fondaparinux + bivalirudin + unfractionated heparin

This is a combination of three anticoagulant drugs—fondaparinux, bivalirudin, and unfractionated heparin—used in the management of thrombotic disorders, particularly in acute coronary syndromes and during percutaneous coronary intervention (PCI). Fondaparinux is a synthetic pentasaccharide that acts as an indirect factor Xa inhibitor by binding to antithrombin III and enhancing its ability to inhibit factor Xa. Bivalirudin is a direct thrombin inhibitor that binds specifically to both circulating and clot-bound thrombin. Unfractionated heparin acts by potentiating antithrombin III activity, leading to inhibition of both factor Xa and thrombin. The combination may be considered in complex clinical scenarios where multiple pathways of coagulation need to be targeted or when there are concerns about catheter thrombosis or bleeding risk[1][4][5][6][8].

Brand names

Arixtra (fondaparinux)

Other names

natural heparin pentasaccharide (fondaparinux)