Fondaparinux [Arixtra®]
  Profilaxis TVP/TEP
No recomendable
  Alto riesgo
Coste tratamiento 

Dr. R.Pitarch. Octubre 2007

Profilaxis TVP: Cir. ortopédica de MMII ( Fx Cadera, cir. mayor de rodilla y prótesis de cadera) y pacientes con alto riesgo de complicaciones tromboembólicas tras cirugía abdominal. SCASEST-Fondaparinux se recomienda en base a su mejor relación eficacia/seguridadi (I-A)- SCACEST Tto TVP/TEP: Percutaneous coronary intervention — The possible role of fondaparinux as an anticoagulant in patients undergoing percutaneous coronary intervention (PCI, almost all with stents) was evaluated in the ASPIRE pilot trial in which 350 patients undergoing urgent or elective PCI were randomly assigned to receive treatment with unfractionated heparin or fondaparinux (2.5 or 5.0 mg intravenously) . There was no difference among the groups in terms of efficacy or clinical safety, although there was an almost significant increase in bleeding with 5.0 compared to 2.5 mg of fondaparinux (9.6 versus 3.4 percent, p = 0.06)

Pacientes de alto riesgo de sangrado — Se recomienda no utilizar fondaparinux.

Embarazo— Initial in vivo studies in animals and in vitro studies in the perfused human placenta have failed to demonstrate placental transfer of this agent at currently recommended doses . However, small amounts of fondaparinux have been detected in the umbilical cord following multiple doses during pregnancy . While there is only anecdotal experience attesting to the safety of fondaparinux during pregnancy , there has been considerable experience with low molecular weight heparin (LMWH). Both fondaparinux and LMWH carry class B labeling with respect to pregnancy.


Comparativa coste
  Fondaparinux Enoxaparina
Posologia 2'5 mg/sc/ dia 40 mg /sc/dia
Coste diario profilaxis TVP 14,15 € 5,24 €
Posologia SCA 2'5 mg/sc/ dia 1mg/sc/kg/12 hs
Coste diario en SCA 14,15 34 / 42 €


Guidelines for the diagnosis and treatment of non-ST-segment elevation acute coronary syndromes: The Task Force for the Diagnosis and Treatment of Non-ST-Segment Elevation Acute Coronary Syndromes of the European Society of Cardiology

Influence of Renal Function on the Efficacy and Safety of Fondaparinux Relative to Enoxaparin in Non–ST-Segment Elevation Acute Coronary Syndromes. Annals of Internal MedicineVolume 147(5), 4 September 2007

Yusuf S, Mehta SR, Chrolavicius S, Afzal R, Pogue J, Granger CB, et al. Comparison of fondaparinux and enoxaparin in acute coronary syndromes. N Engl J Med 2006;354:1464–76.

Yusuf S, Mehta SR, Chrolavicius S et al. Effects of fondaparinux on mortality and reinfarction in patients with acute ST-segment elevation myocardial infarction: the OASIS-6 randomized trial. JAMA. 2006; 295:1519–30.

Managing acute coronary syndrome: Evidence-based approaches [SYMPOSIUM: Managing acute coronary syndrome]

American Society of Health-System Pharmacists, Inc. All rights reserved. Volume 64(11) Supplement 7, 1 June 2007, p S14–S24

Turpie AGG, Bauer KA, Eriksson BI, Lassen MR, for the Steering Committees of the Pentasaccharide Orthopaedic Prophylaxis Studies. Fondaparinux vs enoxaparin for the prevention of venous thromboembolism in major orthopaedic surgery. Arch Intern Med 2002; 162: 1833-40.

Lowe GD, Sandercock PA, Rosendaal FR. Prevention of venous thromboembolism after major orthopaedic surgery: is fondaparinux an advance? Lancet. 2003;362:504-5.