Protamine sulfate

Protamine sulfate is a medication that is used to reverse the effects of heparin. It is specifically used in heparin overdose, in low molecular weight heparin overdose, and to reverse the effects of heparin during delivery and heart surgery. It is given by injection into a vein. The onset of effects is typically within five minutes.

Common side effects include low blood pressure, slow heart rate, allergic reactions, and vomiting. Allergic reactions may be severe and include anaphylaxis. The risk is greater in males who have had a vasectomy. While there is no evidence of harm from using during pregnancy it has not been well studied in this group. Protamine works by binding with heparin.

Protamine sulfate was approved for medical use in the United States in 1969. It is on the World Health Organization's List of Essential Medicines. It was originally made from the sperm of salmon (salmine, salmon protamine). It is now mainly made using recombinant biotechnology.