Protamine Sulphate Injection

Protamine sulfate is used to counteract the anticoagulant effect of heparin: before surgery; after renal dialysis; after open-heart surgery; if excessive bleeding occurs and when an overdose has inadvertently been given.
Protamine Sulfate Injection is a medication used to reverse the effects of heparin, an anticoagulant. It is specifically used in cases of heparin overdose, low molecular weight heparin overdose, and to reverse the effects of heparin during delivery and heart surgery. Protamine sulfate is administered by injection into a vein1. Here are some key details about Protamine Sulfate:
Description: Protamine sulfate is a simple protein derived from the sperm of salmon and certain other fish. It is rich in arginine and strongly basic. Protamine sulfate reacts with heparin to form an inactive complex, neutralizing its anticoagulant effects.
Indications:
Heparin Overdose: Protamine sulfate is used to reverse the effects of excessive heparin.
Low Molecular Weight Heparin Overdose: It is also effective in cases of low molecular weight heparin overdose.
Delivery and Heart Surgery: Protamine is used during delivery and heart surgery to counteract the anticoagulant effects of heparin.
Administration:
Protamine sulfate should be given by very slow intravenous injection over a 10-minute period, with doses not exceeding 50 mg.
It is intended for injection without further dilution, but if dilution is desired, D5-W (dextrose 5% in water) or normal saline may be used2.
Safety Considerations:
Protamine sulfate can cause severe hypotension, cardiovascular collapse, and other adverse reactions. Risk factors include high dose, rapid administration, repeated doses, and previous use of protamine-containing drugs.
Vasopressors and resuscitation equipment should be available in case of severe reactions.
Protamine sulfate should not be given when bleeding occurs without prior heparin use.
Clinical Pharmacology:
Protamine sulfate neutralizes heparin within minutes after intravenous administration.
The metabolic fate of the heparin-protamine complex is not fully understood.
Dosage and Administration:
Protamine sulfate injection should be given by very slow intravenous injection over a 10-minute period in doses not exceeding 50 mg.
Protamine sulfate is intended for injection without further dilution; however, if further dilution is desired, D5-W or normal saline may be used2.
Remember to consult your healthcare provider for personalized advice regarding the use of Protamine Sulfate Injection in your specific situation. 😊