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Public limited (LSE: GSK NYSE: GSK) Pharmaceutical
2000, by merger of Glaxo Wellcome and SmithKline Beecham London, United Kingdom Chris Gent, Chairman Andrew Witty, Chief Executive £28.392 billion(2010) 99,000 (2009) www.gsk.com
Headquarters Key people Revenue Employees Website
GlaxoSmithKline plc (LSE: GSKNYSE: GSK), often abbreviated to GSK, is a global pharmaceutical, biologics, vaccines and consumer healthcare company headquartered in London, United Kingdom. It is the world's third largest pharmaceutical company measured by revenues (after Johnson & Johnson and Pfizer). It has a portfolio of products for major disease areas includingasthma, cancer, virus control, infections, mental health, diabetes and digestive conditions. It also has a large consumer healthcare division which produces and markets oral healthcare products, nutritional drinks and over-the-counter medicines, including Sensodyne, Horlicks and Gaviscon.Its primary listing is on the London Stock Exchange and it is a constituent of the FTSE 100 Index. It has a secondary listing on the New York Stock Exchange.
GlaxoWellcome In 1880.History Former GlaxoSmithKline building inHamburg. The Wellcome Company production centre was moved from New York to North Carolina in 1970 and the following year another research centre was built. In 1959 the Wellcome Company bought Cooper. and SmithKlineBeecham plc (from the merger of Beecham plc. to become more active in animal health. Germany GSK was formed in 2000 by the merger of GlaxoWellcome plc (formed from the acquisition of Wellcome plc by Glaxo plc). Originally Glaxo was a baby food manufacturer processing local milk into a baby food by the same name: the product was sold in the 1930s under the slogan "Glaxo builds bonny babies". New Zealand in 1904. Still visible on the main street of Bunnythorpe is a derelict dairy factory (factory for drying and processing cows' milk into powder) with the original Glaxo logo clearly visible. McDougall & Robertson Inc. and SmithKline Beckman Corporation). Glaxo was founded in Bunnythorpe. . Burroughs Wellcome & Company was founded in London by American pharmacists Henry Wellcome and Silas Burroughs. but nothing to indicate that this was the start of a major multinational company. The Wellcome Tropical Research Laboratories opened in 1902.
In 1983 the American arm Glaxo Inc. Beechams opened its first factory in St Helens. In 1988. It changed its name to Smith Kline & French Laboratories as it focused more on research in 1929. became Smith. The Company merged with Beckman Inc. Subsequently. International Clinical Laboratories. Kline & Co. it merged with French. The Company started to expand globally buying seven laboratories in Canada and the US in 1969. After the Company bought Meyer Laboratories in 1978. and opened new units in London in 1935. Richard and Company. GlaxoWellcome opened its Medicine Research Centre in Stevenage. Smith opened its first pharmacy in Philadelphia. a business doing research into animal health. in 1947 and 1958 respectively. Three years later GlaxoWellcome bought Polfa Poznan Company in Poland. SmithKline Beckman bought its biggest competitor. a manufacturer of eye and skincare products. Years later. and in 1989 merged with Beecham to form SmithKline Beecham plc. Glaxo Laboratories bought two companies. By the 1960s it was extensively involved in pharmaceuticals. Burroughs Wellcome and Glaxo merged in 1995 to form GlaxoWellcome. In 1982. later that year and then changed its name to SmithKline Beckman. Lancashire. In the same year. Thomas Beecham launched his Beecham's Pills laxative in England giving birth to the Beecham Group. it bought Allergan. Smith Kline & French Laboratories bought Recherche et Industrie Thérapeutiques (Belgium) in 1963 to order to focus on vaccines. England for rapid production of medicines in 1859. In 1865 Mahlon Kline joined the business which. The GSK Headquarters in Brentford In 1830. it started to play an important role in the US market. The headquarters of the Company were then moved to England. Joseph Nathan and Allen & Hanburys. SmithKline Beecham In 1843. To expand research & . moved to Research Triangle Park (US headquarters/research) and Zebulon (US manufacturing) in North Carolina. 10 years later. it then bought Norden Laboratories. Smith Kline & French Laboratories opened a new laboratory in Philadelphia.Glaxo became Glaxo Laboratories. in 1891. John K.
