Unfractionated Heparin Reversal

Protamine Sulfate Administration Parameters

  • Administer by slow IV injection not to exceed 5 mg/min

  • Total dose not to exceed 50 mg

  • Monitor for anaphylaxis

Heparin Bolus Reversal

  • Bolus < 30 minutes ago

    • 1 mg Protamine Sulfate for every 100 units of heparin received (maximum dose = 50 mg)

  • Bolus 30-60 minutes ago

    • 0.5 mg Protamine Sulfate for every 100 units of heparin received (maximum dose = 50 mg)

  • Bolus > 60 minutes ago

    • 0.25 mg Protamine Sulfate for every 100 units of heparin received (maximum dose = 50 mg)

Heparin Drip Reversal

  • 1 mg Protamine Sulfate for every 100 units of heparin received within previous 2-3 hours (maximum dose = 50 mg)

Subcutaneous Heparin Reversal

  • 1 mg Protamine Sulfate for every 100 units of heparin received in previous 8 hours (maximum dose = 50 mg)

Monitoring

  • STAT PTT q1 hour for initial 4 hours, then q4 hours for subsequent 8 hours