Class: heparin antidote
- Protamine Sulphate :
Trade names: prosulf
Pregnancy: (Category C)
It binds to heparin to form a stable ion pair which does not have anticoagulant activity.
Protamine sulfate is usually administered to reverse the large dose of heparin administered during certain surgeries, especially heart surgery. It is also used in gene transfer and protein purification.
by intravenous injection over approx. 10 minutes, 1 mg neutralises 80–100 units heparin when given within 15 minutes of heparin; if longer time, less protamine required as heparin rapidly excreted; max. 50 mg
Patients who have shown previous intolerance to the drug.
I.V. injections of protamine may cause a sudden fall in blood pressure, bradycardia, pulmonary hypertension, dyspnea, or transitory flushing and a feeling of warmth. There have been reports of anaphylaxis that resulted in respiratory embarrassment (see Precautions). Other reported adverse reactions include systemic hypertension, nausea, vomiting and lassitude. Back pain has been reported rarely in conscious patients undergoing such procedures as cardiac catheterization.
If given too quickly, may cause a severe drop in blood pressure and severe allergic reaction.
Facilities for resuscitation and treatment of shock should be available.
Patients should be carefully monitored using either the activated partial thromboplastin time or the activated coagulation time, carried out 5-15 minutes after protamine sulphate administration.