Products The company's products include: Advair Ceftin Levitra Sensodyne . Another new research centre at New Frontiers Science Park in Harlow was opened in 1997.000 in sales and marketing. In December 2010. The single largest market is in the United States (approximately 45% of revenue). with its United States headquarters based in Research Triangle Park (RTP) in North Carolina and its consumer products division based in the Pittsburgh suburb of Moon Township. In June 2010. the company had sales of £22. subsidiary) would join the four vaccines approved on 15 September. Glaxo GlaxoSmithKline. for a cash consideration of approximately $253m. according to GSK website. The company's stock is listed on the London stock exchange and ADRs are listed on the NYSE. Operations As the second largest pharmaceutical company in the world. Philadelphia and Research Triangle Park (RTP) in North Carolina.7 billion and made a profit of £7. an Argentine pharmaceutical company focused on the development. marketing and sale of branded generic products. Wellcome and SmithKline Beecham merged to form Recent developments In 2001 it completed its purchase of New Jersey-based Block Drug. Pennsylvania.development in the US. The research and development division has major headquarters in South East England. United Kingdom. including over 40. based on net income. In November 2009 GlaxoSmithKline formed a joint venture with Pfizer to create ViiV Healthcare.8 billion in 2007. In 2000. London. Its global headquarters are GSK House in Brentford. GSK announced its acquisition of the sports nutrition company Maxinutrition. SmithKline Beecham bought a new research center in 1995.000 people worldwide. Viiv Healthcare received all of Pfizer and GlaxoSmithKline's HIV assets. On 16 November 2009 the US Food and Drug Administration (FDA) announced that a vaccine for 2009 H1N1 influenza protection (manufactured by GSK's ID Biomedical Corp. although the company has a presence in almost 70 countries. ViiV Healthcare is 85% owned by GlaxoSmithKline and 15% owned by Pfizer. It employs over 90. the company acquired Laboratorios Phoenix.
Jean-Pierre (JP) Garnier. former CEO of GlaxoSmithKline has said. We remain committed to donating as much albendazole as required to .659 Parodontax GW 501516 Paxil Horlicks Promacta Imitrex Ralgex Keppra Relenza Lamictal Requip Lanoxin Ribena Serlipet Setlers SKF 38393 SKF 82958 Tagamet Treximet Tums Trizivir Tykerb Valtrex Ventolin HFA Veramyst Vesicare Wellbutrin Zantac Zofran Zovirax Initiatives to eradicate disease Glaxo SmithKline has been active in a global alliance to eliminate lymphatic filariasis.Lovaza Albenza Alli Amerge Amoxil Aquafresh Arixtra Arranon Augmentin Avandia Avodart BC Powder Beano Beconase Biotene Boniva Boost Coreg Lucozade Coreg CR Macleans Dexedrine Nicoderm Flixonase Nicorette Geritol NiQuitin Gly-Oxide Pandemrix Goody's Powder Panadol GSK-189. “The Egyptian data shows that we can now eliminate a disease that has plagued the world for centuries.254 Panadol night GSK-873140 Parnate GW-320.
” In addition Glaxo has been short-listed for awards such as the Worldaware Business Award for its work to eliminate malaria in Kenya. Quebec and Upper Merion and Collegeville. Zagreb. GlaxoSmithKline recently donated money to the British flood appeal. Pennsylvania suburb Major R&D sites in Stockley Park. Evreux and Les Ulis in France. and was ranked first on the 2006 UK Corporate Citizenship Index for donations. Canada (Quebec. North Carolina. Laval. North Carolina. Pennsylvania Major centre for biopharmaceutical products in Belgium (Wavre and Rixensart). USA . India and Nashik. Germany (Dresden). Croatia. China and Boston. Consumer Products of Pittsburgh headquarters in Moon Township. India R&D centres in Shanghai. Stevenage and Ware in the United Kingdom. Global locations Factory in Ulverston An entrance to the Ulverston plant Global Pharmaceutical Operations headquarters in Brentford.eliminate this disabling disease. Research Triangle Park. QC) and USA (Marietta PA & Hamilton MT) New R&D centres in Thane. United Kingdom with US operations based in Research Triangle Park. but ultimate success will depend on continued longterm commitments by all partners across the globe.
