA:
- The concomitant use of oral anticoagulants (warfarin), platelet inhibitors (acetylsalicylic acid), NSAIDs (piroxicam), and digoxin did not significantly affect the pharmacokinetics/pharmacodynamics of fondaparinux sodium. In addition, ARIXTRA neither influenced the pharmacodynamics of warfarin, acetylsalicylic acid, piroxicam, and digoxin, nor the pharmacokinetics of digoxin at steady state.
- Agents that may enhance the risk of hemorrhage should be discontinued prior to initiation of therapy with ARIXTRA unless these agents are essential. If co-administration is necessary, monitor patients closely for hemorrhage. [See Warnings and Precautions (5.1).]
In an in vitro study in human liver microsomes:
- Inhibition of CYP2A6 hydroxylation of coumarin by fondaparinux (200 micromolar i.e., 350 mg/L) was 17 to 28%. Inhibition of the other isozymes evaluated (CYPs 1A2, 2C9, 2C19, 2D6, 3A4, and 3E1) was 0 to 16%.
- Since fondaparinux does not markedly inhibit CYP450s (CYP1A2, CYP2A6, CYP2C9, CYP2C19, CYP2D6, CYP2E1, or CYP3A4) in vitro, fondaparinux sodium is not expected to significantly interact with other drugs in vivo by inhibition of metabolism mediated by these isozymes.
Protein-Binding Displacement
Since fondaparinux sodium does not bind significantly to plasma proteins other than ATIII, no drug interactions by protein-binding displacement are expected.[1]
References
Adapted from the FDA Package Insert.