Īvoiding rapid infusion of protamine sulfate and pre-treating at-risk patients with histamine receptor antagonists (H1 and H2) and steroids may minimize these reactions. These occur at rates ranging from 0.28% to 6%.
Protamine has been reported to cause allergic reactions in patients who are allergic to fish, diabetics using insulin preparations containing protamine, and vasectomized or infertile men. Partial thromboplastin time (PTT) should be monitored at 5 to 15 minutes after dose then in 2–8 hours afterward. Protamine is used in insulin aspart protamine and NPH insulin.ĭosage for heparin reversal is 0.5mg to 1.0 mg mg protamine sulfate IV for every 100 IU of active heparin. In gene therapy, protamine sulfate has been studied as a means to increase transduction rates by both viral and nonviral-mediated delivery mechanisms (e.g. It is also used in gene transfer, protein purification and in tissue cultures as a crosslinker for viral transduction. A dose of protamine is given, by drip administered over several minutes, once the patient is off-pump, when extracorporeal circulation and anticoagulation are no longer needed. Protamine sulfate is usually administered to reverse the large dose of heparin administered during certain surgeries, especially heart surgery where anti-coagulation is necessary to prevent clot formation within the cardiopulmonary bypass pump apparatus. It is now mainly made using recombinant biotechnology.
It was originally made from the sperm of salmon (salmine, salmon protamine). It is on the World Health Organization's List of Essential Medicines. Protamine sulfate was approved for medical use in the United States in 1969. While there is no evidence of harm from using during pregnancy it has not been well studied in this group. The risk is greater in males who have had a vasectomy. Allergic reactions may be severe and include anaphylaxis. Ĭommon side effects include low blood pressure, slow heart rate, allergic reactions, and vomiting.
The onset of effects is typically within five minutes. It is specifically used in heparin overdose, in low molecular weight heparin overdose, and to reverse the effects of heparin during delivery and heart surgery. Protamine sulfate is a medication that is used to reverse the effects of heparin.
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