Droperidol Injection - Uses, Dose, Side effects, MOA, Brands

Droperidol is a butyrophenone that has got antiemetic, antianxiety, and antipsychotic properties. It is indicated for postoperative nausea and vomiting and sedation in the intensive care unit.

Droperidol Uses:

  • Postoperative nausea and vomiting (PONV):

    • For prevention and/or treatment of nausea and vomiting after surgical and diagnostic procedures
  • Off Label Use of Droperidol in Adults:

    • Acute undifferentiated agitation

Dose in adults:

 Note: Titrate carefully until the desired effect is acheived

Droperidol Dose in the treatment of Acute undifferentiated agitation (off-label):

  • IM: Initial: 5 to 10 mg, as monotherapy or as an adjunct to a benzodiazepine;
  • wait for at least 10 to 30 minutes before administrating additional medications to relieve agitation if still required.
  • IV: Initial: 2.5 to 10 mg, as monotherapy or in combination with a benzodiazepine; may repeat droperidol dose every 5 minutes until sedation is attained;
  • The maximum dose is 20 mg per episode; median required dose was 10 mg in one study.

Droperidol Dose in the treatment of Postoperative nausea and vomiting (PONV): IM, IV:

  • Manufacturer labeling:

    • Maximum initial dose: 2.5 mg; can be given further 1.25 mg cautiously to reach the desired effect
  • Consensus guideline recommendations:

    • 625 to 1.25 mg IV administered at the end of surgery.

Droperidol Dose in Children:

Dosage must be customized according to age, body weight, underlying comorbid conditions, physical status, concomitant medications, type of anesthesia, and surgical procedure.

Droperidol Dose in the treatment of Postoperative nausea and vomiting (PONV):

  • Prophylaxis if high risk for PONV:

  • Note: Not the preferred agent:
    • Children ≥2 years and Adolescents:
      • IM, IV: 0.01 to 0.015 mg/kg/dose given near the end of surgery;
      • maximum dose: 1.25 mg/dose;
      • Further dose can be cautiously administered after at least 6 hours only if potential benefit is more than risks.

Note:

  • Previous reports suggested a higher dose of 0.075 mg/kg as effective; however, due to associated side effects, doses >0.05 mg/kg are not recommended anymore.
  • Treatment (not first line):

    • Children 2 to 12 years:
      • IM, IV: Maximum initial dose: 0.1 mg/kg/dose; for additional dose use extreme caution, administer only if potential benefit isris greater than the risks

Pregnancy Risk Factor: C

  • In some studies on animal reproduction, adverse events were reported.
  • Droperidol was studied as an adjunctive treatment for hyperemesis gravidarum.
  • However, it is not recommended for pregnant women to use it for persistent nausea and vomiting symptoms.

Use droperidol while breastfeeding

  • Droperidol secreted in breastmilk is not known.
  • Breastfeeding infants can be adversely affected by maternal administration after cesarean birth (based on Neurologic Scores and Adaptive Capacity Scores). However, more research is needed.
  • Droperidol could theoretically interfere with milk production.
  • Limited data suggests that infant exposure to breastmilk after a single maternal dose will reduce the risk of adverse events in infants who are breastfed.
  • Breastfeeding mothers should be cautious, manufacturer recommends

Dose in Kidney disease:

Use with cautioun however no dose adjustment recommended by manufacturer.

Dose in Liver disease:

Use with caution, however, no dose adjustment recommended by manufacturer.

Side effects of Droperidol:

  • Cardiovascular:

    • Cardiac Arrest
    • Hypertension
    • Hypotension (Especially Orthostatic)
    • QT Prolongation (Dose-Dependent)
    • Tachycardia
    • Torsade De Pointes
    • Ventricular Tachycardia
  • Central Nervous System:

    • Anxiety
    • Chills
    • Depression (Postoperative
    • Transient)
    • Dizziness
    • Drowsiness (Postoperative) Increased
    • Dysphoria
    • Extrapyramidal Symptoms (Akathisia
    • Dystonia
    • Oculogyric Crisis)
    • Hallucinations (Postoperative)
    • Hyperactivity
    • Neuroleptic Malignant Syndrome (NMS) (Rare)
    • Restlessness
  • Respiratory:

