Droperidol
INAPSINE
What it isButyrophenone D2 antagonist used parenterally for severe nausea, acute agitation, and perioperative sedation.
Why this oneRapid, reliable control of agitation and refractory emesis in small IM or IV doses.
What limits itQT prolongation, hypotension, and extrapyramidal reactions constrain use; screen for QT risk and monitor when indicated.
FDA-approved for
- nausea/vomiting (~1970)
Off-label
- migraine in the emergency department
- acute agitation
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Perioperative nausea/vomiting (refractory) | Adults | 2.5 mg IM or slow IV | — | Additional 1.25 mg PRN |
| Perioperative nausea/vomiting (refractory) | Children 2-12 yr | 0.1 mg/kg IM or IV (max initial) | — | 0.1 mg/kg initial |
Renal Undefined
Hepatic Undefined
Instructions
- Give IM or slow IV
- Perform 12-lead ECG before dosing and monitor 2-3 hours after treatment
- Initiate at a low dose and titrate upward with caution
Contraindications
- Known or suspected QT prolongation, including congenital long QT syndrome
Cautions
- Risk factors for prolonged QT (CHF, bradycardia, diuretic use, hypokalemia, hypomagnesemia, QT-prolonging drugs)
- Extrapyramidal symptoms (dystonia, akathisia, oculogyric crisis)
- Mild-moderate hypotension and tachycardia
- Caution with other CNS depressants
Adverse reactions
- QT prolongation
- Torsade de pointes
- Cardiac arrest
- Ventricular tachycardia
- Hypotension
- Tachycardia
- Dysphoria
- Postoperative drowsiness
- Restlessness/anxiety
- Extrapyramidal symptoms
Pregnancy Pregnancy Category C; use only if potential benefit justifies risk to fetus.
Lactation Undefined
⚠ BOXED WARNINGS
- QT prolongation and torsades, including fatal cases, have occurred at or below recommended doses
- Reserve for patients who do not respond acceptably to alternatives; obtain a pre-dose ECG and monitor for arrhythmia
Cost, est. cash$20–$1,500/dose or month
Generic entry1986
Classes and tags
Clinical profile
Legacy pregnancy categoryC
Defining liabilityMetabolic effects, extrapyramidal symptoms/tardive dyskinesia and agent-specific QT or orthostatic risk.
Mechanism of action: Droperidol ballicule
Open Droperidol in the interactive console ↗
Memory aids: mascots and interaction avatars
spooky mascot → antipsychotic
greyscale → high potency first-gen antipsychotic
rainbow spray → antiemetic