Bristol. and Kenya GSK has a presence in 99 cities across 39 countries Corporate governance Current members of the board of directors of GlaxoSmithKline are: • • • • • • • • • • • • Sir Christopher Gent (Non-Executive Chairman). Crawley. Italy. Mr Witty himself has seen his pay increase by 76% over the last year. has taken up the position in May 2008 and joined the Board. Sir Crispin Davis (Non-Executive Director). Cork. Barnard Castle. an annual report card of corporate America's treatment of gay. Montrose. Singapore. King of Prussia and Zebulon in the United States. Dungarvan. lesbian. Mississauga. Ontario. Cidra. South Carolina. Romania. Ware. Ireland. Executive Director). France. Brasov. GSK also received a perfect score of 100 percent from the Human Rights Campaign Foundation's 2008 Corporate Equality Index. Moncef Slaoui (Chairman. New Jersey. Lawrence Culp (Non-Executive Director). Executive Director). Ireland. and transgender (GLBT) . Dr Ronaldo Schmitz (Non-Executive Director). Poland. and St. Although job losses have been widespread in the company. Aiken. Dr Stephanie Burns (Non-Executive Director). Executive Director. Research & Development). Jurong. Dr Daniel Podolsky (Non-Executive Director). Louis. Sir Ian Prosser (Senior Independent Non-Executive Director). United Kingdom. Major manufacturing sites for consumer products in Maidenhead. Missouri. Australia. Diversity GlaxoSmithKline was named one of the 100 Best Companies for Working Mothers in 2007 by Working Mother magazine and was recognised by the International Charter for its efforts. Clifton. Julian Spenser Heslop (Chief Financial Officer. Andrew Witty (Chief Executive Officer. Boronia. Parma. Mr Witty. Robert Wilson (Non-Executive Director). Worthing and Ulverston in the United Kingdom. Puerto Rico. On 8 October 2007 it was announced that Dr Garnier would be succeeded as Chief Executive by Mr Andrew Witty. bisexual. 44. Evreux. Sir Deryck Maughan (Non-Executive Director).Poznań.Major manufacturing sites for prescription products in Irvine.
PTPN." At the AGM on 19 May 2003.S. causing minor damage. approximately 5.000 U. showed staff punching. This was the first time such a rebellion by shareholders against a major British company has occurred. even with older patients. AIDS Healthcare Foundation accused the company of boosting its short-term monopoly profit by not increasing production of the anti-AIDS drug AZT despite a surge in demand. There is as yet no proven link between SSRI's and actual suicide. warning of the risk for potential suicidal thinking in children and adolescents. HLS has been the subject since 1999 of an international campaign by Stop Huntingdon Animal Cruelty (SHAC) and the Animal Liberation Front (ALF). citizens have sued GSK. Paxil) is an SSRI antidepressant released in 1992 by GlaxoSmithKline. Since the FDA approved paroxetine in 1992. GLBT. kicking. but was regarded as a possible turning point against other so-called "fat cat" deals within executive pay structure. In November 2005. On 29 January 2007. In November 2007. On 7 September 2005. a United States Congressional committee released a report describing intimidation of Dr John Buse (University of North Carolina at Chapel Hill by GlaxoSmithKline over his concerns about the cardiovascular risks associated with the company's antidiabetes drug Rosiglitazone (Avandia). The company and its shareholders have been targeted by animal rights activists because it is a customer of the controversial animal-testing company. JP Garnier. etc. the ALF detonated a bomb containing two litres of fuel and four pounds of explosives on the doorstop of the Buckinghamshire home of Paul Blackburn. ever since footage shot covertly by People for the Ethical Treatment of Animals (PETA). GSK also supports employee diversity networks for groups such as ECN. In March 2006. GSK shareholders rejected a motion regarding a £22 million pay and benefits package for CEO. AAA.employees. hence creating a shortage that affected many . which was shown on British television. antitrust violations and frivolous litigation to maintain a monopoly and block generic versions from entering the market. customers and investors. In March 2004 the FDA ordered a black box warning placed on SSRI and other antidepressants. Huntingdon Life Sciences(HLS). California Attorney General Bill Lockyer announced that "GlaxoSmithKline (GSK) will pay $14 million to resolve allegations that stategovernment programs paid inflated prices for the firm’s anti-depressant drug Paxil because GSK engaged in patent fraud. and the addition of blackbox warning labels was said to be controversial But many recent analyses prove the link. GSK's corporate controller. Controversy Paroxetine (Seroxat. the BBC in the UK broadcast a fourth documentary in its 'Panorama' series about Seroxat. screaming and laughing at the animals in their care.
