Enoxaparin, Enoxaparin Sodium, Fondaparinux
Enoxaparin, Enoxaparin Sodium
Unfractionated heparin (UFH) has been used for the prevention and treatment of thrombosis since the 1930s.96
Low-molecular-weight heparins (LMWHs), derived from UFH by depolymerisation, were introduced in Europe in the 1980s.96, 100 Because of several clinical advantages, LMWHs have gradually replaced UFH for most indications.101, 102
LMWHs in current use globally include enoxaparin, dalteparin, nadroparin, tinzaparin, certoparin, reviparin, and bemiparin.102
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Fondaparinux
The superior efficacy of LMWHs over UFH for the prevention of VTE after orthopedic surgery, and of fondaparinux over LMWHs, has been demonstrated in numerous large-scale randomized studies.17
Fondaparinux is a synthetic indirect inhibitor of Factor Xa. Its structure is based on the natural pentasaccharide contained within heparin and low-molecular-weight heparins (LMWHs). It potentiates the rate of neutralisation of Factor Xa by antithrombin. Unlike heparin, fondaparinux does not inactivate thrombin. In addition, fondaparinux does not inhibit Factor Xa bound in the prothrombinase complex and therefore does not completely inhibit Factor Xa. Long-term use is limited by the requirement of subcutaneous injection.17, 105
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Find out more about enoxaparin, enoxaparin sodium
, and fondaparinux.
See also: Apixaban
See also: Coagulation
- 96 - Haines S, Racine E, Zeolla M. Venous thromboembolism. In: DiPiro J, Talbert R, Yee G, Matzke G, Wells G, Posey L, eds. Pharmacotherapy: A Pathophysiologic Approach. 5th ed. New York, NY: McGraw-Hill Companies, Inc.; 2002:337-373.
- 100 - Mueller RL, Scheidt S. History of drugs for thrombotic disease. Discovery, development, and directions for the future. Circulation. 1994;89(1):432-449.
- 101 - Hirsh J, Bauer KA, Donati MB, Gould M, Samama MM, and Weitz JI. Parenteral Anticoagulants: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition) Chest. 2008;133(6)(suppl): 141S–159S.
- 102 - Bick RL, Frenkel EP, Walenga J, Fareed J, Hoppensteadt DA. Unfractionated heparin, low molecular weight heparins, and pentasaccharide: basic mechanism of actions, pharmacology, and clinical use. Hematol Oncol Clin North Am. 2005;19(1):1-51, v.
- 17 - Turpie AG. Oral, direct factor Xa inhibitors in development for the prevention and treatment of thromboembolic diseases. Arterioscler Thromb Vasc Biol. 2007;27(6):1238-1247.
- 105 - Weitz JI, Bates SM. New anticoagulants. J Thromb Haemost. 2005;3(8):1843-1853.
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