    • Bronchospasm
    • Laryngospasm
  • Miscellaneous:

    • Anaphylaxis
    • Shivering

Contraindications to Droperidol:

  • Hypersensitivity to droperidol and any component of the formulation
  • QT prolongation known or suspected, including congenital QT syndrome (prolongedQT) is defined as >440msec for males and >450msec for females.
  • Canadian labeling: Additional contraindications not in US labeling
    • Children under 2 years old are not recommended for use

Warnings and precautions

  • Arrhythmias: [US Boxed Warning]:

    • Reports have included cases of QT prolongation, torsade des pointes and even fatalities.
    • Patients with bradycardia (50 beats per minute), cardiac disease, concomitant MAO inhibitor therapy, Class II and Class III antiarrhythmics, or any other drugs that may cause QT prolongation or electrolyte disturbances (hypokalemia and hypomagnesemia) should be treated with extreme caution.
  • Anticholinergic effects

    • Possible anticholinergic side effects: constipation, xerostomia and blurred vision;
    • Patients with reduced gastrointestinal motility, BPH, xerostomia, and urinary retention should be cautious.
    • Droperidol's cholinergic blockade potency is lower than other neuroleptics.
  • CNS depression:

    • CNS depression can lead to mental or physical impairments. Patients should be cautious about driving or operating machinery that requires mental alertness.
  • Aspiration and esophageal dysmotility:

    • Antipsychotic use has been linked to esophageal dysmotility, aspiration, and increased risk with age.
    • Patients at high risk of aspiration pneumonia (eg Alzheimer's disease) should be treated with caution, especially patients over 75 years.
  • Extrapyramidal symptoms:

    • Extrapyramidal symptoms (EPS) may occur, including pseudo parkinsonism and acute dystonic reactions.
    • These reactions are generally less common than those caused by conventional antipsychotics. Frequency reports are comparable to placebo.
    • Higher doses of antipsychotics and use of conventional antipsychotics may increase the risk of dystonia (and other EPS), in younger patients.
    • There are several factors that increase the vulnerability to tardive dyskinesia, including older age, female gender, postmenopausal status and Parkinson disease symptoms.
    • Stop treating tardive dyskinesia symptoms and signs.
  • Hyperprolactinemia:

    • May increase prolactin levels
    • It is unknown if hyperprolactinemia has any clinical significance in breast cancer patients or other prolactin-dependent tumours.
  • Neuroleptic malignant syndrome (NMS):

    • It may also be used in conjunction with neuroleptic malignant syndrome (NMS).
    • Monitor for changes in mental status, fever, rigidity of the muscles, and/or signs of autonomic instability.
  • Orthostatic hypotension

    • May cause orthostatic hypotension; use cautiously in patients at risk of this effect or in those who would not tolerate transient hypotensive episodes (cerebrovascular disease, cardiovascular disease, hypovolemia, or concurrent medication use which may predispose to hypotension/bradycardia).
  • Temperature regulation

    • It is possible to have impaired core body temperature regulation
    • Be careful with heat exposure, strenuous exercise, heat, dehydration, or concomitant anticholinergic medication.
  • Hepatic impairment

    • Patients with severe hepatic impairment should be cautious.
  • Pheochromocytoma:

    • Patients with pheochromocytoma should be cautious; serious hypertension and/or Tachycardia could occur.
  • Renal impairment

    • Patients with impaired renal function should be cautious.
  • Seizures:

    • Patients at high risk of seizures should be treated with caution, especially those who have had seizures in the past, are brain damaged, suffered from head trauma or are taking concurrent treatment with medication that could lower their seizure threshold.

Droperidol: Drug Interaction

Note: Drug Interaction Categories:

  • Risk Factor C: Monitor When Using Combination
  • Risk Factor D: Consider Treatment Modification
  • Risk Factor X: Avoid Concomitant Use

Risk Factor C (Monitor therapy).

