Q: How do I reverse unfractionated heparin in a patient with a major bleed?

For IV heparin: Protamine sulfate dosing is 1 mg per 100 units of heparin, if heparin was given in the previous 2-3 hours. Protamine sulfate is given slower than 5 mg/minute to minimize the risk of adverse reactions. Maximum dose of protamine sulfate is 50 mg. For SC heparin: When heparin has been given subcutaneously (and therefore is cleared with a longer half-life) prolonged or repeated administration of protamine sulfate may be required. See protamine reversal calculator .

Q: How do I reverse unfractionated heparin in a patient with a major bleed?

For IV heparin: Protamine sulfate dosing is 1 mg per 100 units of heparin, if heparin was given in the previous 2-3 hours. Protamine sulfate is given slower than 5 mg/minute to minimize the risk of adverse reactions. Maximum dose of protamine sulfate is 50 mg. For SC heparin: When heparin has been given subcutaneously (and therefore is cleared with a longer half-life) prolonged or repeated administration of protamine sulfate may be required. See protamine reversal calculator .

Question 1

How do I reverse unfractionated heparin in a patient with a major bleed?

William Aird · Accepted Answer

For IV heparin:

Protamine sulfate dosing is 1 mg per 100 units of heparin, if heparin was given in the previous 2-3 hours.
Protamine sulfate is given slower than 5 mg/minute to minimize the risk of adverse reactions.
Maximum dose of protamine sulfate is 50 mg.

For SC heparin:

When heparin has been given subcutaneously (and therefore is cleared with a longer half-life) prolonged or repeated administration of protamine sulfate may be required.

See protamine reversal calculator.

Question 2

How do I reverse unfractionated heparin in a patient with a major bleed?

William Aird · Accepted Answer

For IV heparin:

Protamine sulfate dosing is 1 mg per 100 units of heparin, if heparin was given in the previous 2-3 hours.
Protamine sulfate is given slower than 5 mg/minute to minimize the risk of adverse reactions.
Maximum dose of protamine sulfate is 50 mg.

For SC heparin:

When heparin has been given subcutaneously (and therefore is cleared with a longer half-life) prolonged or repeated administration of protamine sulfate may be required.

See protamine reversal calculator.

How do I reverse unfractionated heparin in a patient with a major bleed?

How do I reverse unfractionated heparin in a patient with a major bleed?

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