Droperidol

Registered South African indications: 

• Nausea and vomiting 

Contraindications

• Hypersensitivity to the active ingredient or any of its excipients 
• Hypersensitivity to butyrophenones 
• Known or suspected QT prolongation 
• Hypokalaemia 
• Hypomagnesaemia 
• Bradycardia or risk factors thereof 
• Phaechromocytoma 
• Comatose states 
• Parkinsons disease
• Severe depression 
• Coadministration with QT prolonging agents 
• Coadministration with alcoholic medicines or beverages 
• Coadministration with medicinal products that induce extrapyramidal symptoms

Cautions 

• Pregnancy 
• Breastfeeding
• Renal impairment 
• Hepatic impairment 
• Elderly
• Epilepsy or risk of seizures
• Serious ventricular arrhythmia 
• Second or third degree heart block 
• Sinus node dysfunction 
• Congestive heart failure 
• Ischaemic heart disease 
• Left ventricular hypertrophy 
• Family history of sudden death 
• Respiratory failure 
• Chronic obstructive pulmonary disease 
• History of alcohol abuse 
• Risk factors for electrolyte disturbances 
• Risk factors for venous thromboembolism 
• May impair ability to drive and operate machinery

Forms avail. in SA and covered in this monograph: inj 

Prevention and treatment of nausea and vomiting associated with surgical and diagnostic procedures 

• IV/IM: 2.5mg, as a single dose

Administered by slow IV if this route is used 

Additional doses of 1.25mg can be administered with caution to achieve desired effect  

Prevention and treatment of nausea and vomiting induced by morphine derivatives during post-operative patient controlled analgesia

• IV/IM: 25μg per 1mg of morphine; Max: 5mg/24hrs

Paed. forms avail. in SA and covered in this monograph: inj 

Prevention and treatment of nausea and vomiting associated with surgical and diagnostic procedures 

• Younger than 2 years: Not established for use
• Between 2-18 years: IV/IM: 0.1-0.5mg/kg, as a single dose; Max: 1.25mg
• Older than 18 years: See adult dosage

Administered by slow IV if this route is used 

Additional doses can be administered with caution to achieve desired effect  

Pregnancy 

• Caution
• A limited amount of clinical data have shown no increase of malformative risk
• Droperidol has not been shown to be teratogenic in rats. Animal studies are insufficient with respect to the effects on pregnancy and embryonal/foetal, parturition and postnatal development
• In newborn babies from mothers under long-term treatment and high doses of neuroleptics, temporary neurological disturbances of extrapyramidal nature have been described. In practice, as a precautionary measure, it is preferable not to administer droperidol during pregnancy. In late pregnancy, if its administration is necessary, monitoring of the newborn's neurological functions is recommended

Breastfeeding 

• Caution
• Neuroleptics of the butyrophenone type are known to be excreted in breast milk; treatment with droperidol should be limited to a single administration. Repeat administration is not recommended

Renal Impairment 

• Caution; no dose adjustment recommended
• Limit use to a single-dose of 2.5mg/ 24 hrs

Hepatic Impairment 

• Caution; no dose adjustment recommended
• Limit use to a single-dose of 2.5mg/ 24 hrs

Elderly 

• Avoid (high risk of drug-induced QT prolongation, agitation and confusion)

Porphyria Information

• Probably not porphyrinogenic (PNP)

Drugs in Sport

• Permitted - No warnings

Central Nervous System Disorders

• Drowsiness
• Dystonia
• Extrapyramidal disorder
• Seizures 
• Tremor
• Parkinson's disease
• Psychomotor hyperactivity
• Coma
• Neuroleptic malignant syndrome 
• Anxiety
• Restlessness
• Confusion
• Agitation
• Dysphoria
• Hallucinations
• Syncope 

Cardiovascular Disorders

• Tachycardia
• Dizziness
• Cardiac arrhythmias
• Cardiac arrest 
• Torsade de pointes 
• QT prolongation 
• Sudden death 
• Hypotension

Respiratory Disorders

• Bronchospasm
• Laryngospasm

Endocrine and Metabolic Disorders

• Inappropriate anti-diuretic hormone secretion

Skin and Subcutaneous System Disorders

• Rash

Immune, Blood and Lymphatic System Disorders

• Blood dyscrasias
• Anaphylactic reaction
• Angioneurotic oedema
• Hypersensitivity

Sensory Disorders

• Oculogyric crisis 

• QT prolonging agents 
• Alcoholic medicines or beverages 
• Medicinal products that induce extrapyramidal symptoms
• Potassium-depleting diuretics
• Laxatives
• Glucocorticoids 
• Barbiturates 
• Benzodiazepines
• Morphine derivatives
• Antihypertensives 
• Opioids
• Bromocriptine 
• Lisuride
• Levodopa 
• CYP1A2 inhibitors 
• CYP3A4 inhibitors  

• ECG

Specific cases may require

• Serum electrolytes

Droperidol produces an antiemetic effect by blockade of dopamine stimulation at the chemoreceptor trigger zone.

Injection (per ml) 2.5mg

• Inapsin (MC Pharma) originator