Noxadium 4000/Noxadium 6000 Overdosage

Accidental overdosage following administration of Enoxaparin may lead to hemorrhagic complications. Injected enoxaparin may be largely neutralized by the slow I.V. injection of protamine sulfate (1% solution). The dose of protamine sulfate should be administered to neutralize 1 mg Enoxaparin If Enoxaparin Sodium was administered in the protamine administration, or if it has been determined that a second dose of protamine is required. The second infusion of 0.5 mg protamine sulfate per 1 mg of Enoxaparin may be administered if the aPTT measured 2 to 4 hours after the first infusion remains prolonged.
After 12 hours of the enoxaparin sodium injection, protamine administration may not be required. However, even with higher doses of protamine, the aPTT may remain more prolonged than under normal condition found following administration of heparin. In all cases, the anti-Factor Xa activity is never completely neutralized (maximum about 60%).