Two medicines, side by side
Fondaparinux vs enoxaparin
Fondaparinux and enoxaparin are both labeled for blood clots (DVT and PE). Drugs@FDA records approvals of fondaparinux since 2001 and of enoxaparin since 1993. Pharmacies paid $44.82 per mL (Fondaparinux 10 mg/0.8 mL syringe) and $6.45 per mL (Enoxaparin 100 mg/mL syringe) (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like. In FDA's classes, fondaparinux is a factor xa inhibitor and enoxaparin a low molecular weight heparin.
Check it at the source: the fondaparinux FDA label on DailyMed (effective December 15, 2024); the enoxaparin FDA label on DailyMed (effective May 28, 2026).
Highlights of the fondaparinux record
Fondaparinux (Arixtra) · label of December 15, 2024
SPINAL/EPIDURAL HEMATOMAS Epidural or spinal hematomas may occur in patients who are anticoagulated with low molecular weight heparins (LMWH), heparinoids, or fondaparinux sodium and are receiving neuraxial anesthesia or undergoing spinal puncture. These hematomas may result in long-term or permanent paralysis. Consider these risks when scheduling patients for spinal procedures.
Used for
From the label: indicationsFondaparinux sodium injection is a Factor Xa inhibitor (anticoagulant) indicated for: • Prophylaxis of deep vein thrombosis (DVT) in adult patients undergoing hip fracture surgery (including extended prophylaxis), hip replacement surgery, knee replacement surgery, or abdominal surgery. ( 1.1 ) • Treatment of DVT or acute pulmonary embolism (PE) in adult patients when administered in conjunction with warfarin sodium. […]
On the market
- Earliest approval on file
- December 7, 2001
- Generic labelers
- 5 labelers
- Pharmacy cost
- $44.82 per mL
Supply and safety
- Shortage
- No current entry
- Recalls
- 1
Highlights of the enoxaparin record
Enoxaparin (Lovenox) · label of May 28, 2026
SPINAL/EPIDURAL HEMATOMAS Epidural or spinal hematomas may occur in patients who are anticoagulated with low molecular weight heparins (LMWH) or heparinoids and are receiving neuraxial anesthesia or undergoing spinal puncture. These hematomas may result in long-term or permanent paralysis. Consider these risks when scheduling patients for spinal procedures.
Used for
From the label: indicationsLovenox is a low molecular weight heparin (LMWH) indicated for: Prophylaxis of deep vein thrombosis (DVT) in abdominal surgery, hip replacement surgery, knee replacement surgery, or medical patients with severely restricted mobility during acute illness ( 1.1 ) Inpatient treatment of acute DVT with or without pulmonary embolism ( 1.2 ) Outpatient treatment of acute DVT without pulmonary embolism ( 1.2 ) Prophylaxis […]
On the market
- Earliest approval on file
- March 29, 1993
- Generic labelers
- 16 labelers
- Pharmacy cost
- $6.45 per mL
Supply and safety
- Shortage
- No current entry
- Recalls
- 6
Source: FDA drug labels via openFDA (Fondaparinux label of December 15, 2024, Enoxaparin label of May 28, 2026); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do fondaparinux and enoxaparin differ on the record?
In FDA's classes, fondaparinux is a factor xa inhibitor and enoxaparin a low molecular weight heparin.
How each works, in its label's words: Fondaparinux, “The antithrombotic activity of fondaparinux sodium is the result of antithrombin III (ATIII)-mediated selective inhibition of Factor Xa.”; Enoxaparin, “Enoxaparin is a low molecular weight heparin which has antithrombotic properties.”
Half-life, in each label's words: Fondaparinux, “The elimination half-life is 17 hours to 21 hours.”; Enoxaparin, “Elimination half-life based on anti-Factor Xa activity was 4.5 hours after a single subcutaneous dose to about 7 hours …”
Both labels carry a boxed warning; the records quote them.
Generics: fondaparinux since 2011; enoxaparin since 2010 (Drugs@FDA).
| Fondaparinux | Enoxaparin | |
|---|---|---|
| Labeled for | Blood clots (DVT and PE) | Angina, Heart attack and coronary artery disease, Blood clots (DVT and PE) |
| Pharmacologic class | Factor Xa Inhibitor | Low Molecular Weight Heparin |
| How it works (label) | The antithrombotic activity of fondaparinux sodium is the result of antithrombin III (ATIII)-mediated selective inhibition of Factor Xa. | Enoxaparin is a low molecular weight heparin which has antithrombotic properties. |
| Half-life (label) | The elimination half-life is 17 hours to 21 hours. | Elimination half-life based on anti-Factor Xa activity was 4.5 hours after a single subcutaneous dose to about 7 hours after repeated dosing. |
| Earliest approval on file (Drugs@FDA) | December 7, 2001 | March 29, 1993 |
| First generic approved | July 11, 2011 | July 23, 2010 |
| Generic labelers (NDC) | 5 labelers | 16 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $44.82 per mL (Fondaparinux 10 mg/0.8 mL syringe) | $6.45 per mL (Enoxaparin 100 mg/mL syringe) |
| 12-month price change | +41% | -26% |
| Boxed warning | Yes | Yes |
| Shortage now | No current entry | No current entry |
| Recalls recorded | 1 | 6 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 8,047 | 57,205 |
| DEA schedule | none | none |
Source: Drugs@FDA, FDA NDC Directory, CMS NADAC of October 7, 2026, FDA shortages and recalls, FAERS via openFDA (FDA files October 8, 2026)
What next?
- Alternatives to fondaparinux
- every medicine labeled for the same conditions