Protamine sulfate indications

Excessive anticoagulant action of heparin is treated by discontinuance of the drug. If bleeding occurs, administration of a specific antagonist such as protamine sulfate is indicated. Protamine is a highly basic peptide that combines with heparin as an ion pair to form a stable complex devoid of anticoagulant activity. For every 100 units of heparin remaining in the... 

The replacement of unfractionated heparin by LMWHs in all indications. Although LMWHs have been used for interventional purposes, these drugs have not still gained the approval of the US FDA for this purpose. This is primarily due to the lack of clinical trial data on specific products and an understanding of the mechanisms of action. Moreover, the pharmacokinetics and pharmacodynamics of these drugs are different from that of unfractionated heparin and require further studies. LMWHs are only partially neutralized by protamine sulfate. Thus, additional data on their safety and efficacy in interventional indications are needed. 

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