Fondaparinux Sodium, Injection fon-da-PARE-ih-nuks SOH-dee-um

What are other names for this medicine?

Type of medicine: anticoagulant (medicine that reduces the chance of blood clots forming)

Generic and brand names: fondaparinux sodium, injection; Arixtra

What is this medicine used for?

This medicine is given by injection (shot) to treat or prevent deep vein thrombosis (blood clots). It is also used to treat blood clots in the lungs (pulmonary embolism). You may be given this medicine if you are having surgery for:

• certain abdominal problems
• hip fracture
• hip replacement
• knee replacement

It may be used for other conditions as determined by your healthcare provider.

What should my healthcare provider know before I take this medicine?

Tell your healthcare provider if you have ever had:

• an allergic reaction to any medicine, or to latex
• a stroke
• an ulcer
• bleeding problems
• brain, spinal or eye surgery
• eye problems due to diabetes
• heart disease or high blood pressure
• infectious endocarditis
• kidney or liver problems

Be sure to tell your healthcare provider if you are taking any medicine that may increase the risk of bleeding, such as warfarin (Coumadin) or heparin.

Females of childbearing age: Tell your healthcare provider if you are pregnant or plan to become pregnant while receiving this medicine. Do not breast-feed without your healthcare provider's approval.

How do I use it?

Your healthcare provider will give you these shots while you are in the hospital. You will receive shots subcutaneously (just under the skin). You will be closely watched to be sure that you do not bleed too much or develop any serious side effects.

Sometimes you can give yourself these shots or have someone at home give them to you. The medicine comes in single use prefilled syringes. Do not try to get rid of the air bubble in the syringe. Use each syringe only once and dispose of them safely, following your healthcare provider's instructions.

Check the label on the medicine for directions about your specific dose. Carefully read and follow the directions that come in the package of medicine for preparing the shots. This medicine should look clear. Do not use it if it is cloudy or has particles in it.

Wash your hands before using this medicine. Follow these steps to give yourself the shots:

1. Your healthcare provider will tell you where you can give yourself the shots. Choose a site around the belly button but not in the belly button. Each day, choose a different spot for the shot to lessen irritation.
2. Use an alcohol swab to clean the skin where you will give yourself the shot.
3. Twist the plunger cap and remove it from the syringe.
4. Hold the syringe in either hand and use your other hand to twist the needle guard counter-clockwise. Pull the needle guard off the needle.
5. Gently pinch a fold of skin at the injection site between your thumb and forefinger and hold it until you finish the injection.
6. Insert the full length of the syringe needle straight into the skin fold between your thumb and forefinger.
7. Push the plunger on the syringe down as far as it will go.
8. When you have injected all the contents of the syringe, release the plunger. The plunger will rise while the needle withdraws from the skin and goes back into the security sleeve.
9. Discard the syringe. Use syringes ONLY ONCE. Throw them away after use. Put used syringes in rigid puncture-resistant containers with lids or caps, such as heavy plastic bleach bottles with screw caps. DO NOT throw syringes directly into garbage cans or dumpsters.

What if I overdose?

If you or anyone else has intentionally taken too much of this medicine, call 911 or go to the emergency room right away. If you pass out, have seizures, weakness or confusion, or have trouble breathing, call 911. If you think that you or anyone else may have taken too much of this medicine, call the poison control center. Do this even if there are no signs of discomfort or poisoning. The poison control center number is 800-222-1222.

Symptoms of an acute overdose may include: nosebleeds, severe bruising, black or tarry stools, blood in the urine, vomiting or coughing up blood, bleeding that won’t stop.

What should I watch out for?

Bleeding is the most common side effect. Your healthcare provider will check for bleeding. Use a soft brush to brush your teeth. Avoid injury while shaving, cutting fingernails or toenails, or when using sharp objects. If you notice any bleeding, tell your healthcare provider.

You will need to have lab tests regularly to see how this medicine affects you. Keep all appointments for tests.

If you need emergency care, surgery, or dental work, tell the healthcare provider or dentist you are taking this medicine.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you are unable to reach your healthcare provider right away, get emergency medical care or call 911 for help): Allergic reaction (hives, itching, rash, tightness or pain in your chest, swelling of your lips, tongue or throat, trouble breathing).

Serious (Report these to your healthcare provider right away): Unusual bleeding or bruising; severe tiredness or weakness; swelling, numbness, or tingling of hands, feet, or ankles; severe headache; pain in joints or back.

Other: Nausea, constipation, diarrhea, vomiting, lightheadedness, trouble sleeping, headache, fever, irritation at the injection site, cough.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• aspirin and other salicylates
• deferasirox (Exjade)
• drotrecogin alfa (Xigris)
• medicine that reduces the chance of blood clots forming such as abciximab (ReoPro), anagrelide (Agrylin), cilostazol (Pletal), clopidogrel (Plavix), dalteparin (Fragmin), dipyridamole (Persantine, Aggrenox), enoxaparin (Lovenox), fondaparinux (Arixtra), heparin, prasugrel (Effient), rivaroxaban (Xarelto), ticagrelor (Brilinta), and warfarin (Coumadin)
• medicines to dissolve blood clots such as alteplase (Activase), reteplase (Retavase), and tenecteplase (TNKase)
• medicines to treat cancer such as dasatinib (Sprycel), ibritumomab (Zevalin), and tositumomab (Bexxar)
• natural remedies such as alfalfa, agrimony, anise, arnica, bilberry, black cohosh, bladderwrack, cat’s claw, dong quai, evening primrose oil, fenugreek, feverfew, garlic, ginger, ginkgo biloba, ginseng, goldenseal, grape seed, green tea, horse chestnut, licorice, nettle, passion flower, pau d'arco, red clover, St. John's wort, sweet clover, and willow,
• nonsteroidal anti-inflammatory medicines (NSAIDs) such as diclofenac (Voltaren, Cataflam), ibuprofen (Motrin, Motrin IB, Advil), indomethacin (Indocin), ketoprofen, ketorolac (Toradol), nabumetone (Relafen), naproxen (Naprosyn, Anaprox, Aleve, Naprelan), oxaprozin (Daypro), piroxicam (Feldene), and sulindac (Clinoril)
• pentoxifylline (Trental)
• vitamin E

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicines in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.