protamine

Protamine is a strongly basic, low molecular weight protein originally derived from salmon sperm and now mainly produced by recombinant biotechnology. It is used as an antidote to reverse the anticoagulant effects of heparin and low molecular weight heparin. Protamine binds to the strongly acidic heparin to form a stable inactive complex (salt), thereby neutralizing its anticoagulant effect. This reversal is critical in cases of heparin overdose or when rapid reversal of anticoagulation is needed during surgeries such as cardiac surgery or after renal dialysis. The onset of action occurs within about five minutes after intravenous administration. Common side effects include hypotension, bradycardia, allergic reactions (which can be severe), and vomiting; risk for allergic reaction is higher in males with prior vasectomy[1][6][8]. Protamine also has weak intrinsic anticoagulant activity when not complexed with heparin and may have additional biological effects such as influencing lipid metabolism and exhibiting antibacterial properties[8]. It appears on the World Health Organization's List of Essential Medicines[1][6].

Brand names

Prosulf

Other names

鱼精蛋白硫酸鱼精蛋白protamine sulfatesalmine