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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]