Protamine sulfate, 10 mg/ml 5 pcs 5 pcs

Protamine sulfate is a specific heparin antagonist. 1 mg of protamine sulfate neutralizes 80 – 120 units of heparin in blood.

The complexation is due to the abundance of cationic groups (due to arginine) that bind to the anionic centers of heparin.

The action of the drug after intravenous administration occurs immediately and lasts for 2 hours. After intravenous administration a protamine-heparin complex is formed which may break down with release of heparin.

In overdose, it may decrease blood clotting because protamine sulfate itself has anticoagulant activity.

Indications

Bleeding

• bleeding due to heparin overdose
• before surgery in patients who are taking heparin for therapeutic purposes;
• After cardiac and vascular surgery with extracorporeal circulation;
• Hyperheparinemia.

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Active ingredient

Protamine sulfate

Composition

Solution for injection 1 ml of protamine sulfate 10 mg

How to take, the dosage

The protamine sulfate solution is administered slowly intravenously by trickle or drip.

The rate of administration should not exceed 5 mg per minute (e.g., 50 mg of the drug administered within 10 minutes), since faster administration may cause an anaphylactoid reaction.

The dose of the drug depends on the method of administration of heparin. The calculated dose is dissolved in 300-500 ml of 0.9% sodium chloride solution. Do not administer more than 150 mg of protamine sulfate within 1 hour.

Interaction

Incompatible with cephalosporin solutions and penicillin (do not administer simultaneously). There are no data on the interaction with other drugs.

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Special Instructions

Injection is performed under control of blood clotting. Before administration, make sure that the patient’s blood volume is adequate (hypovolemia increases the risk of collapse).

Contraindications

• High sensitivity to the components of the drug;
• idiopathic or congenital hyperheparinemia (in such cases the drug is ineffective and may increase bleeding);
• severe arterial hypotension;
• thrombocytopenia
• insufficiency of the adrenal cortex;
• painful patients taking insulin containing insulin sulfa.
• thrombocytopenia;
• insufficiency of the adrenal cortex;
• patients taking insulins containing protamine sulfate as well as other medications containing protamine sulfate;
• allergic reactions to fish in the history.

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Side effects

Cardiovascular system: decreased blood pressure, bradycardia.

Digestive system disorders: nausea, vomiting.

Immune system disorders: skin rash, itching, development of anaphylactoid reactions.

Others: feeling of heat, hyperemia of the skin, feeling of shortness of breath (if injected too quickly).

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Overdose

May be accompanied by bleeding, because protamine has its own anticoagulant activity.

The treatment is symptomatic.

Interaction with other medicines

Incompatible with cephalosporins and penicillins.

It is an antagonist of low molecular heparins. Can increase the intensity and duration of action of nondepolarizing myorelaxants.

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