Protamine sulfate

Adult: Dose depends on the administered dose of the LMWH, time elapsed since drug was administered and blood coagulation tests. For enoxaparin: If ≤8 hr since admin, 1 mg for every 1 mg of enoxaparin administered; if >8 hr has elapsed since admin, infuse 0.5 mg for every 1 mg of enoxaparin administered. For dalteparin: 1 mg for every 100 anti-Xa U of dalteparin administered. If aPTT remains prolonged 2-4 hr after the 1st infusion, a 2nd infusion may be given.

Adult: Dosage depends on administered heparin dose, its route of admin, time elapsed since heparin admin, and blood coagulation studies. For heparin administered via IV inj: If only a few min have elapsed since admin, 1 mg for every 100 U of heparin administered; if 30-60 min have elapsed since admin, 0.5-0.75 mg for every 100 U of heparin; and if ≥2 hr have elapsed since admin, 0.25-0.375 mg for every 100 U of heparin. Doses to be given via inj at ≤5 mg/min. Max: 50 mg/dose. For heparin administered via IV infusion: 25-50 mg via inj after stopping heparin infusion. For heparin administered via SC inj: 1-1.5 mg via IV inj for each 100 U of heparin administered. Alternatively, loading dose of 25-50 mg via slow IV inj and the rest of the dose via continuous IV infusion over 8-16 hr or the expected duration of absorption of heparin.