Department of Justice announced in October 2010 that GlaxoSmithKline would pay $150 million in criminal fines and $600 million in civil penalties. GSK announced that it had halted clinical trials of the CCR5 entry inhibitor. and nasal-allergy spray Flonase. "I wouldn't say that most drugs don't work. Legal In 2003 GSK signed a corporate integrity agreement and paid $88 million in a civil fine for overcharging Medicaid for the antidepressant Paxil. was attempting to 'sugar-coat' the adverse effects of Paxil on children by 'miscoding' suicidal ideations and/or suicidal behavior. On 26 August 2004. in HIV-infected. treatment-naive patients because of concerns about severe hepatotoxicity. Senator Charles Grassley. Later that year GSK also ran afoul of the Internal Revenue Service (IRS) and was facing a demand for $7. Food and Drug Administration (FDA) and other pharmaceutical companies had thus far been willing to make public. In June 2006 GSK said it was further cutting.AIDS patients in Africa. aplaviroc(GW873140). by about 30%. shortly before the settlement. stating that he was concerned that "some drug companies" may not have provided the FDA with all the information at their disposal.S. Allen Roses. admitted that most prescription medicines do not work on most people who take them." This part of the settlement was the main objective of the New York AG and Rose Firestein. His letter was spurred by statements earlier in 2008 by Dr. I would say that most drugs work in 30 to 50 per cent of people. "The vast majority of drugs – more than 90 per cent – only work in 30 or 50 per cent of the people. the highest in IRS history." The U. the not-for-profit prices it charges for some of these medicines in the world's poorest countries. In December 2003. both sides finally agreed to $2.5 million. New York State Attorney General Eliot Spitzer's office announced it had settled legal action against GlaxoSmithKline. On 3 August 2004. Puerto Rico. an FDA official. Attorney General Spitzer hailed the settlement as "transformational in that it will provide doctors and patients access to the clinical testing data necessary to make informed judgments. Andrew Mosholder. As for the monetary compensation.S." Dr Roses said." Glaxo officials never commented on . in his opinion. GlaxoSmithKline agreed to pay the $750 million settlement in response to criminal and civil complaints against the company stemming from production of improperly made and adulterated drugs at their subsidiary SB Pharmco Puerto Rico Inc in Cidra. who worked in the office of the AG and initially argued the case should be undertaken. a Republican senator from Iowa sent a letter to GSK. who had told senators at a 2 February 2004 hearing that "GlaxoSmithKline. the then worldwide vice-president of genetics at GlaxoSmithKline.8 billion in backdated taxes and interest. The settlement required GSK to post a registry which would include much more information about pretrial and clinical drug study results than what the U.
