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Table 1 Comparison of UFH, LMWHs and fondaparinux

From: Platelet factor 4 polyanion immune complexes: heparin induced thrombocytopenia and vaccine-induced immune thrombotic thrombocytopenia

Anticoagulation therapy

UFH

LMWH

Fondaparinux

Nomenclature

Unfractionated heparin

Two LMWHs based formulation (1) dalteparin (Fragmin®) and (2) enoxaparin (Lovenox®)

Fondaparinux (Arixtra®)

Mechanism of action

Bind to AT and increases the affinity of AT to bind and inactivate both Fxa and thrombin

Bind to AT and increases the affinity of AT to bind and inactivate Fxa.

The effect on inactivation of thrombin is relatively less.

Bind to AT and increases the affinity of AT to bind and inactivate Fxa.

Half life

60–120 min

(4–7 h) Enoxaparin

2–5 (dalteparin)

17–21 h

Neutralization with protamine sulfate

Yes

Yes

-NA-

Clearance

Hepatic & Reticulo-endothelial system No renal adjustments

Renal

Renal

Ability to cause HIT

Yes

Yes

Low; Cases reported