Acetylcholinesterase inhibitors Anticholinergic Agents may have a decreased therapeutic effect. Anticholinergic Agents can decrease the therapeutic effects of Acetylcholinesterase inhibitors.
Inhibitors of Acetylcholinesterase (Central) Antipsychotic Agents may increase the neurotoxic (central), effect. Some patients have experienced severe extrapyramidal symptoms.
Alizapride CNS Depressants may increase the CNS depressant effects.
Amifampridine Agents with Seizure Threshold Lower Potential can enhance the neuroexcitatory or seizure-potentiating effects of Amifampridine.
Amphetamines Antipsychotic Agents can reduce the stimulatory effects of Amphetamines.
Anticholinergic Agents Other Anticholinergic Agents may have an adverse/toxic effect.
Botulinum Toxin-Containing Products Anticholinergic Agents may have an enhanced anticholinergic effect.
Brimonidine (Topical) CNS Depressants may increase the CNS depressant effects.
BuPROPion May increase the neuroexcitatory or seizure-potentiating effects of Agents With Seizure Threshold Lowering Potential.
Cannabidiol CNS Depressants may increase the CNS depressant effects.
Cannabis CNS Depressants may increase the CNS depressant effects.
Chlorphenesin Carbamate CNS Depressants may have an adverse/toxic effect that can be exacerbated by them.
Clarithromycin QT-prolonging Antipsychotics may increase Clarithromycin's QTc-prolonging effects (Moderate risk). When using these agents together, monitor for QTc interval prolongation or ventricular arrhythmias. Patients at higher risk for QTc prolongation might have additional risk factors.
CloZAPine CloZAPine may increase the QTc prolonging effects by QT-prolonging antipsychotics (Moderate risk). When these agents are used together, monitor for QTc interval prolongation or ventricular arrhythmias. Patients at higher risk for QTc prolongation might have additional risk factors.
Dimethindene (Topical). CNS Depressants may increase the CNS depressant effects.
Dronabinol CNS Depressants may increase the CNS depressant effects.
Gastrointestinal Agents (Prokinetic) Anticholinergic Agents can reduce the therapeutic effects of Gastrointestinal Agents (Prokinetic).
Glucagon Anticholinergic agents may increase the toxic/adverse effects of Glucagon. Particularly, there may be an increase in the likelihood of gastrointestinal adverse reactions.
Guanethidine Guanethidine's therapeutic effects may be diminished by antipsychotic agents.
Haloperidol QT-prolonging antipsychotics (Moderate risk) can increase the QTc prolonging effect of Haloperidol. When using these agents together, monitor for QTc interval prolongation or ventricular arrhythmias. Patients at higher risk for QTc prolongation might have additional risk factors.
Itopride Itopride's therapeutic effects may be diminished by anticholinergic agents.
Kava Kava CNS Depressants may have an adverse/toxic effect that can be exacerbated by them.
Lithium Antipsychotic Agents may have a neurotoxic effect that can be increased by lithium. The serum concentrations of Antipsychotic Agents may be decreased by lithium. Particularly noted for chlorpromazine.
Magnesium Sulfate CNS Depressants may increase the CNS depressant effects.
Methylphenidate Antipsychotic Agents can increase the harmful/toxic effects of Methylphenidate. Antipsychotic Agents may have an adverse/toxic effect that is magnified by Methylphenidate.
MetyroSINE Droperidol may have an adverse/toxic effect.
Minocycline CNS Depressants may increase the CNS depressant effects.
Mirabegron Anticholinergic agents may increase the toxic/adverse effects of Mirabegron.
Nabilone CNS Depressants may increase the CNS depressant effects.
Nitroglycerin The absorption of Nitroglycerin may be decreased by anticholinergic agents. Anticholinergic Agents may reduce the dissolution sublingual nitroglycerin tablet, which could impair or slow down nitroglycerin absorbtion.
Ondansetron QTc-prolonging effects of QT-prolonging antipsychotics may be increased (moderate risk). When these agents are used together, monitor for QTc interval prolongation or ventricular arrhythmias. Patients at higher risk for QTc prolongation might have additional risk factors.
Pentamidine (Systemic) QTc-prolonging effects of QT-prolonging antipsychotics may be increased (moderate risk). When these agents are used together, monitor for QTc interval prolongation or ventricular arrhythmias. Patients at higher risk for QTc prolongation might have additional risk factors.
