II. Indications: Not a first line drug due to QT Prolongation

  1. Antiemetic in refractory Vomiting
  2. Surgical or Diagnostic procedure
    1. Procedure related Nausea or Vomiting
    2. Conscious Sedation
  3. Migraine Headache
  4. Chemical Restraint (e.g. violent patient)

III. Contraindications

  1. Absolute contraindications
    1. QT Prolongation prior to use (>440 ms)
  2. Relative contraindications: Risk of QT Prolongation
    1. Congestive Heart Failure
    2. Bradycardia (Heart Rate <50 beats per minute)
    3. Concurrent Diuretic use
    4. Cardiac hypertrophy
    5. Hypokalemia
    6. Hypomagnesemia
    7. Other medication use associated with QT Prolongation
      1. Class I Antiarrhythmics
      2. Class III Antiarrhythmics
      3. Monoamine Oxidase Inhibitors

IV. Mechanism

  1. Butyrophenone Neuroleptic similar to Haloperidol
  2. Antiemetic activity via Dopamine antagonist

V. Adverse effects

  1. QT Prolongation
    1. FDA Black box warning due to observed QT Prolongation at therepeutic doses
    2. Studies have since demonstrated its safety when used at moderate dose
      1. Calver (2015) Ann Emerg Med 66(3): 230-8 +PMID:25890395 [PubMed]
  2. Sedation
    1. Usually resolves within 4 hours of dose
    2. Alertness may be decreased for 12 hours after dose

VI. Drug Interactions

  1. Other agents that prolong QT Interval (see above)

VII. Dosing

  1. Adults: 2.5 mg IM or IV slowly
  2. Children: 0.1 mg/kg IM or IV slowly

VIII. Monitoring

  1. Baseline EKG
  2. Continuous cardiac monitoring for 3 hours after dose

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Ontology: Droperidol (C0013136)

Definition (NCI) A butyrophenone with anti-emetic, sedative and anti-anxiety properties. Although the exact mechanism through which droperidol exerts its effects is unknown, droperidol may block dopamine receptors in the chemoreceptor trigger zone (CTZ), which may lead to its anti-emetic effect. This agent may also bind to postsynaptic gamma-aminobutyric acid (GABA) receptors in the central nervous system (CNS), which increases the inhibitory effect of GABA and leads to sedative and anti-anxiety activities.
Definition (NCI_NCI-GLOSS) A drug used to prevent nausea and vomiting in patients who receive anesthesia before surgery. It is also used to treat anxiety. Droperidol is a type of antiemetic, adjunct anesthesia, and antipsychotic.
Definition (MSH) A butyrophenone with general properties similar to those of HALOPERIDOL. It is used in conjunction with an opioid analgesic such as FENTANYL to maintain the patient in a calm state of neuroleptanalgesia with indifference to surroundings but still able to cooperate with the surgeon. It is also used as a premedicant, as an antiemetic, and for the control of agitation in acute psychoses. (From Martindale, The Extra Pharmacopoeia, 29th ed, p593)
Definition (PDQ) A butyrophenone with anti-emetic, sedative and anti-anxiety properties. Although the exact mechanism through which droperidol exerts its effects is unknown, droperidol may block dopamine receptors in the chemoreceptor trigger zone (CTZ), which may lead to its anti-emetic effect. This agent may also bind to postsynaptic gamma-aminobutyric acid (GABA) receptors in the central nervous system (CNS), which increases the inhibitory effect of GABA and leads to sedative and anti-anxiety activities. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=39227&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=39227&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C458" NCI Thesaurus)
Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH D004329
SnomedCT 321398008, 334009009, 26574002, 387146001
LNC LP18863-8, MTHU006087
English 2H-Benzimidazol-2-one, 1-(1-(4-(4-fluorophenyl)-4-oxobutyl)-1,2,3,6-tetrahydro-4-pyridinyl)-1,3-dihydro-, Droperidol [CNS], droperidol, Droperidol [anaesthesia], Droperidol [anesthesia], Droperidol [central nervous system use], droperidol (medication), Droperidol [Chemical/Ingredient], dehydrobenzperidol, DROPERIDOL, Droperidol, Droperidol [central nervous system use] (product), Droperidol [anesthesia] (product), Droperidol (product), Droperidol (substance), Droperidol [anesthesia] (substance), Droperidol [central nervous system use] (substance)
Swedish Droperidol
Czech droperidol
Finnish Droperidoli
Russian DEGIDROBENZPERIDOL, DROPERIDOL, ДЕГИДРОБЕНЗПЕРИДОЛ, ДРОПЕРИДОЛ
Croatian DROPERIDOL
Polish Dehydrobenzoperidol, Properidol, Inapsin, Droperidol
Japanese デヒドロベンツペリドール, ドロペリドール
Spanish droperidol [con indicación para el sistema nervioso central] (producto), droperidol [con indicación para el sistema nervioso central], droperidol [anestésico], droperidol [anestésico] (producto), droperidol (producto), droperidol (sustancia), droperidol, Droperidol
French Dropéridol
German Droperidol
Italian Droperidolo
Portuguese Droperidol

Ontology: Inapsine (C0699335)

Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH D004329
German Inapsin
English inapsine, Inapsine, Taylor Brand of Droperidol