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lüll Review of fondaparinux sodium injection for the prevention of venous thromboembolism in patients undergoing surgery Bergqvist DVasc Health Risk Manag 2006[]; 2 (4): 365-70The antithrombin binding sequence of heparin, a pentasaccharide, has been synthesized as fondaparinux, an indirect, selective, and reversible factor Xa inhibitor. It can be administered subcutaneously, is well absorbed, and has a half-life of c. 17 hours permitting once-daily injection. It has been evaluated in an extensive study program in major orthopedic surgery, including hip fracture, and in major abdominal surgery with a large proportion of surgery for cancer. The effect is at least as effective as for low-molecular-weight heparins and it has also been shown effective for extended prophylaxis in hip fracture patients. Several thousands of patients have been studied and the substance is safe, although a slightly higher frequency of bleedings is found than in patients on low-molecular-weight heparins. There is no specific antidote but if necessary, recombinant activated factor VII can be used. Other side-effects are rare. Fondaparinux is cost saving and sometimes cost neutral when compared with enoxaparin.|Abdomen/surgery[MESH]|Anticoagulants/administration & dosage/adverse effects/economics/*therapeutic use[MESH]|Cost-Benefit Analysis[MESH]|Drug Costs[MESH]|Factor Xa Inhibitors[MESH]|Fondaparinux[MESH]|Hemorrhage/chemically induced[MESH]|Heparin, Low-Molecular-Weight/therapeutic use[MESH]|Humans[MESH]|Injections, Subcutaneous[MESH]|Orthopedic Procedures/adverse effects[MESH]|Polysaccharides/administration & dosage/adverse effects/economics/*therapeutic use[MESH]|Surgical Procedures, Operative/*adverse effects[MESH]|Thromboembolism/etiology/*prevention & control[MESH]|Treatment Outcome[MESH]|Venous Thrombosis/etiology/*prevention & control[MESH] |