Adult Dosing
DVT prophylaxis following hip/knee replacement
- 2.5 mg SC qd x 5-9 days
- Start 6-8 hrs after surgery when hemostasis established
DVT prophylaxis following abdominal surgery
- 2.5 mg SC qd x 5-9 days
- Start 6-8 hrs after surgery when hemostasis established
DVT prophylaxis following hip fracture surgery
- 2.5 mg SC qd x 24-32 days
- Start 6-8 hrs after surgery when hemostasis established
Treatment of DVT/PE
- Adults (< 50 kg): 5 mg SC qd x 5-9 days until therapeutic anticoagulation with warfarin is achieved (INR 2-3). Start warfarin within 72 hrs
- Adults (50-100 kg): 7.5 mg SC qd x 5-9 days until therapeutic anticoagulation with warfarin is achieved (INR 2-3). Start warfarin within 72 hrs
- Adults (>100 kg): 10 mg SC qd x 5-9 days until therapeutic anticoagulation with warfarin is achieved (INR 2-3 ). Start warfarin within 72 hrs
ST Elevation Myocardial Infarction
- Initial dose: 2.5 mg IV
- Maintenance dose: 2.5 mg SC qd following initial dose up to 8 days or until revascularization
Pediatric Dosing
- Safety and efficacy in pediatric patients have not been established
[Outline]
Renal Dose Adjustment (Based on CrCl)
- 30-50 mL/min: Use with caution
- < 30 mL/min: Contraindicated
Hepatic Dose Adjustment
- Hepatic impairment: Dose adjustments not defined. Monitor patient for signs of bleeding.
- During epidural or spinal anesthesia or puncture, patients receiving drug or scheduled to receive it for thromboprophylaxis are at risk for epidural or spinal hematoma, which can lead to long-term or permanent paralysis [US Black Box Warning]
- Risk increases with use of indwelling epidural catheter for analgesia administration and with concurrent use of drugs affecting hemostasis (such as nonsteroidal anti-inflammatory drugs, platelet inhibitors, and other anticoagulants). Risk also rises with traumatic or repeated epidural or spinal puncture [US Black Box Warning]
- Monitor patient frequently for signs and symptoms of neurologic impairment. If these occur, treat urgently [US Black Box Warning]
- Before neuraxial intervention, weigh potential benefits versus risks in anticoagulated patients/patients planned for anticoagulation [US Black Box Warning]
- Monitor hepatic and renal function; discontinue if severe renal impairment develops
- Monitor CBC, serum Cr, platelet count, anti-Xa assay (using fondaparinux as calibrator) during the recommended course of treatment
Cautions: Use cautiously in
- Mild to moderate renal impairment
- Untreated hypertension
- Gastrointestinal disorders (PUD)
- History of GI bleed
- History of congenital or acquired bleeding disorder
- History of heparin induced thrombocytopenia
- Hemorrhagic stroke
- Diabetic retinopathy
- History of recent surgery or trauma
- Geriatric population (increased risk of bleeding)
- Patients with body weight < 50 kgs (decreased renal clearance)
- Latex allergy
- Bleeding disorders
- platelet inhibitors
Pregnancy Category:B
Breastfeeding: Safety unknown; use with caution
Pricing data from www.DrugStore.com in U.S.A.
- Arixtra 2.5 MG/0.5ML SOLN [Syringe] (GLAXO SMITH KLINE)
5 0.5ml = $593.04
15 0.5ml = $1610.79 - Arixtra 7.5 MG/0.6ML SOLN [Syringe] (GLAXO SMITH KLINE)
0.6 0.6ml = $140.09
1.8 0.6ml = $406.24
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.