Food and Drug Administration published a new product warning about the drug." On 22 December 2006. The lawsuit stemmed from a consumer advocate protest against Paroxetine manufacturer GSK. In 2002... SmithKline Beecham Corp that individuals who purchased Paxil(R) or Paxil CR(TM) (paroxetine) for a minor child may be eligible for benefits under a $63. et al. approximately 5.S. citizens – and thousands more worldwide – have sued GSK. v. According to the Paxil Protest website. At issue in the case were Zantac and the other Glaxo Group heritage products sold from 1989–2005. The original Paxil Protest website was removed from the internet in 2006. GlaxoSmithKline's marketing of the drug stated falsely that it was "not habit forming". Since the FDA approved paroxetine in 1992. They are accused of paying bribes to Saddam Hussein's regime. generating about a tenth of their entire revenue. In February 2007. the U.. The case was about an area of taxation dealing with intracompany "transfer pricing"—determining the share of profit attributable to the US subsidiaries of GSK and subject to tax by the IRS.The British Medical Journal quoted Charles Medawar. It is understood that the action to take down the site was undertaken as part of a . and the International Federation of Pharmaceutical Manufacturers Associations (IFPMA) declared GSK guilty of misleading the public about paroxetine on US television. the BBC reported the World Health Organization had found paroxetine to have the hardest withdrawal problems of any antidepressant. head of Social Audit: "This drug has been promoted for years as safe and easy to discontinue. so how profits were allocated among various legacy Glaxo divisions based on the functions they performed was central to the dispute in this case. GlaxoSmithKline has evaded the issue since it was granted a licence for paroxetine over 10 years ago. On 12 September 2006 GSK settled the largest tax dispute in IRS history agreeing to pay $3. The fact that it can cause intolerable withdrawal symptoms of the kind that could lead to dependence is enormously important to patients.S. Paroxetine For the first 10 years of paroxetine's availability. hundreds more lawsuits have been filed against GSK. The company has been promoting paroxetine directly to consumers as 'nonhabit forming' for far too long. a US court decided in Hoorman. doctors.1 billion. Most of these people feel they were not sufficiently warned in advance of the drug's side effects and addictive properties.whether there was any connection between Senator Grassley's letter and their decision to pursue a settlement with the New York State attorney general's lawsuit. and the drug has become a blockbuster for them. the Serious Fraud Office in the UK launched an investigation into allegations of GSK being involved in the discredited oil-for-food sanctions regime in Iraq.8 million Proposed Settlement. investors. Taxes for large multi-divisional companies are paid to revenue authorities based on the profits reported in particular tax jurisdictions. and the company. In 2001.000 U.
confidentiality agreement or 'gagging order' which the owner of the site entered into as part of a settlement of his action against GlaxoSmithKline. Ribena On 27 March 2007. according to the Seroxat Secrets website. The commission's testing found that ready-to-drink Ribena contained no detectable vitamin C. or 44 per cent of the recommended daily intake. The charges related to a popular blackcurrant fruit drink Ribena which the company had led consumers to believe contained high levels of vitamin C.000 for the 15 charges. the national group litigation in the United Kingdom. Hugh James Solicitors have confirmed this news. the company accepted Commerce Commission allegations that claims that ready-todrink Ribena contained 7 mg of vitamin C per 100ml. The number of charges was reduced from 88 and covered a period from March 2002 to March 2006. GSK pleaded guilty in an Auckland District Court to 15 charges relating to misleading conduct brought against them under the Fair Trading Act by New Zealand'sCommerce Commission. As of 2008. The issue at the heart of this particular action claims Seroxat has a propensity to cause a withdrawal reaction. were incorrect. against GlaxoSmithKline plc. moved a step closer to the High Court in London. on behalf of several hundred people who allege withdrawal reactions through their use of the drug Seroxat. two 14year-old school girls (Anna Devathasan and Jenny Suo) from Pakuranga College in Auckland (New Zealand) discovered that ready-to-drink juice sold in 100ml containers contained very little vitamin C.org) In January 2007. In March 2008 the Medicines and Healthcare Products Regulatory Agency concluded that GSK should have warned of the possible ill effects of taking Seroxat a lot sooner. GSK maintains that it did not intend to mislead consumers and that the advertising claims were based on testing procedures that have since been changed. GlaxoSmithKline's prescribing information acknowledges that "serious discontinuation symptoms" may occur. GSK could not be prosecuted under the old legislation. It was ordered to run an advertising campaign to provide the facts after it admitted misleading the public about the vitamin C component in its Ribena drink. The company was fined $217. (However. Through its lawyer. in March 2007. the website Seroxat Secrets discovered that an archive of Paxil Protest sitewas still available on the internet via Archive. with the confirmation that Public Funding had been reinstated following a decision by the Public Interest Appeal Panel. Approaches by the two teens to the company didn't resolve the issue but after the matter was publicised on a national consumer affairs television show (Fair Go) the matter came to the attention of the Commerce Commission (a government funded 'consumer watch-dog'). The company also agreed television advertising claiming the blackcurrants in Ribena had four times the vitamin C of . Adam Ross. As part of a school science project.
