Class
- Antiemetic, antipsychotic
Droperidol
Commonly Prescribed for
(FDA approved in bold)
- Antiemetic
- Migraine (acute)
- Chemotherapy-induced nausea and vomiting
Droperidol
How the Drug Works
- Antidopaminergic, with mild alpha-1 adrenergic blockade and sedative effects
Droperidol
How Long Until It Works
- Migraine, nausea in less than 10 minutes
Droperidol
If It Works
- Use at lowest required dose
- Monitor QT corrected (QTc) interval
Droperidol
If It Doesn’t Work
- Change to another agent
Droperidol
Best Augmenting Combos for Partial Response or Treatment-Resistance
- For migraine, can be used with dihydroergotamine or NSAIDs
Droperidol
Tests
- Obtain ECG to monitor QTc
Adverse Effects (AEs)
Droperidol
How Drug Causes AEs
- Hypotension and dizziness are related to alpha-blockade, and abnormal movement AEs are related to dopamine blocking effects
Droperidol
Notable AEs
- Drowsiness, hypotension, tachycardia, chills
- Dystonia, akathisia, restlessness, anxiety
- Less common: elevated blood pressure, apnea, muscular rigidity
Droperidol
Life-Threatening or Dangerous AEs
- QTc prolongation and torsade de pointes have been reported, especially with higher doses
Droperidol
Weight Gain
- Unusual
Droperidol
Sedation
- Common
Droperidol
What to Do About AEs
- Lowering dose or changing to another antiemetic improves most AEs
- Use with caution in patients if QTc is above 450 (females) or 440 (males). Lower dose or change to another agent. Do not administer droperidol with QTc greater than 500
- For patients on daily intravenous therapy, continue to monitor with daily ECG, especially as dose increases
Droperidol
Best Augmenting Agents for AEs
- Give fluids to avoid hypotension and dizziness
- Give anticholinergics (diphenhydramine or benztropine) for extrapyramidal reactions
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