Fondaparinux contraindications

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]


Fondaparinux sodium (Arixtra) Injection is contraindicated in patients with severe renal impairment (creatinine clearance <30 mL/min). Fondaparinux sodium (Arixtra) is eliminated primarily by the kidneys, and such patients are at increased risk for major bleeding episodes.

Fondaparinux sodium (Arixtra) prophylactic therapy is contraindicated in patients with body weight <50 kg undergoing hip fracture, hip replacement or knee replacement surgery, and abdominal surgery. During the randomized clinical trials of prophylaxis in the peri-operative period following hip fracture, hip replacement, or knee replacement surgery, occurrence of major bleeding was doubled in patients with a body weight <50 kg compared with those with a body weight ≥50 kg (5.4% versus 2.1%). In the clinical trial in patients undergoing abdominal surgery, the major bleeding rate was also higher in patients with a body weight <50 kg as compared to those with a body weight ≥50 kg (5.3% versus 3.3%), respectively.

The use of Fondaparinux sodium (Arixtra) is contraindicated in patients with active major bleeding, bacterial endocarditis, in patients with thrombocytopenia associated with a positive in vitro test for anti-platelet antibody in the presence of fondaparinux sodium, or in patients with known hypersensitivity to fondaparinux sodium.