the New York Times published an article detailing Nissen's conversation with pharmaceutical executives.The decision has received mixed reactions from medical charities. that is. but criticised GSK for failing to include HIV patents in their patent pool. encouraging other companies to follow suit. On February 2010 GlaxoSmithKline tried to suppress publishing of a critical article concerning rosiglitazone. More recently. it stops blood from clotting. Anticoagulant An anticoagulant is a substance that prevents coagulation.Médecins Sans Frontières welcomed the decision. These conversations were recorded unbeknownst to the GSK executives but are legal in the State of Ohio as long as one participating party is aware. This meta-analysis demonstrated an increased odds ratio of myocardial infarction in patients taking rosiglitazone marketed as Avandia.In July a US Finance Committee Letter accessed GSK of failing "to publish studies in a timely manner that found problems with Avandia". and for not including middle-income countries in the initiative. GSK head Andrew Witty announced that the company will cut drug prices by 25% in 50 of the poorest nations. release intellectual property rights for substances and processes relevant to neglected disease into a patent pool to encourage new drug development. Announced policy change In February 2009. Chair of the Division of Cardiovascular Medicine at the Cleveland Clinic in the New England Journal of Medicine. A group of pharmaceuticals called anticoagulants can be used in vivo as a . while literally true. were likely to mislead consumers about the relative levels of vitamin C in Ribena. a Congressional investigation has been initiated to determine what information was known at the time of the approval of rosiglitazone as well as post approval and whether or not GSK willfully suppressed such information. and invest 20% of profits from the least developed countries in medical infrastructure for those countries. Avandia On 14 June 2007. Currently.oranges. an article was published by Steve Nissen.
which blocks thrombin from clotting blood. It works by activating antithrombin III. not used medically Phenindione Heparin and derivative substances Heparin is a biological substance. As medications Anticoagulants reduce blood clotting. These oral anticoagulants are used widely as poisons for mammalian pests. especially if too much vitamin D is present. Heparin can be used in vivo (by injection). pulmonary embolism. myocardial infarction and stroke. see rodenticide and warfarin. especially rodents. blood transfusion bags. such as test tubes. Examples include warfarin. Some chemical compounds are used in medical equipment. and also in vitro to prevent blood or plasma clotting in or on medical devices.S. heparin must be given concomitantly.S. Where an immediate effect is required. and renal dialysis equipment. Vacutainer brand test tubes containing heparin are usually colored green.) Depletion of vitamin K by coumadin therapy increases risk of arterial calcification and heart valve calcification. and UK Acenocoumarol and phenprocoumon This is used more commonly outside the U. Low molecular weight heparin .medication forthrombotic disorders. and the UK Brodifacoum Rat poison. pulmonary embolism(PE). These anticoagulants are used to treat patients with deep-vein thrombosis (DVT). atrial fibrillation (AF). Coumadins (Vitamin K antagonists) These oral anticoagulants are a class of pharmaceuticals that antagonize the effects of vitamin K. Available agents Warfarin (Coumadin) This is the main agent used in the U. It takes at least 48 to 72 hours for the anticoagulant effect to develop. This prevents deep vein thrombosis. Adverse effects Patients aged 80 years or more may be especially susceptible to bleeding complications with a rate of 13 bleeds per 100 person-years. and mechanical prosthetic heart valves. usually made from pig intestines. (For details.
