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What is Protamine Sulfate?

By Debra Durkee
Updated May 17, 2024
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Protamine sulfate is a solution administered to a patient through an intravenous drip. It is used mainly in cases of a heparin overdose, which occurs when a patient has too much of the anticoagulant in his or her blood. The medication is typically administered in a clinical setting by a medical professional.

Alone, protamine sulfate is also an anticoagulant; that is, it acts in the same way as heparin and makes the blood thinner and less likely to clot. When it is introduced into the same body as a large amount of heparin, the two medications interact to form another inert compound. This eliminates the anticoagulant properties of both drugs, and restores the blood's ability to form clots at the site of injuries.

Heparin is often administered to a patient before surgery to lower the chances of a blood clot forming during the procedure. After surgery, however, the clotting nature of the blood is desired in order to properly begin the healing process of incisions. Protamine sulfate can be administered to speed the process of ridding the body of heparin, and restoring the natural clotting ability of the blood.

Protamine sulfate is a naturally occurring substance that is found in the sperm of a number of species of fish. When it is extracted, it forms a white powder that is then dissolved in water to create the final solution. It generally acts quickly on any heparin present in the body, and administration does not take long. Correct formulation of the dose and strength of the solution to be administered is crucial, as protamine sulfate can begin to act as an anticoagulant on its own if it runs out of heparin. Small amounts are generally administered over a prolonged amount of time so medical professionals can judge how it is interacting with the heparin in the body and on the blood.

There may be some unwanted side effects during the administration of protamine sulfate. While nausea and vomiting are fairly common, there have also been cases wherein the patient's blood pressure drops well below normal with the introduction of the medication. If the patient is also taking antibiotics, these drugs may interfere with the protamine sulfate and increase the chances of side effects. There is also a chance that too high a dose of the medication can create an instance of internal hemorrhage, but this is rare and proper administration and dosing of the drug should avoid this undesired outcome.

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