Protamine sulphate

Indications

Protamine sulphate is used for: Used in the management of heparin overdose.

Adult Dose

Heparin Neutralization 1-1.5 mg per 100 USP units of heparin; not to exceed 50 mg Monitor APTT 5-15 min after dose then in 2-8 hr In accidental overdoses of heparin, consider t1/2 heparin 60-90 min In setting without bleeding complications, consider observation, rather than reversal of anticoagulation with protamine (avoids ADR's) Complex of protamine and heparin may degrade over time requiring further doses Dalteparin or Tinzaparin Overdose 1 mg protamine for 100 units dalteparin or tinzaparin; if PTT prolonged 4hr after protamine overdose administer 0.5 mg per 100 units of dalteparin or tinzaparin Enoxaparin Overdose 1 mg per mg enoxaparin (if enoxaparin overdose given within 8 hr); if >8 hr of overdose or bleeding continues after 4 hr after first dose, give 0.5 mg protamine per mg enoxaparin

Child Dose

Renal Dose

Administration

IV Preparation Reconstitute with 5 mL sterile water Resulting solution equals 10 mg/mL IV Administration Inject without further dilution over 1-3 min; maximum of 50 mg in any 10 min period For IV use only

Contra Indications

Hypersensitivity

Precautions

Heparin rebound causing bleeding may occur 8-9 hr after protamine administration May be ineffective in cardiac surgery patients despite adequate dose Rapid infusion reactions can cause severe hypotensive reactions

Pregnancy-Lactation

Interactions

Adverse Effects

Side effects of Protamine sulphate : Frequency Not Defined Anaphylaxis Hypotension N/V Decreased O2 consumption Flushing Pulmonary hypertension Uncontrollable bleeding Circulatory collapse Pulmonary edema

Mechanism of Action

Protamine that is strongly basic combines with acidic heparin forming a stable complex and neutralizes the anticoagulant activity of both drugs