vomiting. It is a smaller molecule than low molecular weight heparin. Current members of this class include argatroban. Direct thrombin inhibitors Another type of anticoagulant is the direct thrombin inhibitor.ximelagatran (Exanta) was denied approval by the Food and Drug Administration (FDA) in September 2004 and was pulled from the market entirely in February 2006 after reports of severe liver damage and heart attacks. Food and Drug Administration was quoted as stating that at least 19 deaths were believed linked to a raw Heparin ingredient imported from the People's Republic of China. and dabigatran.S. Idraparinux Major pharmaceutical Heparin recall due to contamination In March 2008 major recalls of Heparin were announced by pharmaceuticals due to a suspected and unknown contamination of the raw Heparin stock imported from China. and that they had also received 785 reports of serious injuries associated with the drug’s use.Low molecular weight heparin is a more highly processed product that is useful as it does not require monitoring of the APTT coagulation parameter (it has more predictable plasma levels) and has fewer side effects. a toxin from a snake venom that clots platelet-rich plasma without affecting platelets functions (lyses fibrinogen). An oral direct thrombin inhibitor. The U. and more or less uses as drug candidates or diagnostics Batroxobin. excessive sweating and rapidly falling blood pressure that in some cases led to life-threatening shock'. nausea. According to the New York Times: 'Problems with heparin reported to the agency include difficulty breathing. Hementin is an anticoagulant protease from the salivary glands of Haementeria ghilianii Food supplements Food supplements with blood thinning effect include Nattokinase and Lumbrokinase . Synthetic pentasaccharide inhibitors of factor Xa Fondaparinux is a synthetic sugar composed of the five sugars (pentasaccharide) in heparin that bind to antithrombin.  The contaminant was later found to be a non-naturally occurring compound called oversulfated chondroitin sulfate. for use in Research & Development. Other types of anticoagulants Many other anticoagulants exist. lepirudin. bivalirudin.
It is in liquid form in the tube and is used for coagulation tests.myocardial infarction. This chemical strongly and irreversibly binds calcium. It gets rid of the calcium. Fondaparinux Fondaparinux . preventing the coagulation proteins from using them. blood transfusion bags.General indications Therapeutic uses of anticoagulants include atrial fibrillation. Citrate is usually in blue Vacutainer tube. It can be in the form of sodium citrate or ACD. most of these chemicals work by binding calcium ions. genetic or acquired hypercoagulability Anticoagulants outside the body Laboratory instruments. or venous thromboembolism (VTE). Correct proportion of this anticoagulant to blood is crucial because of the dilution. stroke. Apart from heparin. but not as strongly as EDTA. congestive heart failure. pulmonary embolism (PE). deep vein thrombosis (DVT). as well as in blood transfusion bags. It is in a powdered form. and medical and surgical equipment will get clogged up and become nonoperational if blood is allowed to clot. Oxalate has a mechanism similar to that of citrate. Chemicals can be added to stop blood clotting. test tubes. EDTA is denoted by mauve or purple caps on Vacutainer brand test tubes. It is the anticoagulant used in fluoride (grey top) tubes.
Chemical data Formula Mol.Systematic (IUPAC) name 2-deoxy-6-O-sulfo-2-(sulfoamino)-α-Dglucopyranosyl-(1→ 4)-O-β-D-glucopyranuronosyl-(1→4)-O-2-deoxy3. Structure and mechanism Fondaparinux is a synthetic pentasaccharide Factor Xa inhibitor.(sulfoamino)-α-D-glucopyranosyl(1→4)-O-2-O-sulfo-α-L-idopyranouronosyl-(1→ 4)O-methyl-2-deoxy-6-O-sulfo-2-(sulfoamino)-α-Dglucopyranoside. Apart from the O-methyl group at the reducing end of the . It is marketed byGlaxoSmithKline. decasodium salt.6-di-O-sulfo-2. as evident by its chemical structure on the right.77 g/mol Pharmacokinetic data Bioavailability Protein binding Metabolism Half-life N/A 94% renally excreted unchanged 17-21 hours Therapeutic considerations Licence data Legal status Routes EMA:Link. US FDA:link POM (UK) ℞-only (US) subcutaneous Fondaparinux (trade name Arixtra) is an anticoagulant medication chemically related to low molecular weight heparins. mass C31H43N3Na10O49S8 1726.
