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Droperidol (Droperidol) - Summary

 
 



WARNING

Cases of QT prolongation and/or torsade de pointes have been reported in patients receiving droperidol at doses at or below recommended doses. Some cases have occurred in patients with no known risk factors for QT prolongation and some cases have been fatal.

Due to its potential for serious proarrhythmic effects and death, droperidol should be reserved for use in the treatment of patients who fail to show an acceptable response to other adequate treatments, either because of insufficient effectiveness or the inability to achieve an effective dose due to intolerable adverse effects from those drugs (see CONTRAINDICATIONS, WARNINGS, PRECAUTIONS, and ADVERSE REACTIONS).

Cases of QT prolongation and serious arrhythmias (e.g., torsade de pointes) have been reported in patients treated with droperidol. Based on these reports, all patients should undergo a 12-lead ECG prior to administration of droperidol to determine if a prolonged QT interval (i.e., QTc greater than 440 msec for males or 450 msec for females) is present. If there is a prolonged QT interval, droperidol should NOT be administered. For patients in whom the potential benefit of droperidol treatment is felt to outweigh the risks of potentially serious arrhythmias, ECG monitoring should be performed prior to treatment and continued for 2-3 hours after completing treatment to monitor for arrhythmias.

Droperidol is contraindicated in patients with known or suspected QT prolongation, including patients with congenital long QT syndrome.

Droperidol should be administered with extreme caution to patients who may be at risk for development of prolonged QT syndrome (e.g., congestive heart failure, bradycardia, use of a diuretic, cardiac hypertrophy, hypokalemia, hypomagnesemia, or administration of other drugs known to increase the QT interval). Other risk factors may include age over 65 years, alcohol abuse, and use of agents such as benzodiazepines, volatile anesthetics, and IV opiates. Droperidol should be initiated at a low dose and adjusted upward, with caution, as needed to achieve the desired effect.

 

DROPERIDOL SUMMARY

DROPERIDOL
INJECTION, USP
For IV or IM Use Only

Droperidol Injection, USP is a sterile, nonpyrogenic solution of droperidol in water for injection for intravenous or intramuscular injection. Each mL contains droperidol 2.5 mg. Contains lactic acid to adjust pH. pH is 3.4 (3.0 to 3.8). The solution contains no bacteriostat, antimicrobial agent or added buffer and is intended only for use as a single-dose injection. Discard unused portion.

Droperidol injection is indicated to reduce the incidence of nausea and vomiting associated with surgical and diagnostic procedures.


See all Droperidol indications & dosage >>

NEWS HIGHLIGHTS

Published Studies Related to Droperidol

[Preoperative intravenous administration of droperidol (1.25 mg) reduced postoperative nausea and vomiting after intrathecal morphine administration]. [2011.02]
BACKGROUND: Intrathecal morphine (ITM) is an excellent postoperative analgesic, but may often cause postoperative nausea and vomiting (PONV). We designed this prospective, randomized and controlled study to evaluate the antiemetic efficacy of low-dose droperidol for the treatment of PONV caused by ITM... CONCLUSIONS: Single intravenous administration of 1.25 mg droperidol before operation showed prophylactic efficacy in early PONV caused by ITM. The duration of droperidol action was shorter than that of ITM. Hence we recommend that droperidol should be administered more frequently or continuously in the postoperative period.

A randomized comparison of droperidol, metoclopramide, tropisetron, and ondansetron for the prevention of postoperative nausea and vomiting. [2011]
BACKGROUND: Nausea and vomiting are the most common causes of postoperative complications, and they are seen most often after operations performed using general anesthesia and sedation. We designed this study to compare the effects of droperidol, metoclopramide, tropisetron, and ondansetron for the prevention of postoperative nausea and vomiting in patients undergoing gynecologic operations... CONCLUSION: We conclude that metoclopramide is not effective in preventing postoperative nausea and vomiting after gynecologic operations. Droperidol, tropisetron, and ondansetron are effective; however, the sedating effects of droperidol and tropisetron should be considered. Copyright (c) 2010 S. Karger AG, Basel.

