Protamine
Brand: (no brand; generic only)
Boxed warning
Severe hypotension, cardiovascular collapse, pulmonary edema, pulmonary vasoconstriction, and pulmonary hypertension; give slowly with resuscitation equipment at hand.
- Caution
- Higher reaction risk with fish allergy, prior vasectomy, or previous protamine exposure (including NPH insulin).
- Storage
- Refrigerate vials (36 to 46 F); do not freeze.
Common side effects
- Sudden drop in blood pressure
- Slow heartbeat
- Flushing
- Shortness of breath
Key interactions
- Neutralizes heparin; only partially reverses low-molecular-weight heparin
Counseling points
- Given by slow intravenous infusion in a monitored setting
- Higher risk of reaction in people with fish allergy or prior vasectomy
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