QT-prolonging Antidepressants (Moderate risk) QT-prolonging antipsychotics (Moderate risk) can increase the QTc prolonging effect QT-prolonging antidepressants (Moderate risk). When these agents are used together, monitor for QTc interval prolongation or ventricular arrhythmias. Patients at higher risk for QTc prolongation might have additional risk factors.
QT-prolonging Antipsychotics (Moderate Risk) Droperidol may increase the QTc-prolonging effects. When using these agents together, monitor for QTc interval prolongation or ventricular arrhythmias. Patients at higher risk for QTc prolongation might have additional risk factors. Exceptions: Amisulpride; CloZAPine; Droperidol; Pimozide.
QT-prolonging Class IC Antiarrhythmics (Moderate Risk) QTc-prolonging effects of QT-prolonging antipsychotics may be increased (moderate risk). When these agents are used together, monitor for QTc interval prolongation or ventricular arrhythmias. Patients at higher risk for QTc prolongation might have additional risk factors.
QT-prolonging Kinase Inhibitors (Moderate Risk) QT-prolonging antipsychotics (Moderate risk) can increase the QTc prolonging effect QT-prolonging kinase inhibitors (Moderate risk). When these agents are used together, monitor for QTc interval prolongation or ventricular arrhythmias. Patients at higher risk for QTc prolongation might have additional risk factors.
QT-prolonging Miscellaneous Agents (Moderate Risk) QTc-prolonging effects of QT-prolonging antipsychotics may be increased (moderate risk). When these agents are used together, monitor for QTc interval prolongation or ventricular arrhythmias. Patients at higher risk for QTc prolongation might have additional risk factors. Domperidone is an exception.
QT-prolonging Moderate CYP3A4 Drug Inhibitors (Moderate risk) QTc-prolonging effects of QT-prolonging antipsychotics may be increased (moderate risk). When these agents are used together, monitor for QTc interval prolongation or ventricular arrhythmias. Patients at higher risk for QTc prolongation might have additional risk factors.
Quinolone Antibiotics for QT-prolonging (Moderate risk) QTc-prolonging effects of QT-prolonging antipsychotics may be increased (moderate risk). When these agents are used together, monitor for QTc interval prolongation or ventricular arrhythmias. Patients at higher risk for QTc prolongation might have additional risk factors.
Quinagolide Quinagolide's therapeutic effects may be diminished by antipsychotic agents.
Ramosetron Ramosetron's constipating effects may be enhanced by anticholinergic agents.
Rufinamide CNS Depressants may have an adverse/toxic effect that can be exacerbated by this. Particularly, dizziness and sleepiness may be increased.
Saquinavir QT-prolonging antipsychotics (Moderate risk) can increase the QTc prolonging effects of Saquinavir. When using these agents together, monitor for QTc interval prolongation or ventricular arrhythmias. Patients at higher risk for QTc prolongation might have additional risk factors.
Selective Serotonin Reuptake inhibitors CNS Depressants can increase the toxic/adverse effects of Selective Serotonin Resuptake Inhibitors. Particularly, psychomotor impairment could be increased.
Serotonin Modulators Antipsychotic Agents may have an adverse/toxic effect that can be exacerbated by serotonin modulators. Serotonin modulators, in particular, may increase dopamine blockade and possibly increase the risk of neuroleptic malignant syndrome. Serotonin modulators may have a serotonergic effect that is enhanced by antipsychotic agents. This could lead to serotonin syndrome. Nicergoline is an exception.
Tetrahydrocannabinol CNS Depressants may increase the CNS depressant effects.
Tetrahydrocannabinol, and Cannabidiol CNS Depressants may increase the CNS depressant effects.
Thiazide and Thiazide - Like Diuretics Anticholinergic Agents can increase serum Thiazide or Thiazide-Like Diuretics.
Voriconazole QTc-prolonging effects of QT-prolonging antipsychotics may be increased (moderate risk). When these agents are used together, monitor for QTc interval prolongation or ventricular arrhythmias. Patients at higher risk for QTc prolongation might have additional risk factors.

