Protamine sulfate is primarily used as what in anticoagulation management?

• A. Procoagulant
• B. Thrombolytic
• C. Antiplatelet
• D. Anticoagulation reversal agent

Answer: (D)

Protamine sulfate reverses heparin anticoagulation. It binds to heparin to form a stable complex, effectively neutralizing heparin’s ability to prevent clotting. This makes it the go-to agent when rapid reversal is needed after surgery, procedures, or in the setting of bleeding. It works best for unfractionated heparin and can partially reverse low-molecular-weight heparin, but it is not a procoagulant, thrombolytic, or antiplatelet agent. Its role is specifically to counteract the anticoagulant effect of heparin.