Fondaparinux as a Treatment Option for Heparin-Induced Thrombocytopenia

Stella Papadopoulos, Pharm.D.; Jeremy D. Flynn, Pharm.D.; Daniel A. Lewis, Pharm.D.


Pharmacotherapy. 2007;27(6):921-926. 

In This Article


The combination of once-daily subcutaneous administration, predictability of response, and minimal adverse effects makes fondaparinux an appealing alternative anticoagulant for patients with HIT. Although clinical experience with this agent in the setting of HIT is limited, the successful use of fondaparinux in patients with HIT has been reported. To date, one multicenter, blinded, comparative, in vitro study has demon-strated a lack of cross-reactivity between fondaparinux and HIT antibodies. At this time, use of fondaparinux in the setting of HIT is not recommended by the American College of Chest Physicians. Rather, the direct thrombin inhibitors lepirudin and argatroban are recommended as first-line agents. Nevertheless, limited clinical experience suggests that fondaparinux may be an alternative for anticoagulation in patients with HIT. Large, in vivo comparison trials must be performed before fondaparinux can become a standard treatment option in the setting of HIT.


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