Droperidol

Intravenous
Intramuscular
Class
Antipsychotics
Subclass
Butyrophenones
Substance name
Droperidol
Common formulations
Solution for injection
Dosage and administration
Adults patients
Symptomatic relief
Agitation in patients with psychotic disorders • Off-label
•
2.5-10 mg IV once
May repeat droperidol dose every 5 minutes until sedation achieved. Maximum dose 20 mg per episode.
Opioid-induced pruritus • Off-label
•
2.5-5 mg IV once
Treatment
Treatment of cannabinoid hyperemesis syndrome • Off-label
•
0.625 mg IV once
Prevention
Prevention of postoperative nausea and vomiting
•
up to 2.5 mg IV once, administered as a slow injection, with additional 1.25 mg doses repeated if necassary
Alternative
•
0.625 mg IV × 1 at the end of surgery
Other off-label uses
•
Treatment of postoperative delirium
•
Facilitation of procedural sedation
Indications for use
Labeled indications
Adults
•
Prevention of postoperative nausea and vomiting
Off-label indications
Adults
•
Symptomatic relief of agitation in patients with psychotic disorders
•
Symptomatic relief of opioid-induced pruritus
•
Treatment of cannabinoid hyperemesis syndrome
•
Treatment of postoperative delirium
•
Facilitation of procedural sedation
Safety risks
Boxed warnings
Prolonged QT interval, torsade de pointes
•
Do not use in patients with known or suspected QT prolongation, including congenital long QT syndrome. Use extreme caution in patients at risk of QT prolongation, such as with congestive HF, bradycardia, cardiac hypertrophy, significant cardiac disease, hypokalemia, hypomagnesemia, or receiving diuretics, MAOIs, or other other drugs known to increase the QT interval.
Contraindications
Hypersensitivity to droperidol or its components
Warnings and precautions
CNS depression
•
Use caution in patients receiving other CNS depressants, such as barbiturates, tranquilizers, opioids, and general anesthetics. Reduce the dose of other agents.
Hypertensive crisis
•
Use caution in patients with confirmed or suspected pheochromocytoma.
Hypotension
•
Maintain a high level of suspicion, as droperidol can cause hypotension. Monitor vital signs and ECG routinely.
Specific populations
Renal impairment
eGFR 0-90 mL/min/1.73 m²
•
Use with caution.
Renal replacement therapy
Continuous renal replacement
•
Use with caution.
Intermittent hemodialysis
•
Use with caution.
Peritoneal dialysis
•
Use with caution.
Hepatic impairment
Any severity
•
Use with caution.
Pregnancy and breastfeeding
Pregnancy
All trimesters • Australia Category: C
•
Use only if benefits outweigh potential risks. Evidence of fetal harm in humans.
Breastfeeding
Use with caution during breastfeeding.
Unknown amount excreted in breastmilk.
Unknown drug levels in breastfed infants.
May potentially cause adverse effects in breastfed infants.
Adverse reactions
Unknown frequency
•
↑QT interval, hypotension, palpitations, syncope, tachycardia, somnolence, restlessness, dysphoria, anxiety, hyperactivity, dystonia, akathisia, extrapyramidal signs, hallucinations, dizziness, chills, shivering, laryngospasm, bronchospasm, hypertension, torsades de pointes, cardiac arrest, ventricular tachycardia, oculogyric crisis, anaphylaxis
Interactions
Drug(s)
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