৳ 1/unit
Pack: ৳ 10
৳ 1/unit
Pack: ৳ 10
At a glance
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.
Indications
- Counteract anticoagulant effect of heparin (before surgery)
- After renal dialysis
- After open-heart surgery
- Excessive bleeding
- Heparin overdose
Pharmacology
Protamine sulfate is a basic protein that binds with strongly acidic heparin to form a stable inactive complex. This complex neutralizes the anticoagulant effect of heparin. In gross excess, protamine itself acts as an anticoagulant.
Dosage
Adult Dose (IV):
- Heparin neutralization: 1-1.5 mg per 100 units of heparin; max 50 mg
- If >15 min since IV heparin: reduce dose: 30-60 min: 0.5-0.75 mg/100 units; ≥2 hours: 0.25-0.375 mg/100 units
- Dalteparin/Tinzaparin overdose: 1 mg per 100 units; if PTT prolonged after 4 hr, give 0.5 mg per 100 units
- Enoxaparin overdose: 1 mg per mg enoxaparin (if within 8 hr); if >8 hr or bleeding continues after 4 hr, give 0.5 mg per mg
Side effects
Side Effects:
- Anticoagulant effect (at excess doses)
- Hypersensitivity reactions (angioedema, anaphylactoid, anaphylaxis)
- Bradycardia
- Sudden fall in blood pressure
- Pulmonary and systemic hypertension
- Dyspnea
- Nausea
- Vomiting
- Back pain
Use in pregnancy
Use in Pregnancy: Use only if clearly indicated; caution required.
Pregnancy Category: C — always consult a doctor before taking during pregnancy.
Precautions & warnings
- Too rapid administration may cause severe hypotension and anaphylactoid reactions
- Caution in patients allergic to fish, protamine insulin, vasectomy, infertility
- Monitor clotting parameters with repeated doses
- Rebound bleeding may occur up to 18 hours post-operatively
Overdose effects
Overdose: Protamine itself acts as an anticoagulant when given in excess of the dose required to neutralize heparin; treatment: symptomatic supportive care.
Storage conditions
Store between 15°C and 25°C.