Fondaparinux
Fondaparinux is a selective anti-Xa inhibitor that, unlike unfractionated heparin (UFH) and low molecular weight heparin (LMWH), has no antithrombin activity. Fondaparinux is more effective than enoxaparin at prevention of deep vein thrombosis for hip and knee arthroplasty and for hip fracture surgery, and is a suitable option for those procedures. It has a slightly increased bleeding risk. Clearance is reduced in patients with renal impairment. Use of fondaparinux is contraindicated when creatinine clearance is less than 30 mL/minute, and it should be used with caution when creatinine clearance is 30 to 50 mL/minute and the patient carefully monitored due to the increased bleeding risk.
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