Risk Factor D (Consider therapy modifications)

Anti-Parkinson Agents (Dopamine Agonist). Antipsychotic Agents [First Generation] may decrease the therapeutic effect Anti-Parkinson Agents ("Dopamine Agonist") Anti-Parkinson Agents, Dopamine Agonist, may decrease the therapeutic effect Antipsychotic Agents First Generation [Typical]. If possible, avoid concomitant therapy and watch for decreased effects of both agents if they cannot be avoided. AntiParkinson agents may not be affected by atypical antipsychotics like quetiapine or clozapine.
Blonanserin CNS Depressants can increase the CNS depressant effects of Blonanserin.
Buprenorphine CNS Depressants can increase the CNS depressant effects of buprenorphine. Management: Consider reduced doses of other CNS depressants, and avoiding such drugs in patients at high risk of buprenorphine overuse/self-injection. Buprenorphine patches (Butrans) should be initiated at 5 mg/hr for adults who are taking other CNS depressants.
Chlormethiazole CNS Depressants may increase the CNS depressant effects. Monitoring: Look out for signs of CNS depression. If a combination of chlormethiazole and other drugs is required, a reduced dose should be used.
ChlorproMAZINE Droperidol could increase the CNS depressant effects of ChlorproMAZINE. Droperidol could increase the QTc-prolonging effects of ChlorproMAZINE. Management: You may consider other combinations of this drug. Dose reductions are advised if the drug combination is combined. You should monitor for additive toxicities like QTc interval prolongation and ventricular arrhythmias.
CNS Depressants Droperidol can increase the CNS depressant effects of CNS Depressants. Droperidol and other CNS agents, such as opioids, may be reduced or combined with droperidol. Separate drug interaction monographs provide more detail on exceptions to this monograph. Exceptions: ChlorproMAZINE, CloZAPine, Flupentixol and Haloperidol; Methadone. OLANZapine. QUEtiapine. RisperiDONE. Thioridazine.
Domperidone QT-prolonging agents (moderate risk) could increase the QTc-prolonging effects of Domperidone. Management: Look for alternatives to this combination. Monitor for QTc interval prolongation or ventricular arrhythmias if the drug combination is combined. Patients at higher risk for QTc prolongation might have additional risk factors.
Flunitrazepam CNS Depressants can increase the CNS depressant effects of Flunitrazepam.
HYDROcodone CNS Depressants can increase the CNS depressant effects of HYDROcodone. When possible, avoid concomitant use with hydrocodone and other CNS depressants. Combining these agents is not recommended unless there are other options. Limit the amount and duration of each drug when combined.
Iohexol Agents with Seizure Threshold Lowering Potential can increase the toxic/adverse effects of Iohexol. The risk of seizures could be elevated. Management: Stop using agents that lower the seizure threshold 48 hrs before you start intrathecal iohexol. To resume these agents, wait at least 24 hours following the procedure. Consider using prophylactic anticonvulsants in non-elective procedures.
Iomeprol Agents with Seizure Threshold Lowering Potential can increase the toxic/adverse effects of Iomeprol. The risk of seizures could be elevated. Management: Stop using agents that lower the seizure threshold 48 hrs before you start intrathecal iomeprol. To resume these agents, wait at least 24 hours following the procedure. Consider using prophylactic anticonvulsants in non-elective procedures.
Iopamidol Agents with Seizure Threshold Lowering Potential can increase the toxic/adverse effects of Iopamidol. The risk of seizures could be elevated. Management: Stop using agents that lower the seizure threshold 48 hrs before you start intrathecal iopamidol. To resume these agents, wait at least 24 hours following the procedure. Consider using prophylactic anticonvulsants in non-elective procedures.