Randomized controlled trial of intramuscular droperidol versus midazolam for violence and acute behavioral disturbance: the DORM study. [2010.10]
STUDY OBJECTIVE: We determine whether droperidol, midazolam, or the combination is more effective for intramuscular sedation in violent and acute behavioral disturbance in the emergency department (ED)... CONCLUSION: Intramuscular droperidol and midazolam resulted in a similar duration of violent and acute behavioral disturbance, but more additional sedation was required with midazolam. Midazolam caused more adverse effects because of oversedation, and there was no evidence of QT prolongation associated with droperidol compared with midazolam. Copyright (c) 2010 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.

Comparison between ketamine and fentanyl-droperidol for rectal premedication in children: a randomized placebo controlled trial. [2010.04]
PURPOSE: A common concern of anesthesiologists is the management of children involved in stressful scenarios, and premedication is considered, in most situations, as useful to reduce the stress responses. This randomized placebo-controlled study was designed to evaluate two premedicants, ketamine versus a combination of fentanyl-droperidol, rectally administered, in pediatric surgical outpatients... CONCLUSION: In this study, premedication with rectal ketamine showed significantly better overall results in the preoperative period than premedication with either fentanyl-droperidol or placebo.

Randomized controlled trial of intramuscular droperidol versus midazolam for violence and acute behavioral disturbance: the DORM study. [2010]
disturbance in the emergency department (ED)... CONCLUSION: Intramuscular droperidol and midazolam resulted in a similar duration

more studies >>

Clinical Trials Related to Droperidol

Evaluation of 2 Doses of Intravenous Droperidol in the Prevention of Postoperative Nausea [Recruiting]
In this prospective, randomised, placebo-controlled study, the researchers determined whether 0. 625 mg or 2. 5 mg of IV droperidol given 30 min before emergence from general anaesthesia reduces the incidence of immediate and delayed post operative nausea and vomiting (PONV) in thyroid surgical female population. Two hundred and forty six female patients receiving general anaesthesia for thyroid surgery received either droperidol 0. 625 mg or droperidol 2. 5 mg or placebo before emergence.

Droperidol Versus Metoclopramide for the Treatment of Primary Headaches [Recruiting]

Postoperative Vomiting in Children: Comparison Tri - Versus bi -Prophylaxis [Recruiting]
The purpose of this study is to evaluate the benefit of addition of droperidol to prophylaxis with ondansetron and dexamethasone in children with high risk of postoperative vomiting (POV). In adults some authors showed that the effectiveness of prophylaxis is correlated to the number of molecules or specific procedures used.

Comparison of Three Different Prophylactic Treatments of Postoperative Nausea and Vomiting (PONV) in Children [Recruiting]
Incidence of postoperative nausea and vomiting (PONV) in children after tonsillectomy with or without adenoidectomy may be as high as 75%.

Several medications may prevent and treat PONV, such as steroids, antidopaminergic drugs and serotonin (5-HT3) antagonists. The objective of this study is to compare three prophylactic antiemetic treatments:

- dexamethasone alone (250 mcg/kg)

- dexamethasone (250 mcg/kg) + droperidol (10 mcg/kg)

- dexamethasone (250 mcg/kg) + ondansetron (150 mcg/kg).

The Effects of the Anti Nausea Drugs Droperidol and Ondansetron on the Way the Heart Recovers Between Beats [Recruiting]
We are investigating a new technique for testing the effect of drugs on electrical activity in the heart. Disturbances of this electrical activity can cause life-threatening changes to heart rhythms. A better way of measuring the risk has recently been developed, and our research team leads the world in using this tool to test the safety of drugs used in children. Children and their families want to know that the drugs being used are safe, as do the doctors that care for them. In this study, we will take heartbeat tracings (ECGs) from 60 children before and during their operations. The ECGs will then be checked by a children's heart specialist. Differences on the ECGs will be related to the presence and amount of drug (droperidol or ondansetron) given. We expect that the droperidol or ondansetron will not cause any changes that show increased risk of abnormal heart rhythms. We can then tell patients, parents and regulatory authorities of the safety profile of this aspect of the drug; moreover, the study can be used as a model for testing many other drugs used in hospitals.

more trials >>

Reports of Suspected Droperidol Side Effects

Blood Bilirubin Increased (3)Cholestasis (3)Abnormal Behaviour (3)Hepatic Enzyme Increased (3)Electrocardiogram QT Prolonged (2)Unwanted Awareness During Anaesthesia (2)Drug Ineffective (2)Hospitalisation (2)Drug Hypersensitivity (2)Ventricular Tachycardia (2)more >>


Page last updated: 2013-02-10

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