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Precautions and Warnings With Fondaparinux

You may not be able to use fondaparinux safely if you have certain medical conditions, such as a bleeding disorder, high blood pressure, or stomach ulcers. Being aware of these and other fondaparinux precautions and warnings can help ensure a safe treatment process, so make sure your healthcare provider has a list of all medications you are taking and any medical conditions you have.

What Should I Tell My Healthcare Provider?

Talk with your healthcare provider prior to taking fondaparinux sodium (Arixtra®) if you have:
 
  • A bleeding disorder (not a clotting disorder)
  • Intestinal or stomach ulcers or bleeding
  • Bleeding in the brain
  • An aneurysm
  • A bacterial infection of the endocardium (the inner layer of the heart)
  • Had a negative reaction to heparin
  • Kidney disease, such as kidney failure
  • Had recent brain, eye, or spinal surgery
  • High blood pressure
  • Diabetic retinopathy (an eye condition)
  • Any allergies, including allergies to foods, dyes, or preservatives.
     
Also, let your healthcare provider know if you are:
 
  • Breastfeeding
  • Pregnant or thinking of becoming pregnant.
     
Make sure to tell your healthcare provider about any medications you are taking, including prescription and nonprescription medicines, vitamins, and herbal supplements.
 

Specific Precautions and Warnings With Fondaparinux

Some warnings and precautions to be aware of prior to using this medicine include the following:
 
  • As with all "blood thinners," most of the serious side effects of fondaparinux are related to bleeding, especially internal bleeding, which can be fatal. Let your healthcare provider know if you develop any signs of bleeding, such as:
     
    • Easy bruising
    • Cuts or scrapes that are slow to stop bleeding
    • Black, tarry stools; bright-red blood in the stool; or vomiting of blood (signs of gastrointestinal bleeding)
    • Signs of a bleeding in the brain, such as vision or speech changes, weakness or numbness in an arm or leg, or a severe headache.
 
  • There have been reports of spinal or epidural hematoma in people who had spinal, epidural, or caudal anesthesia (or spinal punctures) while on anticoagulants like fondaparinux. This is a serious problem that can sometimes cause long-term or permanent paralysis. Each case must be evaluated on an individual basis, but you may not be a candidate for these types of anesthesia or procedures if you are on fondaparinux.
     
  • Make sure your healthcare provider knows if you have kidney disease, diabetic retinopathy, uncontrolled high blood pressure, current or recent ulcers of the digestive tract, or any obvious bleeding. Extreme caution must be taken in such situations. Extreme caution should also be taken in people with bleeding disorders (that increase the risk of bleeding), bleeding in the brain, or recent brain, spinal, or eye surgery.
     
  • Fondaparinux may interact with a number of other medications (see Drug Interactions With Fondaparinux for more information).
     
  • Rarely, fondaparinux can cause low blood platelets (thrombocytopenia). In many cases, this is mild and causes no other problems. Rarely, though, a severe reaction, similar to heparin-induced thrombocytopenia (HIT), may occur. This dangerous problem can cause excessive clotting, loss of limbs, and even death. It is important to note that fondaparinux is not a heparin medication, and many people who have HIT can successfully take fondaparinux.
     
  • People with kidney disease and people who weigh less than 110 pounds may be at an increased risk for bleeding due to fondaparinux.
     
  • The needle guard of fondaparinux prefilled syringes contains dry natural latex rubber, which can cause problems for people with latex allergies.
     
  • It is not known if fondaparinux passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to taking the drug (see Arixtra and Breastfeeding).
     
  • Fondaparinux is considered a pregnancy Category B medication. This means that it is probably safe for use during pregnancy, although the full risks are currently unknown (see Arixtra and Pregnancy).
     
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Fondaparinux Drug Information

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