Do not interrupt a heparin drip for any other drug or IV therapy. (1 gm protamine inactivates 100 units heparin). Although antidotes against anticoagulant treatment are widely available, our analysis shows that in only a very small number of patients a direct, or slow-acting antidote to reverse the anticoagulant effect was used. Protamine sulfate is the antidote for overly anticoagulated dose of heparin. Vitamin K was more frequently given in case of a higher international normalized ratio value. Antidotes were statistically significantly more frequently given in Canada as compared to other participating countries. Unfractionated heparin (UFH), low-molecular-weight heparins (LMWHs) and the synthetic heparin pentasaccharide known as fondaparinux are the most commonly used anticoagulants in acute settings. Heparin is given by injection and excessive bleeding is its main side effect.

The use of antidotes was comparable for initial and long-term treatment. Heparin reduces the ability of the blood to clot and is used to treat or prevent blood clots. Vitamin K was given to 23 (1.2%) patients, one (0.05%) patient received protamin sulfate and seven (0.4%) patients received fresh frozen plasma. The heparin product or fondaparinux should be continued for at least five days and until the patient’s international normalized ratio is at least 2.0 for two consecutive days. Of the patients with at least one major hemorrhage, 19 (41.3%) received an antidote. Some form of antidote was given to 26 (14.4%) patients with a hemorrhage. Maximum dose is 50 mg per dose Low Molecular Weight Heparin Reversal of Life Threatening Bleeding: Protamine (works just as well with LMWH as heparin) - if with-in 4 hours of dose: 1 mg of protamine for each 1 mg of enoxaparin or 100 units of dalteparin and tinzaparin. We investigated 1877 patients treated for venous thromboembolism included in three large clinical trials, of which 181 (9.6%) had a total of 225 adjudicated bleeding episodes 46 hemorrhages being designated as major. Standard Heparin Infusion rate should not exceed 5 mg/min. Interestingly, it is unknown how often the use of an antidote is necessary in clinical practice. Several new anticoagulants have been developed that are likely to have some risk of bleeding complications, for which no specific antidotes are available.

When a bleeding complication occurs during therapy with heparin or vitamin K antagonists, there is an option to give a specific antidote.

Heparin antidote