Droperidol ( Inapsine, Droleptan, Dridol, Xomolix, Innovar combination) is an antidopaminergic medication used as an antiemetic (that is, to prevent or treat nausea) and as an antipsychotic. Droperidol is also often used as a rapid sedative in intensive-care treatment, and where "agitation aggression or violent behavior"
/ref> are present.
History
Discovered at Janssen Pharmaceutica in 1961, droperidol is a
butyrophenone which acts as a potent D
2 (dopamine receptor) antagonist with some
histamine and
serotonin antagonist activity.
Medical use
It has a central antiemetic action and effectively prevents postoperative nausea and vomiting in adults using doses as low as 0.625 mg.
For treatment of nausea and vomiting, droperidol and ondansetron are equally effective; droperidol is more effective than metoclopramide.
Black box warning
In 2001, the FDA changed the labeling requirements for droperidol injection to include a Black Box Warning, citing concerns of
QT prolongation and torsades de pointes. The evidence for this is disputed, with 9 reported cases of
torsades in 30 years and all of those having received doses in excess of 5 mg.
QT prolongation is a dose-related effect,
and it appears that droperidol is not a significant risk in low doses.
A study in 2015 showed that droperidol is relatively safe and effective for the management of violent and aggressive
adult
patients in hospital emergency departments in doses of 10mg and above and that there was no increased risk of QT prolongation and torsades de pointes.
Side effects
Dysphoria, sedation,
hypotension resulting from peripheral
Alpha blocker, prolongation of QT interval which can lead to torsades de pointes, and extrapyramidal side effects such as
Dystonia/neuroleptic malignant syndrome.
Further reading
