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Pharmacy 2017, 5(1), 1; doi:10.3390/pharmacy5010001

Fondaparinux Outpatient Use for Patients with a Heparin-Induced Thrombocytopenia History: A Case Report and Review

Anticoagulation Clinic, St. Elizabeth Healthcare, 1 Medical Village Drive, Edgewood, KY 41017, USA
Academic Editor: Yvonne Perrie
Received: 1 December 2016 / Revised: 5 December 2016 / Accepted: 16 December 2016 / Published: 22 December 2016
View Full-Text   |   Download PDF [177 KB, uploaded 22 December 2016]

Abstract

The purpose of this article is to report a case of fondaparinux outpatient utilization for anticoagulation in a patient with a past medical history of heparin-induced thrombocytopenia (HIT) and discuss the options and need for future anticoagulation research in this unique patient population. A 63-year-old Caucasian female with a previous medical history of HIT thromboprophylaxed with warfarin for a pulmonary embolism presented to an anticoagulation clinic with a subtherapeutic international normalized ratio (INR) after missed warfarin doses. The patient was instructed to increase her warfarin dose and was prescribed fondaparinux daily injections until her INR was in range. The patient tolerated the fondaparinux therapy without thromboembolic, thrombocytopenia or bleeding occurrence. Fondaparinux therapy for HIT is controversial and differs between established guidelines. Currently, there is no studied use of fondaparinux for thromboprophylaxis in warfarin therapy outpatients with a HIT history who need thromboprophylaxis while undergoing therapy for a procedure, or those who have a subtherapeutic INR. Further study of the outpatient use of fondaparinux for this patient subset is needed to explore the potential benefit of an outpatient, less invasive, less expensive and potentially better tolerated option. View Full-Text
Keywords: anticoagulation; heparin-induced thrombocytopenia; factor-Xa inhibitors; novel oral anticoagulants; warfarin; periprocedural anticoagulation; subtherapeutic anticoagulation anticoagulation; heparin-induced thrombocytopenia; factor-Xa inhibitors; novel oral anticoagulants; warfarin; periprocedural anticoagulation; subtherapeutic anticoagulation
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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Christopher, A. Fondaparinux Outpatient Use for Patients with a Heparin-Induced Thrombocytopenia History: A Case Report and Review. Pharmacy 2017, 5, 1.

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