Fondaparinux sodium: a selective inhibitor of factor Xa.
The pharmacology and mechanism of action of fondaparinux sodium are described. Fondaparinux sodium is the first agent of a new class of anticoagulants that selectively target factor Xa. It has a linear, dose-dependent pharmacokinetic profile, which provides a highly predictable response. It is 100% bioavailable, has a rapid onset of action, and has a half-life of 14 to 16 hours, allowing for sustained antithrombotic activity over a 24-hour period. The drug does not affect prothrombin time or activated partial thromboplastin time, nor does it affect platelet function or aggregation. Studies in patients with confirmed heparin-induced thrombocytopenia demonstrate that the drug is not associated with in vitro cross-reactivity to heparin antibodies. Fondaparinux sodium appears to meet the criteria for an ideal antithrombotic agent: equal or better effectiveness than currently available agents, a low bleeding risk, no need for laboratory monitoring, and once-daily administration.
Bauer
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Hematology Section, VA Boston Healthcare System, Beth Israel Deaconess Medical Center, MA, USA. kbauer@caregroup.harvard.edu
D000925:Anticoagulants / Q000009:adverse effects / Q000494:pharmacology; D001777:Blood Coagulation / Q000187:drug effects; D003429:Cross Reactions; D015951:Factor Xa / Q000502:physiology; D065427:Factor Xa Inhibitors; D005343:Fibrinolytic Agents / Q000009:adverse effects / Q000493:pharmacokinetics / Q000494:pharmacology*; D000077425:Fondaparinux; D006493:Heparin / Q000009:adverse effects / Q000494:pharmacology; D006801:Humans; D011134:Polysaccharides / Q000009:adverse effects / Q000493:pharmacokinetics / Q000494:pharmacology*; D013921:Thrombocytopenia / Q000139:chemically induced; D014859:Warfarin / Q000494:pharmacology
D000925:Anticoagulants; D065427:Factor Xa Inhibitors; D005343:Fibrinolytic Agents; D011134:Polysaccharides; D014859:Warfarin; D006493:Heparin; D015951:Factor Xa; D000077425:Fondaparinux