Fondaparinux for VTE prophylaxis

Fondaparinux is an alternative to LMWH for VTE prophylaxis in patients undergoing major orthopaedic surgery of the lower limbs, or abdominal surgery. It can be used for patients with a history of heparin-induced thrombocytopenia (HIT). The first dose of fondaparinux is administered at least 6 hours after surgery, and only after haemostasis has been established.

For fondaparinux indications and duration for nonsurgical patients, see Examples of VTE prophylaxis for nonsurgical patients in hospital for surgical patients, see VTE prophylaxis for surgical patients in hospital.

The fondaparinux dosage regimen for VTE prophylaxis is:

If fondaparinux is required for patients with a CrCl 30 to 50 mL/min, seek specialist advice. Do not use fondaparinux for patients with a CrCl less than 30 mL/min.

Fondaparinux should be used with caution in patients aged 75 years or older, and those who weigh less than 50 kg, as the clinical trials showed an increased bleeding risk in these patients.