What is the treatment for LMW heparin and heparin overdose?

The treatment for low molecular weight (LMW) heparin and heparin overdose is protamine. Protamine is a specific antagonist for heparin, neutralizing its anticoagulant effects. When heparin is administered, it binds to antithrombin III, which inactivates thrombin and factor Xa, leading to a decrease in blood clotting. In cases of overdose or when rapid reversal of the anticoagulation effect is necessary—such as during surgical procedures or in the event of severe bleeding—protamine can be given.

Protamine binds to heparin in a 1:1 molar ratio, effectively forming a non-anticoagulant complex and reversing the effects of heparin. The administration of protamine is particularly effective for standard heparin; however, its effectiveness may vary when administered for LMW heparin, depending on the specific agent used, as LMW heparins have a more complex structure and may not bind as completely to protamine. Nonetheless, protamine remains the most appropriate countermeasure for heparin-related complications.

In contrast, vitamin K, calcium gluconate, and desmopressin are utilized in the treatment of other conditions. Vitamin