Protamine Sulfate

From Anvita Health Wiki

Contents 1 Indications 2 Contraindications 3 Dosage 4 Pharmacokinetics 5 Adverse-effects 6 Mechanism-of-action 7 More General Terms 8 Additional Terms 9 References

Indications

• reversal of severe heparin overdose

• most cases are managed by stopping heparin administration

• reversal of heparin effects after surgery or dialysis

Contraindications

• Pregnancy category: C)
• Safety in lactation: ?

Dosage

• 10-50 mg IV over 10 minutes
• 1 mg antagonizes approximately 100 U of heparin
• doses > 100 mg produce paradoxical anticoagulation
• for subcutaneous heparin overdose, dosage may need to be repeated

• Injection: 10 mg/mL (5 mL, 25 mL).

Pharmacokinetics

• elimination: plasma
• neutralization of heparin occurs within 5 minutes of IV administration
• duration of action: 2 hours (dependent upon body temperature)

Adverse-effects

• common (> 10%)

• hypotension, dyspnea, bradycardia

• less common (1-10%)

• hemorrhage

• uncommon (< 1%)

• flushing, lassitude, nausea/vomiting, pulmonary hypertension, hypersensitivity reactions

Mechanism-of-action

• binds to heparin forming a stable salt which has no anticoagulant activity
• protamine given in excess has anticoagulant properties

More General Terms

• hematologic agent
• antidote

Additional Terms

• protamine

References

1. The Pharmacological Basis of Therapeutics, 9th ed. Gilman et al, eds. Permagon Press/McGraw Hill, 1996
2. Drug Information & Medication Formulary, Veterans Affairs, Central California Health Care System, 1st ed., Ravnan et al eds, 1998
3. Kaiser Permanente Northern California Regional Drug Formulary, 1998

protamine sulfate