Fondaparinux

DB00569ApprovedInvestigationalSmall moleculeFactor Xa Inhibitors

Fondaparinux is an anticoagulant used to prevent venous thromboembolism, to treat deep vein thrombosis, and to improve survival following myocardial infarction. Fondaparinux (Arixtra) is a synthetic anticoagulant agent consisting of five monomeric sugar units and a O-methyl group at the reducing end of the molecule.

Mechanism: The antithrombotic activity of fondaparinux is the result of ATIII-mediated selective inhibition of Factor Xa. By selectively binding to ATIII, Fondaparinux potentiates (about 300 times) the neutralization of Factor Xa by ATIII. Neutralization of Factor Xa interrupts the blood coagulation cascade and thus inhibits thrombin formation and thrombus development. It is thought that fondaparinux is unlikely to induce thrombocytopenia via a heparin-induced thrombocytopenia (HIT)-like mechanism given its chemical structure. As a result, fondaparinux has been used as an alternative anticoagulant in heparin-induced thrombocytopenia (HIT) patients. However, it is important to note that rare cases of HIT have been reported in patients treated with fondaparinux.
Curator reviewed · 6 references
Primary indication: Approved for: (1) prophylaxis of VTE for up to one month post surgery in patients undergoing orthopedic surgery of the lower limbs such as hip fracture, hip replacement and knee surgery; (2) prophylaxis of VTE...Curator reviewed · 10 structured indications
Formula / weight: C₃₁H₅₃N₃O₄₉S₈ · 1508.263 g/mol (avg)
First approval: Canada, 2013 · United States, 2001 · European Union, 2016
Also known as: Natural heparin pentasaccharide
Brand names: Arixtra

Resolves to

Compound

UNIIJ177FOW5JLCAS104993-28-4ChEMBLCHEMBL1201202ChEBI61033PubChem49852292

Clinical / RWD

RxNorm321208ATCB01AX05PharmGKBPA164746297

Structure

InChIKeyKANJSNBRCNMZMV-ABRZTLGGSA-NSMILES

CO[C@H]1O[C@H](COS(O)(=O)=O)[C@@H](O[C@@H]2O[C@H]([C@@H](O[C@H]3O[C@H](COS(O)(=O)=O)[C@@H](O[C@@H]4O[C@@H]([C@@H](O[C@H]5O[C@H](COS(O)(=O)=O)[C@@H](O)[C@H](O)[C@H]5NS(O)(=O)=O)[C@H](O)[C@H]4O)C(O)=O)[C@H](OS(O)(=O)=O)[C@H]3NS(O)(=O)=O)[C@H](O)[C@H]2OS(O)(=O)=O)C(O)=O)[C@H](O)[C@H]1NS(O)(=O)=O

Targets

P00742F10P01008SERPINC1

What you can answer from here — as of September 23, 2026

2Protein targetsEach mapped to UniProt, with action and pharmacological action

Listed above

1,408Drug interactionsStructured to mechanism, not free text

62Clinical trialsPhase, status and sponsor resolved per trial

10Structured indicationsCondition, population, route and combination as fields, not prose

5ContraindicationsEach with its own population and attribute set

147Marketed productsAcross 10 countries and 21 labellers

1ATC codeIncluding every combination product, plus 18 drug categories

36+ReferencesStructured and connected to the statements they support

Which drugs share a target with Fondaparinux, and which of those have an active Phase 3 trial?

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