Special instructions for use / side effects
Due to the increased risk of bleeding and the kidney dysfunctions that increase with age, treatment of older patients (over 75 years of age) should be carried out with caution. Arixtra® must also not be used in children and adolescents under 17 years of age. Patients with a low body weight (<50 kilograms body weight) and patients with congenital or acquired coagulation disorders also have a higher risk of bleeding and should be treated with great care.
For patients with known renal dysfunction, creatinine clearance is an important parameter for assessing the risk of possible bleeding. At a creatinine clearance of 20-50 ml/min, Arixtra® 1.5 mg should be used with caution and a creatinine clearance < 20 ml/min completely excludes the use of the drug (contraindication). In the case of a severe liver dysfunction the active ingredient Fondaparinux should be used with caution, as there is also an increased risk of bleeding for the patient. During pregnancy or while breast-feeding, medication with Arixtra® should not be used if at all possible, as there is insufficient experience with this.
Interactions with other drugs
Various drugs that increase the risk of bleeding should not be administered together with Arixtra®. These should be mentioned in this context: Non-steroidal painkillers with anti-inflammatory effects and platelet aggregation inhibitors such as: should only be administered together with Arixtra® under strict control. If the patient switches to oral anticoagulants such as Marcumar, the therapy with Arixtra® should only be terminated once the patient’s INR has been correctly adjusted.
- Fibrinolytics (e.g. urokinase, streptokinase) or
- GP IIb/IIIa receptor antagonists (e.g. Abciximab, Tirofiban). – Clopidogrel
- Acetylsalicylic acid
Arixtra® should not be used if the active ingredient fondaparinux or any of its components is known to cause hypersensitivity in the patient. In addition, treatment with Arixtra® should not be attempted in the case of current bleeding, a bacterial infection of the inner skin of the heart (endocarditis) or a severe kidney dysfunction (creatinine clearance <20ml/min).
- Unfractionated heparin