Table 4.

Comparative properties of unfractionated heparin, low molecular weight heparins (LMWH), and fondaparinux.

Unfractionated HeparinLMWHFondaparinux
Source Animal Animal Synthetic 
Structure Heterogeneous Heterogeneous Homogeneous 
Targets Multiple Multiple Single (factor Xa) 
Pharmacologic Effect Activity expressed as IU (anti-Xa = anti-IIa) Activity expressed as IU (anti-Xa > anti-IIa) Activity expressed gravimetrically as μg or μmol 
Administration Intravenously or two to three times daily, subcutaneously One to two times daily subcutaneously Once daily subcutaneously 
HIT Response — ~80% crossreactivity with heparin-induced thrombocytopenia (HIT) antibodies No crossreactivity with HIT antibodies 
Bioavailability Variable High High 
Half-life Dose-dependent ~1–1.5 hours (IV) ~4 hours ~17 hours 
Mode of Excretion Reticuloendothelial, urinary Urinary Urinary 
Antidote Protamine sulfate Protamine sulfate (partial neutralization) None 
Unfractionated HeparinLMWHFondaparinux
Source Animal Animal Synthetic 
Structure Heterogeneous Heterogeneous Homogeneous 
Targets Multiple Multiple Single (factor Xa) 
Pharmacologic Effect Activity expressed as IU (anti-Xa = anti-IIa) Activity expressed as IU (anti-Xa > anti-IIa) Activity expressed gravimetrically as μg or μmol 
Administration Intravenously or two to three times daily, subcutaneously One to two times daily subcutaneously Once daily subcutaneously 
HIT Response — ~80% crossreactivity with heparin-induced thrombocytopenia (HIT) antibodies No crossreactivity with HIT antibodies 
Bioavailability Variable High High 
Half-life Dose-dependent ~1–1.5 hours (IV) ~4 hours ~17 hours 
Mode of Excretion Reticuloendothelial, urinary Urinary Urinary 
Antidote Protamine sulfate Protamine sulfate (partial neutralization) None 

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