fondaparinux

If you miss a dose, use it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.

This medicine comes with a Patient Information Leaflet. Read it carefully. Learn all preparation and usage instructions in the product package. Ask your doctor, nurse, or pharmacist any questions that you may have about this medicine. Before injecting each dose, clean the injection site with rubbing alcohol. It is important to change the location of the injection site daily to avoid problem areas under the skin. Before using, check this product visually for particles or discoloration. If either is present, do not use the liquid. Do not mix any other medication in the same injection. Inject this medication under the skin of the stomach/abdomen, usually once daily or as directed by your doctor. Do not inject into a muscle. To lower the risk of bruising, do not rub the injection site after a shot. When treating a blood clot, another "blood thinner" (warfarin) is usually started within 3 days after you start using fondaparinux. Your doctor will direct you to use both of these medications until the warfarin is working well. Do not stop either of these medications until your doctor directs you to stop. To prevent blood clots due to surgery, your doctor may direct you to start using this medication (usually 6 to 8 hours after surgery) and continue for several days. Follow your doctor's directions closely. Starting this medication too soon after surgery may increase the risk of serious bleeding. Use this medication regularly to get the most benefit from it. To help you remember, use it at the same time each day. Dosage and length of treatment are based on your medical condition and response to treatment. Dosage may also be based on your weight. Learn how to store and discard needles and medical supplies safely. Consult your pharmacist.

See also Warning section. Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor or pharmacist first. This drug should not be used with the following medication because a very serious interaction may occur: mifepristone. If you are currently using this medication, tell your doctor or pharmacist before starting fondaparinux. Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially of: "blood thinners"/anti-platelet drugs (e.g., dipyridamole, ticlopidine), salicylates/nonsteroidal anti-inflammatory drugs-NSAIDs (e.g., aspirin, ibuprofen, ketorolac), sulfinpyrazone. Check all prescription and nonprescription medicine labels carefully since many medications contain pain relievers/fever reducers (NSAIDs such as ibuprofen, naproxen, or aspirin). Ask your pharmacist about using those products safely. Low-dose aspirin should be continued if it has been prescribed by your doctor for specific medical reasons such as heart attack or stroke prevention (usually at dosages of 81-325 milligrams per day). Consult your doctor or pharmacist for more details. This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist.

Your condition can cause complications in a medical emergency. For information about enrolling in MedicAlert, call 1-800-854-1166 (USA) or 1-800-668-1507 (Canada).

Do not share this medication with others. Laboratory and/or medical tests (e.g., complete blood count, kidney function tests, tests to check for blood in the stool) should be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.

If overdose is suspected, contact your local poison control center or emergency room immediately. US residents can call the US National Poison Hotline at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: uncontrolled bleeding.

See also Warning section. Before using fondaparinux, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients (such as dry natural rubber/latex in the needle cover on the prefilled syringe), which can cause allergic reactions or other problems. Talk to your pharmacist for more details. This medication should not be used if you have certain medical conditions. Before using fondaparinux, tell your doctor or pharmacist if you have: infection in the heart (bacterial endocarditis), severe kidney disease, current serious bleeding (e.g., bleeding ulcer), low platelet count because of antiplatelet antibody. Before using fondaparinux, tell your doctor or pharmacist your medical history, especially of: bleeding/blood problems (e.g., low blood count/platelets), a past blood-clotting problem because of heparin (heparin-induced thrombocytopenia), certain eye problem (diabetic retinopathy), high blood pressure, kidney disease, seizures, stomach/intestinal problems (e.g., recent ulcers, colitis), stroke, recent spinal procedures or puncture, spine problems (such as spinal deformity), recent surgery (especially on the eye, brain, or spine), low body weight (less than 50 kilograms/110 pounds). Before having surgery, tell your doctor or dentist that you are using this medication. This medicine may cause stomach bleeding. Daily use of alcohol while using this medicine may increase your risk for stomach bleeding. To lower the chance of getting cut, bruised, or injured, use caution with sharp objects like safety razors and nail cutters, and avoid activities such as contact sports. Kidney function declines as you grow older. This medication is removed by the kidneys. Therefore, elderly people may be at greater risk for bleeding while using this drug. During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor. If you become pregnant or think you may be pregnant, tell your doctor immediately. It is not known whether this drug passes into breast milk. Consult your doctor before breast-feeding.

Store at room temperature at 77 degrees F (25 degrees C) away from light and moisture. Brief storage between 59-86 degrees F (15-30 degrees C) is permitted. Do not store in the bathroom. Keep all medicines away from children and pets. Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

Pain, bruising, redness, and swelling at the injection site may occur. Headache, nausea, vomiting, swelling of the hands/feet, or fever may also occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly. Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects. Tell your doctor immediately if any of these unlikely but serious side effects occur: easy bleeding/bruising. This medication may rarely cause serious bleeding. (See also Warning section.) Tell your doctor immediately if any signs of serious bleeding occur, including: shortness of breath, coughing up blood, chest pain, cold/blue fingers or toes, unusual dizziness, fainting, fast/irregular heartbeat, joint/muscle pain, mental/mood changes (e.g., confusion), numbness/tingling, severe stomach/abdominal pain, bloody/black/tarry stool, red/pinkish urine, vomit that looks like coffee grounds. Tell your doctor immediately if any of these rare but very serious side effects occur: dark urine, yellow eyes/skin. Seek immediate medical attention if any of these rare but very serious side effects occur: vision problems, weakness on one side of the body, slurred speech, seizures, difficulty moving, severe/persistent headache. A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing. This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist. In the US - Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Tell your doctor you use/have used fondaparinux before having any procedures involving puncture of the spine or needles left in the spine to give pain-blocking medication (including lumbar punctures, indwelling spinal/epidural catheters). Also, before starting fondaparinux, tell your doctor if you have had any of these procedures. Using this medication before/after these procedures has rarely caused severe bruising/bleeding in the area of the spine (epidural/spinal hematoma). This effect may cause paralysis that may be permanent. Discuss the risks and benefits of treatment with your doctor. Tell your doctor immediately if you have any of these serious side effects: back pain, tingling, weakness, numbness, or difficulty urinating. (See also Precautions section.) This risk is increased the longer the needles are left in the spine or the more often these spinal puncture procedures are done. Using other "blood-thinning" or anti-platelet medications such as aspirin, clopidogrel, or warfarin, or nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen, also increases the risk. Do not stop taking any prescribed medication without first consulting your doctor. Your doctor will monitor you closely while you are using this medication.