DROPERIDOL

Butyrophenone which blocks dopamine receptors in the chemoreceptor trigger zone

Dosage Forms

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Injection

2.5 mg/ml

Uses

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  • Postoperative nausea and vomiting
  • Opioid induced nausea and vomiting in patient-controlled analgesia (PCA)

Dose and Duration

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Postoperative nausea and vomiting
Adult:1 by IV injection, 0.625–1.25 mg (0.625 mg in the elderly) 30 minutes before end of surgery, then every 6 hours as required
Child 2-18 years: by IV injection, 0.01–0.05 mg/kg (max 1.25 mg) 30 minutes before the end of surgery, then every 6 hours as necessary

Hepatic/renal impairment:max 0.625 mg every 6 hours as required

Opioid induced nausea and vomiting in PCA
Adult: by IV injection, 0.015–0.05 mg per 1 mg of morphine in PCA (max 5 mg daily)

Reduce dose in renal, hepatic impairment and elderly

Contraindications

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  • Hypersensitivity to droperidol or butyrophenones
  • Known or suspected QT-interval prolongation
  • Hypokalaemia
  • Hypomagnesaemia
  • Bradycardia
  • Pheochromocytoma
  • Comatose states
  • Parkinson’s disease
  • Parkinson’s disease
  • Severe depression
  • Known concomitant treatment leading to bradycardia

Side Effects

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  • Drowsiness, sedation
  • Hypotension

Interactions

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  • General anaesthetics (enhanced hypotensive effect)
  • Amiodarone, disopyramide (increased risk of ventricular arrhythmias-avoid concomitant use)
  • Azithromycin, erythromycin, clarithromycin, fluoxetine, sertraline, fluvoxamine, tamoxifen, tacrolimus (risk of ventricular arrhythmias- avoid concomitant use)
  • Amitrptyline, imipramine (possibly increased risk of ventricular arrhythmias)
  • Chloroquine and hydroxychloroquine, quinine, amisul pride, pimozide, sulpride, haloperidol, sotalol, pentamidine isethionate (increased risk of ventricular arrhythmias)

Patient Instructions

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  • Do not drive or operate a machine within 24 hours of droperidol administration

Pregnancy

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  • Can be used

Breastfeeding

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  • Can be used

⚠️ Caution

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  • Use with caution in chronic obstructive pulmonary disease or respiratory failure, electrolyte disturbances and history of alcohol abuse
  • If there is a risk of ventricular arrhythmias, continuous pulse oximetry during and 30 minutes following administration is required
  • Excreted in breast milk. Avoid repeated administration in a breast-feeding mother
  • May cause temporary neurological disturbances in infants whose mothers used droperidol during pregnancy. Monitor infant for neurological functions if used in pregnancy