Droperidol

Administration

• Type: antipsychotic, antiemetics
• Dosage Forms: 5mg/2mL
• Routes of Administration: IV/IM
• Common Trade Names: Inapsine

Adult Dosing

Combative patient

• 5-10mg IV
• 10mg IM

Nausea/vomiting

• 0.625-2.5mg IV

Headache

• 2.5mg IV or 2.5-5mg IM

Pain (with or without opiate tolerance)

• 0.625-5mg or higher IV/IM

Pediatric Dosing

Nausea/vomiting

• 2-12yo: 0.015-0.1mg/kg IV/IM

Special Populations

• Pregnancy Rating: C
• Lactation risk: Infant risk cannot be ruled out
• Renal dosing: Administer with caution
• Hepatic dosing: Administer with caution

Contraindications

• Allergy to class/drug
• Known or suspected prolonged QT

Adverse Reactions

Serious

• Prolonged QT, torsades, ventricular tachycardia, cardiac arrest
  • Note: effect on QT interval is dose-dependent
  • In 2001, FDA gave black box warning for risk of torsades de pointes, however there was little evidence to support this
  • Large cohort of patients in ED showed safety of its administration
• Neuroleptic malignant syndrome
• Anaphylaxis

Common

• Somnolence, dysphoria, anxiety
• Akathisia
• Hypotension
• Tachycardia

Pharmacology

• Half-life: 123-147m (adults), 75-127m (children)
• Metabolism: hepatic
• Excretion: mostly renal

Mechanism of Action

• Dopamine (D2) antagonist. Some serotonergic, histaminergic, and α-adrenergic effect

See Also

• Antipsychotics
• Combative patient

External Links

• emDOCs: Droperidol Use in the Emergency Department – What’s Old is New Again
• ACEP: Oldie but a Goodie: 10 Pearls of Droperidol