Generally, 1 mg of protamine sulfate will neutralize no less than 100 units of heparin sodium.īlood heparin concentrations decrease rapidly after IV administration of heparin dose of protamine sulfate required in the treatment of IV heparin overdosage also decreases rapidly as time elapses. Blood transfusions may be required for massive blood loss.ĭose of protamine sulfate determined by dose of heparin received, route of administration, time elapsed since heparin was given, and blood coagulation studies. With severe heparin overdosage, discontinue heparin and administer protamine sulfate immediately. (See Actions.) Protamine Dosage and Administration General Heparin Overdosage However, neutralization of an LMW heparin is not complete even with multiple doses of protamine. Has been used for treatment of low molecular weight (LMW) heparin (e.g., dalteparin, enoxaparin, tinzaparin ) overdosage †. Neutralization of anticoagulant effect of heparin to reduce risk of bleeding near delivery † in pregnant women receiving heparin therapy who go into spontaneous labor. Heparin Neutralization in Pregnant Women Near Delivery Neutralization of heparin administered during extracorporeal circulation † in arterial and cardiac surgery or dialysis procedures. Heparin Neutralization during Extracorporeal Circulation (See Boxed Warning.) Heparin withdrawal usually corrects minor overdosage or bleeding within a few hours. Uses for Protamine Heparin Overdosageĭo not use for minor bleeding during heparin therapy. Heparin antagonist prepared from the sperm or mature testes of salmon or related species. Protamine should not be used for bleeding that occurs without prior exposure to heparin. (See Sensitivity Reactions under Cautions.) Administer only when facilities and equipment for treatment of such reactions are readily available. Weigh risk against anticipated benefit of protamine therapy in patients with risk factors. Other possible risk factors include known sensitivity to fish, vasectomy, severe left ventricular dysfunction, and abnormal pulmonary hemodynamics. Possible severe hypotension, cardiovascular collapse, noncardiogenic pulmonary edema, catastrophic pulmonary vasoconstriction, and pulmonary hypertension with rapid IV injection, high doses, repeated doses, or previous exposure to protamine or protamine-containing drugs (e.g., insulin).
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