Protocol of Hirsh and Raschke for the Reversal of Antithrombotic Effect of Low Molecular Weight Heparin (LMWH) Using Protamine Sulfate


Bleeding associated with low molecular weight heparin (LMWH) may be difficult to treat. Protamine sulfate neutralizes about 60% of the anti-factor Xa activity of LMWH, possibly due to reduced protamine binding. The effectiveness of protamine therapy in reversing the antithrombotic effect of LMWH is unclear but may be attempted if there is no alternative.

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