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Intravenous Dilution Guidelines

Protamine

The authors make no claims of the accuracy of the information contained herein; and these suggested doses and/or guidelines are not a substitute for clinical judgment. Neither GlobalRPh Inc. nor any other party involved in the preparation of this document shall be liable for any special, consequential, or exemplary damages resulting in whole or part from any user's use of or reliance upon this material.    PLEASE READ THE DISCLAIMER CAREFULLY BEFORE ACCESSING OR USING THIS SITE. BY ACCESSING OR USING THIS SITE, YOU AGREE TO BE BOUND BY THE TERMS AND CONDITIONS SET FORTH IN THE DISCLAIMER.

Usual Diluents

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Standard Dilutions   [Amount of drug] [Infusion volume] [Infusion rate]

Dilute 50 mg vial with 5 ml-sterile water (10mg/ml). Normally given undiluted.
May add to 25-50ml NS or D5W and infuse over 10-20 min.

[Too rapid administration can cause severe hypotensive and anaphylactoid reactions. Facilities to treat shock should be available.]

Stability / Miscellaneous

Treatment of heparin overdose: If immediate, give 1 mg (up to 1.5mg) IV for every 100u of heparin infused in preceding 2 hours. Give by slow IV injection (50mg over 10 minutes). Maximum of 50mg in any 10 minute period. May dilute with 25-50ml NS/D5W and infuse over 10-20 minutes.

Obtain PTT 5-15 minutes after protamine administration.

If 30 minutes to 1 hour have elapsed before starting protamine:
use 0.5 to 0.75 mg/100 u of heparin (in preceding 2 hours).

If > 2 hours have elapsed: use 0.25 to 0.375mg/ 100units. Symptoms of overdose of protamine include hypertension, and possible hemorrhage due to paradoxical anticoagulation with higher doses (eg > 100mg).

Source: [package insert]
Disclaimer
The authors make no claims of the accuracy of the information contained herein; and these suggested doses are not a substitute for clinical judgment. Neither GlobalRPh Inc. nor any other party involved in the preparation of this program shall be liable for any special, consequential, or exemplary damages resulting in whole or part from any user's use of or reliance upon this material.  PLEASE READ THE DISCLAIMER CAREFULLY BEFORE ACCESSING OR USING THIS SITE. BY ACCESSING OR USING THIS SITE, YOU AGREE TO BE BOUND BY THE TERMS AND CONDITIONS SET FORTH IN THE DISCLAIMER.
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