Indications for Protamine sulfate:

Treatment of heparin overdose.


Give by slow IV inj over 10 mins. Determine dose by coagulation studies; dose requirement decreases with time elapsed after heparin administration. 1mg neutralizes ≥100units of heparin; max 50mg/dose.


Not recommended.


Avoid rapid administration. Fish allergy. Previous exposure to protamine (including insulin). Severe left ventricular dysfunction. Abnormal pulmonary hemodynamics. Previous vasectomy. Pregnancy (Cat.C). Nursing mothers.

Pharmacologic Class:

Heparin antagonist.


Incompatible with certain antibiotics (eg, cephalosporins, penicillins).

Adverse Reactions:

Hypotension, bradycardia, transient flushing, feeling of warmth, dyspnea, GI upset, lassitude, pulmonary edema, anaphylaxis, cardiovascular collapse, pulmonary vasoconstriction, pulmonary hypertension.

How Supplied:

Vial (5mL)—25; 25mL—1