What is dosage regimen of fondaparinux in the treatment of non-ST-elevation acute coronary syndrome (unstable angina and NSTEMI), and when is it contraindicated?

Updated: May 07, 2019
  • Author: A Maziar Zafari, MD, PhD, FACC, FAHA; Chief Editor: Eric H Yang, MD  more...
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Answer

Fondaparinux is a selective factor X inhibitor. This agent is given as a once-daily SC injection of 2.5 mg, which is continued for the duration of hospitalization or until PCI is performed.

Note that fondarparinux is contraindicated in patients with impaired kidney function. In addition, in patients undergoing PCI, administer another anticoagulant agent (eg, unfractionated heparin or bivalirudin), as fondaparinux is associated with a higher risk of catheter thrombosis; this was demonstrated in the Fifth Organization to Assess Strategies in Ischemic Syndromes (OASIS-5) trial. [87, 109, 110]


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