Comparison to other agents One potential advantage of fondaparinux over LMWH or unfractionated heparin is that the risk for heparin-induced thrombocytopenia is substantially lower. or fondaparinux sodium and are receiving neuraxial anesthesia or undergoing spinal puncture. Uses Fondaparinux is similar to enoxaparin in reducing the risk of ischemic events at nine days. Clinically. Binding of heparin/HS to ATIII has been shown to increase the anti-coagulant activity of antithrombin III 1000 fold. heparinoids. there have been case reports of fondaparinux being used to anticoagulate patients with established HIT as it has no affinity to PF-4. fondaparinux does not inhibit thrombin. However. it is selective for factor Xa. In contrast to heparin. Administration Fondaparinux is given subcutaneously daily. it is used for the prevention of deep vein thrombosis in patients who have had orthopedic surgery as well as for the treatment of deep vein thrombosis and pulmonary embolism. its renal excretion precludes its use in patients with renal dysfunction. but unlike heparin. Within heparin and heparan sulfate this monomeric sequence is thought to form the high affinity binding site for the anti-coagulant factorantithrombin III (ATIII). . Furthermore. It has been investigated for use in conjunction with streptokinase.molecule. ARIXTRA® (fondaparinux sodium) Injection Indications and Important Safety Information WARNING: SPINAL/EPIDURAL HEMATOMAS Epidural or spinal hematomas may occur in patients who are anticoagulated with low molecular weight heparins (LMWH). the identity and sequence of the five monomeric sugar units contained in fondaparinux is identical to a sequence of five monomeric sugar units that can be isolated after either chemical or enzymatic cin]] and heparan sulfate (HS). it mediates its effects indirectly through antithrombin III. Can be used as treatment against Heparin-induced Thrombocytopenia. Unlike direct factor Xa inhibitors. but it substantially reduces major bleeding and improves long term mortality and morbidity.
such as nonsteroidal antiinflammatory drugs (NSAIDs). • abdominal surgery who are at risk for thromboembolic complications. Thrombocytopenia can occur with administration of ARIXTRA. or other anticoagulants • a history of traumatic or repeated epidural or spinal puncture • a history of spinal deformity or spinal surgery Monitor patients frequently for signs and symptoms of neurologic impairment. Treatment of Acute Deep Vein Thrombosis ARIXTRA is indicated for the treatment of acute deep vein thrombosis when administered in conjunction with warfarin sodium. which may lead to pulmonary embolism (PE) in patients undergoing: • hip fracture surgery. Bleeding risk is increased in renal impairment and in patients with low body weight <50 kg. Consider these risks when scheduling patients for spinal procedures. . serum creatinine level. WARNINGS AND PRECAUTIONS • • • • Use with caution in patients who have conditions or who are taking concomitant medications that increase risk of hemorrhage. and stool occult blood tests are recommended. Factors that can increase the risk of developing epidural or spinal hematomas in these patients include: • use of indwelling epidural catheters • concomitant use of other drugs that affect hemostasis. If neurologic compromise is noted. • Active major bleeding. • hip replacement surgery. urgent treatment is necessary. Treatment of Acute Pulmonary Embolism ARIXTRA is indicated for the treatment of acute pulmonary embolism when administered in conjunction with warfarin sodium when initial therapy is administered in the hospital. • Thrombocytopenia associated with a positive in vitro test for anti-platelet antibody in the presence of fondaparinux sodium.These hematomas may result in long-term or permanent paralysis. including extended prophylaxis. INDICATIONS AND USAGE Prophylaxis of Deep Vein Thrombosis ARIXTRA is indicated for the prophylaxis of deep vein thrombosis (DVT). • Bacterial endocarditis. Consider the benefit and risks before neuraxial intervention in patients anticoagulated or to be anticoagulated for thromboprophylaxis. Periodic routine complete blood counts (including platelet counts). • Body weight <50 kg (venous thromboembolism prophylaxis only). platelet inhibitors. CONTRAINDICATIONS ARIXTRA is contraindicated in the following conditions: • Severe renal impairment (creatinine clearance <30 mL/min) in prophylaxis or treatment of venous thromboembolism. • knee replacement surgery.
• The packaging (needle guard) contains dry natural rubber and may cause allergic reactions in latex sensitive individuals. .
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