Therapeutic Action
Neutralisation of the anticoagulant action of unfractionated heparin Partial neutralisation of the anticoagulant action of low molecular weight heparin
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Drug reference
Neutralisation of the anticoagulant action of unfractionated heparin Partial neutralisation of the anticoagulant action of low molecular weight heparin
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Haemorrhagic syndromes resulting from accidental heparin overdosage
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May cause: hypotension, bradycardia and dyspnoea; allergic reactions, notably in diabetics treated by protamine-insulin. If excessive doses are used, haemorrhage may persist or reappear, as protamine sulfate itself has some anticoagulant activity. Administer by very slow IV (over 10 minutes) in order to reduce risks of hypotension and bradycardia. Pregnancy: no contra-indication Breast-feeding: no contra-indication
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50 mg protamine sulfate in 5 ml ampoule (10 mg/ml) for slow IV injection Concentration may be expressed in antiheparin units (AHU): 1000 AHU = 10 mg.
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Depends on the amount of heparin to be neutralised. Heparin overdosage If administered between 0 and 30 minutes after the heparin injection, 1 mg of protamine sulfate (100 AHU) neutralises 100 units of heparin. If more than 30 minutes have elapsed since the heparin injection, the dose of protamine to be given should be one half the dose of heparin injected. Do not administer more than 50 mg per dose Enoxaparin overdosage Time since last enoxaparin dose Protamine dose < 8 hours 1 mg per 1 mg enoxaparin > 8 hours and < 12 hours 0.5 mg per 1 mg enoxaparin > 12 hours May not be required Do not administer more than 50 mg per dose.
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According to clinical response. Monitor coagulation parameters.
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Anticoagulant effect of protamine may vary according to the origin of the heparin: follow manufacturer's recommendations. Protamine sulfate may be used to neutralize the effect of heparin before surgery.
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– To be kept refrigerated (2 °C to 8 °C)
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