Mequitazine Antipsychotic Agents can increase the arrhythmogenic effects of Mequitazine. Management: If you are unable to use one of these agents, consider alternatives. This combination is not contraindicated but mequitazine labels it as discouraged.
Methadone Methadone's CNS depressant effects may be enhanced by Droperidol. Methadone's QTc-prolonging effects may be enhanced by Droperidol. You should consider other options. Dose reductions are recommended if the doses are combined. You should monitor for additive toxicities like QTc interval prolongation and ventricular arrhythmias. Patients at higher risk for additional risk factors are even more vulnerable.
Methotrimeprazine Methotrimeprazine may have a higher CNS depressant activity than CNS Depressants. Methotrimeprazine can increase the CNS depressant effects of CNS Depressants. Management: Lower the adult dose of CNS Depressants by 50% and start concomitant methotrimeprazine treatment. After clinically proven efficacy of methotrimeprazine, further CNS depressant dose adjustments should only be made.
OxyCODONE CNS Depressants can increase OxyCODONE's CNS depressant effects. When possible, avoid the simultaneous use of oxycodone, benzodiazepines, or other CNS depression drugs. Combining these agents is not recommended unless there are other options. Limit the amount and duration of each drug when combined.
Perampanel CNS Depressants may have a greater CNS depressant effect. Perampanel and any other CNS depressant drug should be used in combination. Patients who take perampanel together with any other drug should not engage in complex or high-risk activities until they have had experience using the combination.
Pramlintide Anticholinergic Agents may have an enhanced anticholinergic effect. These effects are only for the GI tract.
Agents that prolong QT (Highest risk) Droperidol may increase the QTc-prolonging effects. Management: Look for alternatives to this combination. These toxicities are more likely to occur in patients with other risk factors, such as older age, female sexual activity, bradycardia and hypokalemia. There are exceptions to this rule: Methadone, ChlorproMAZINE and Ziprasidone.
Secretin Secretin's therapeutic effects may be diminished by anticholinergic agents. Concomitant use: Secretin and anticholinergic agents should be avoided. Stop using anticholinergic drugs for at least five half-lives before administering secretin.
Sodium Oxybate CNS Depressants may have a greater depressant effect if taken in combination. Management: Look for alternatives to the combination use. If you must combine use, reduce the doses of any one or more drugs. It is not recommended to combine sodium oxybate and alcohol, or any sedative hypnotics.
Suvorexant CNS Depressants can increase the CNS depressant effects of Suvorexant. Management: Suvorexant or any other CNS depressionant can be reduced in doses. Suvorexant should not be taken with alcohol. It is also not recommended to take suvorexant along with any other drugs for insomnia.
Tapentadol CNS Depressants may increase the CNS depressant effects. Tapentadol, benzodiazepines and other CNS depressants should be avoided when possible. Combining these agents is not recommended unless there are other options. Limit the amount and duration of each drug when combined.
Thiopental Thiopental may have a therapeutic effect that dropseridol can enhance. Thiopental dosage reduction should be considered when combined with droperidol. If you use this combination, monitor patient responses to treatment.
Zolpidem CNS Depressants can increase the CNS depressant effects of Zolpidem. Management: For men who also take CNS depressants, reduce the adult Intermezzo brand sublingual Zolpidem dose to 1.75mg. For women, no dose adjustment is advised. Avoid using CNS depressants at night; do not use alcohol.

