First-generation antipsychotic, butyrophenone. Used as antiemetic.
Brand names: Inapsine
Updated · Methodology
Second line
Droperidol is second-line antiemetic for postoperative nausea and vomiting when ondansetron and metoclopramide fail. recommends 0.625–1.25 mg IV. Use requires ECG screening due to boxed warning for torsades de pointes.
ICD-10: R11 · ICD-11: MD90
Blocks D2 receptors in the chemotrigger zone of the medulla – suppresses nausea. Also blocks alpha-1 adrenoceptors (hypotension) and hERG potassium channels (QT prolongation). added a boxed warning in 2001 for torsades de pointes even at low PONV doses.
Limited data. Not used in caesarean section (hypotension risk).
Interrupt breastfeeding for 24 hours after single dose.
Reference information, not a clinical decision. Discuss feeding pauses or changes with your physician or an IBCLC.
4 pairs found. Sorted from critical to minor.
Mechanism
Dual QT prolongation (amiodarone 30-50 ms, droperidol 10-20 ms). boxed warning on droperidol.
Symptoms
QTc above 500 ms, syncope, torsades de pointes risk.
Management
Combination contraindicated. Alternative – low-dose ondansetron or metoclopramide.
Mechanism
Dual QT prolongation, especially with methadone above 80 mg/day.
Symptoms
QTc above 500 ms, syncope, torsades de pointes risk.
Management
Combination contraindicated.
Mechanism
Dual QT prolongation.
Symptoms
QTc above 500 ms, syncope, torsades de pointes risk.
Management
Combination contraindicated.
Mechanism
Additive QT prolongation (ondansetron 10-15 ms + droperidol 10-20 ms).
Symptoms
QTc above 500 ms, syncope, torsades de pointes risk.
Management
Choose one antiemetic or use ECG monitoring.
Verbatim lines from the interaction sections, in the language of the label
«Potentially Arrhythmogenic Agents:: Any drug known to have the potential to prolong the QT interval should not be used together with droperidol. Possible pharmacodynamic interactions can occur…»FDA, section 7 · Open on DailyMed
«Potentially Arrhythmogenic Agents:: Any drug known to have the potential to prolong the QT interval should not be used together with droperidol. Possible pharmacodynamic interactions can occur…»FDA, section 7 · Open on DailyMed
«Potentially Arrhythmogenic Agents:: Any drug known to have the potential to prolong the QT interval should not be used together with droperidol. Possible pharmacodynamic interactions can occur…»FDA, section 7 · Open on DailyMed
«Potentially Arrhythmogenic Agents:: Caution should be used when patients are taking concomitant drugs known to induce hypokalemia or hypomagnesemia as they may precipitate QT prolongation and…»FDA, section 7 · Open on DailyMed
«CNS Depressant Drugs:: Other CNS depressant drugs (e.g. barbiturates, tranquilizers, opioids and general anesthetics) have additive or potentiating effects with droperidol. When patients have…»FDA, section 7 · Open on DailyMed
«CNS Depressant Drugs:: Other CNS depressant drugs (e.g. barbiturates, tranquilizers, opioids and general anesthetics) have additive or potentiating effects with droperidol. When patients have…»FDA, section 7 · Open on DailyMed
«DRUG INTERACTIONS: Because pimozide prolongs the QT interval of the electrocardiogram, an additive effect on QT interval would be anticipated if administered with other drugs, such as phenothiazines…»FDA, section 7 · Open on DailyMed
«CONTRAINDICATIONS: dofetilide, sotalol, quinidine, other Class Ia and III anti-arrhythmics, mesoridazine, thioridazine, chlorpromazine, droperidol, pimozide, sparfloxacin, gatifloxacin, moxifloxacin…»FDA, section 4 · Open on DailyMed
«Drugs Prolonging the QT Interval: BARHEMSYS causes dose- and concentration-dependent QT prolongation [see Clinical Pharmacology (12.2) ] . To avoid potential additive effects, avoid use of BARHEMSYS…»FDA, section 7 · Open on DailyMed
«Sustancias que pueden desencadenar torsades de pointes: - ciertos antipsicóticos: fenotiazinas (por ejemplo, clorpromazina, ciamemazina, levomepromazina, tioridazina, trifluoperazina), benzamidas…»AEMPS, section 4.5 · Open on CIMA
«Potential for Other Drugs to Affect Clozapine: Use caution when administering concomitant medications that prolong the QT interval or inhibit the metabolism of clozapine. Drugs that cause QT…»FDA, section 7 · Open on DailyMed
«Drugs that Prolong the QT Interval: Do not use fluoxetine in combination with thioridazine or pimozide. Use fluoxetine with caution in combination with other drugs that cause QT prolongation. These…»FDA, section 7 · Open on DailyMed
«Medicamentos afectados por alteraciones de los niveles de potasio: Algunos antipsicóticos (p.ej., trioridazina, clorpromazina, levomepromazina, trifluoperazina, ciamemazina, sulpirida, sultoprida…»AEMPS, section 4.5 · Open on CIMA
«Medicamentos que ocasionan “torsades de pointes”, pero sin limitarse a: butirofenonas (ej. droperidol, haloperidol),»AEMPS, section 4.5 · Open on CIMA
«Dado que la bradicardia constituye un factor de riesgo en la aparición de torsades de pointes, se debe observar con precaución e incluso puede requerirse una monitorización clínica (ECG), si se…»AEMPS, section 4.5 · Open on CIMA
«Clinically-Significant Drug Interactions: Droperidol Use with caution QT interval prolongation»FDA, section 7 · Open on DailyMed
«Antipsicóticos ( amisulprida , haloperidol, droperidol, mesoridazina, pimozida, sertindol, tioridazina y clozaril )»AEMPS, section 4.5 · Open on CIMA
«Clinically Significant Drug Interactions: E xamples: Specific antipsychotics (e.g., ziprasidone, iloperidone, chlorpromazine, mesoridazine, droperidol); specific antibiotics (e.g., erythromycin…»FDA, section 7 · Open on DailyMed
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Droperidol is evaluated for the following indications with varying evidence strength: Postoperative nausea and vomiting (evidence tier B). See the full indication matrix with dosing and citations above on this page.
Common side effects of Droperidol (≥ 1 in 100): Hypotension, Sedation, Extrapyramidal symptoms, QT prolongation. See the Safety section for uncommon and serious reactions.
Limited data. Not used in caesarean section (hypotension risk).
Interrupt breastfeeding for 24 hours after single dose.
Droperidol is contraindicated in: QTc above 440 ms (men) or 450 ms (women); Combination with other QT-prolongers (amiodarone, sotalol, high-dose ondansetron); Hypokalaemia or hypomagnesaemia; Bradycardia below 55. Full list in the Safety section.
Direct links to regulator labels. Open in a new tab.
Fabomotizole, Haloperidol, Hydroxyzine, Melissa officinalis (leaf extract), Lorazepam, Phenazepam, Valeriana officinalis (root extract), Aripiprazole