DRUG	SUPPLIED	DOSE	COMMENTS
PROTAMINE (Paeds) Mechanism of action: Heparin reversal agent. Ref: 90, 140 Last update: 2018-07-26	Injection: 50 mg/5 mL ampoule Refrigeration required.	Heparin Reversal:   Time since               Protamine dose last heparin dose    mg/100 units heparin < 30 min.                 1 30 - 60 min.             0.5 - 0.75 60 - 120 min.           0.375 - 0.5 > 120 min.               0.25 - 0.375 Maximum dose: 50 mg Enoxaparin Reversal: 1 mg protamine per 1 mg of enoxaparin (if last dose of enoxaparin was given within 4 hr). If APTT still prolonged at 2 to 4 hrs may readminister 0.5mg protamine per 1 mg enoxaparin.	If anticoagulation with heparin needs to be discontinued for clinical reasons, termination of the heparin infusion will usually suffice due to rapid clearance of heparin. May cause severe hypotension or cardiovascular collapse if given by rapid IV injection. May cause hypersensitivity and anaphylaxis reactions (fish allergy is a risk factor). Obtain APTT and PT 15 min. after the administration of protamine. Protamine does not completely neutralize the anti-Xa activity of enoxaparin. Heparin neutralization occurs within 5 minutes following IV administration. Standard Prescription: protamine __mg IV x 1 dose, infuse over _ minutes