Risk Factor X (Avoid Combination)

Aclidinium Anticholinergic Agents may have an enhanced anticholinergic effect.
Amisulpride Antipsychotic agents may increase the toxic/adverse effects of Amisulpride. Management: The drug interactions monographs for drugs listed as an exception to this monograph provide more information.
Amisulpride May increase the QTc prolonging effect of QT Prolonging Antipsychotics (Moderate risk).
Azelastine (Nasal) CNS Depressants could increase the CNS depressant effects of Azelastine.
Bromopride Bromopride may have an adverse/toxic effect that Droperidol can increase.
Bromperidol CNS Depressants may increase the CNS depressant effects.
Cimetropium Cimetropium may have an anticholinergic effect that can be enhanced by the use of anticholinergic agents.
Eluxadoline Eluxadoline may cause constipation by using anticholinergic agents.
Glycopyrrolate (Oral Inhalation) Anticholinergic agents may increase the anticholinergic effects of Glycopyrrolate (Oral inhalation).
Glycopyrronium (Topical) Anticholinergic Agents may have an enhanced anticholinergic effect.
Oral Inhalation with Ipratropium Anticholinergic Agents may have an enhanced anticholinergic effect.
Levosulpiride Anticholinergic Agents can reduce the therapeutic effects of Levosulpiride.
Metoclopramide Metoclopramide may be more toxic or adversely affected by Droperidol.
Orphenadrine Orphenadrine may be more effective against CNS depression than other drugs.
Oxatomide Anticholinergic Agents may have an enhanced anticholinergic effect.
Oxomemazine CNS Depressants may increase the CNS depressant effects.
Paraldehyde Paraldehyde may be enhanced by CNS depressants.
Pimozide QTc-prolonging agents may have a moderate risk of increasing their QTc-prolonging effects (Moderate risk).
Piribedil Antipsychotic Agents can reduce the therapeutic effects of Piribedil. Antipsychotic Agents may have a lower therapeutic effect due to Piribedil. Management: Piribedil is not recommended for use with antiemetic or antipsychotic neuroleptics.
Potassium Chloride Potassium Chloride may have an ulcerogenic effect that can be exacerbated by anticholinergic agents. Treatment: Patients taking drugs that have significant anticholinergic effects should not consume any oral dose form of potassium chloride.
Potassium Citrate Potassium Citrate may be more ulcerogenic if it is given to anticholinergic agents.
Revefenacin Revefenacin may be enhanced by anticholinergic agents.
Sulpiride Sulpiride's toxic/adverse effects may be exacerbated by antipsychotic agents.
Thalidomide CNS Depressants can increase Thalidomide's CNS depressant effects.
Tiotropium Anticholinergic agents may increase the anticholinergic effects of Tiotropium.
Umeclidinium Anticholinergic Agents may have an enhanced anticholinergic effect.
Ziprasidone Ziprasidone may have a higher QTc-prolonging effects if Droperidol is added. Management: Look for alternatives to this combination. Monitor for QTc interval prolongation and ventricular arrhythmias if the drug combination is combined. Patients at higher risk for QTc prolongation might have additional risk factors.

Monitoring parameters:

  •  12-lead ECG prior to use is recommended to look for QT prolongation
  • continued ECG monitoring for 2-3 hours following administration is recommended.
  • Vital signs
  • serum magnesium and potassium
  • mental status, abnormal involuntary movement scale (AIMS)
  • observefor dystonias, extrapyramidal side effects, and temperature changes

How to administer Droperidol?

  • IM, IV: Administer IM or IV; according to the manufacturer,
  • slow IV push
  • Dilute for IV infusion

Mechanism of action of Droperidol:

  • Droperidol, a butyrophenone-antipsychotic, is blocked dopamine stimulation in the chemoreceptor trigger area.
  • Other effects include alpha-adrenergic blockade, peripheral vascular dilation, and reduction of the pressor effect of epinephrine resulting in hypotension and decreased peripheral vascular resistance; may also decrease pulmonary artery pressure.

Onset of action:

  • 3 to 10 minutes

Peak effect:

  • ~30 minutes

Duration:

  • 2 to 4 hours, may extend to 12 hours

Absorption:

  • IM: Rapid.

Distribution:

  • Crosses blood-brain barrier

Protein binding:

  • 85% to 90%

Metabolism:

  • Hepatic, to p-fluorophenylacetic acid, benzimidazolone, p-hydroxypiperidine

Half-life elimination:

  • Children ~ 1.7 hours;
  • Adults: ~2 hours

Excretion:

  • Urine (75%, <1% as unchanged drug);
  • feces (22%, 11% as unchanged drug)

International Brand Names of Droperidol:

  • Dehidrobenzoperidol
  • Dehydrobenzperidol
  • Dridol
  • Droleptan
  • Dropedol
  • Dropel
  • Droperdal
  • Droperidol
  • Droperol
  • Inapsin
  • Sintodian
  • Xomolix

Droperidol Brand Names in Pakistan:

No Brands Available in Pakistan. 

Comments

NO Comments Found