Classes
DEA Class; Rx
Common Brand Names;
- Antidotes, Other
Description
Heparin antagonist; derived from fish sperm
For heparin overdose and is used to neutralize heparin during extracorporeal circulation following dialysis and arterial or cardiac surgery
Must be given at a rate not to exceed 50 mg over a 10 minute period
Indications
Indicated for the treatment of low-molecular weight heparin (LMWH) or unfractionated heparin toxicity, or for hemorrhage associated with unfractionated heparin (UFH) or LMWH therapy.
Contraindications
Hypersensitivity
Previous intolerance to drug
Adverse Effects
Anaphylaxis
Hypotension
N/V
Decreased O2 consumption
Flushing
Pulmonary hypertension
Uncontrollable bleeding
Circulatory collapse
Pulmonary edema
Warnings
Heparin rebound causing bleeding may occur 8-9 hr after protamine administration
May be ineffective in cardiac surgery patients despite adequate dose
Rapid infusion reactions can cause severe hypotensive reactions
Because of anticoagulant effect of the drug, it is unwise to give more than 50 mg over a short period unless a larger dose is clearly needed
Patients with history of allergy to fish may develop hypersensitivity reactions to drug, although no relationship established to date between allergic reactions to protamine and fish allergy
Pregnancy and Lactation
Pregnancy Category: C
Lactation: not known if excreted in breast milk
Maximum Dosage
100 mg IV within a 2-hour period unless a larger quantity is indicated through confirmation by coagulation tests.
100 mg IV within a 2-hour period unless a larger quantity is indicated through confirmation by coagulation tests.
Must individualize dosage; do not exceed 50 mg/dose.
Must individualize dosage; do not exceed 50 mg/dose.
Must individualize dosage; do not exceed 50 mg/dose.
Must individualize dosage; do not exceed 50 mg/dose.
How supplied
Protamine Sulfate
IV solution
- 10 mg/mL