What is the role of fondaparinux sodium in deep venous thrombosis (DVT) prophylaxis for patients undergoing orthopedic surgery?

Updated: Jan 28, 2021
  • Author: David A Forsh, MD; Chief Editor: Vinod K Panchbhavi, MD, FACS, FAOA, FABOS, FAAOS  more...
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Answer

Fondaparinux sodium, a synthetic pentasaccharide, selectively binds to ATIII and potentiates neutralization of factor Xa, inhibiting thrombin formation and thrombus development. [38] Fondaparinux acts rapidly but has a long half-life (18 hours). A dose of 2.5 mg SC daily can be started 6-8 hours postoperatively. Renal clearance requires a minimal kidney function of creatinine clearance (CrCl) of greater than 30 mL/min or a weight of over 110 lb. In a controlled study by Bauer et al, fondaparinux was more effective than enoxaparin in preventing DVT after TKR, but episodes of major bleeding were more frequent. [39] For a comparison between fondaparinux and enoxaparin, see Turpie et al. [40]


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