Drugs List

Therapeutic Indications

Uses

PONV induced by morphine derivatives in post-operative PCA use in adults
Prevention/treatment of post-operative nausea and vomiting

Administration

For intravenous injection or intravenous injection via a patient controlled analgesia (PCA) system.

Contraindications

Children under 2 years
Bradycardia
Coma
Hypokalaemia
Hypomagnesaemia
Parkinson's disease
Phaeochromocytoma
QTc interval greater than 440 milliseconds in males
QTc interval greater than 450 milliseconds in females
Severe depression
Torsade de pointes

Precautions and Warnings

Elderly
Family history of long QT syndrome
Family history of sudden death
Predisposition to epileptic disorder
Predisposition to thromboembolic disease
Sinus node dysfunction
Vomiting
Breastfeeding
Central nervous system depression
Chronic diarrhoea
Chronic renal failure
Congestive cardiac failure
Epileptic disorder
Hepatic impairment
History of alcohol abuse
History of left ventricular hypertrophy
History of torsade de pointes
Ischaemic heart disease
Pregnancy
Renal impairment
Respiratory failure
Second degree atrioventricular block
Severe chronic obstructive pulmonary disease
Third degree atrioventricular block
Ventricular arrhythmias

Correct electrolyte disorders before treatment
Reduce dose in patients with hepatic impairment
Reduce dose in patients with renal impairment
Advise patient not to drive/operate machinery within 24 hours of treatment
Perform ECG before and during treatment
Hypovolaemia occurring during therapy must be corrected
Monitor continuous pulse oximetry if risk of ventricular arrhythmia
Monitor patients at risk for signs & symptoms of thromboembolism
Monitor patients for signs and symptoms of Neuroleptic Malignant Syndrome
Monitor serum electrolytes
May potentiate effect of CNS depressants
Predisposition QT prolongation: Counsel patient on symptoms of arrhythmias
Discontinue if hyperthermia occurs
Discontinue if patient develops neuroleptic malignant syndrome
Reduce dose in elderly
Advise patient to avoid alcohol during treatment

Continuous pulse oximetry should be performed in patients with identified or suspected risk of ventricular arrhythmia and should continue for 30 minutes following single intravenous administration.

In the event of persistent hypotension, hypovolaemia should be considered and appropriate fluid replacement administered.

Pregnancy and Lactation

Pregnancy

Use droperidol with caution in pregnancy.

The manufacturer does not recommend using droperidol during pregnancy. At the time of writing, there is limited published information regarding the use of droperidol during pregnancy. If necessary during late pregnancy, monitor neonatal neurological functions. Briggs (2015) concludes that the limited animal and human data suggest that droperidol does not represent a significant risk to the foetus for major anomalies. Potential risks are unknown.

Lactation

Use droperidol with caution in breastfeeding.

The manufacturer does not recommend breastfeeding whilst taking droperidol. The presence of droperidol in human breast milk is unknown but is expected due to the low molecular weight of 379 Da (Briggs, 2015). The manufacturer therefore recommends that treatment with droperidol should be limited to a single administration, and repeat administration is not recommended. Single dose or short-term use during breastfeeding is unlikely to adversely affect the infant, especially if the infant is older than 2 months. In cases of multiple doses, monitor the infant for drowsiness, especially younger, exclusively breastfed infants and in combination with psychotropic drugs (LactMed, 2021). Effects on exposed infants are unknown.

Side Effects

Agitation
Akathisia
Altered consciousness
Altered temperature sensation
Amenorrhoea
Anaphylactic reaction
Angioneurotic oedema
Anxiety
Blood dyscrasias
Bronchospasm
Cardiac arrest
Cardiac arrhythmias
Changes of blood pressure
Coma
Confusion
Convulsions
Deep vein thrombosis (DVT)
Dizziness
Drowsiness
Dyskinesia
Dysphoria
Dystonia
Epileptic seizures
Extrapyramidal effects
Fever
Galactorrhoea
Gynaecomastia
Hallucinations
Hepatobiliary disorders
Hyperhidrosis
Hyperprolactinaemia
Hypersalivation
Hypersensitivity reactions
Hypotension
Inappropriate secretion of antidiuretic hormone
Laryngospasm
Mental status changes
Neuroleptic malignant syndrome
Oculogyric crisis
Oligomenorrhoea
Parkinsonism
Prolongation of QT interval
Psychomotor hyperactivity
Pulmonary embolism
Rash
Renal disorders
Restlessness
Sedation
Stiffness
Sudden death reported
Syncope
Tachycardia
Torsades de pointes
Tremor
Ventricular arrhythmias

Presentation

Injections of droperidol.

Drugs List

Therapeutic Indications

Uses

PONV induced by morphine derivatives in post-operative PCA use in adults
Prevention/treatment of post-operative nausea and vomiting

Dosage

Administration is recommended 30 minutes before the anticipated end of surgery. Repeat doses may be given every 6 hours as required.

Adults

Elderly

Children

Patients with Renal Impairment

Patients with Hepatic Impairment

Administration

For intravenous injection or intravenous injection via a patient controlled analgesia (PCA) system.

Contraindications

Children under 2 years
Bradycardia
Coma
Hypokalaemia
Hypomagnesaemia
Parkinson's disease
Phaeochromocytoma
QTc interval greater than 440 milliseconds in males
QTc interval greater than 450 milliseconds in females
Severe depression
Torsade de pointes

Precautions and Warnings

Elderly
Family history of long QT syndrome
Family history of sudden death
Predisposition to epileptic disorder
Predisposition to thromboembolic disease
Sinus node dysfunction
Vomiting
Breastfeeding
Central nervous system depression
Chronic diarrhoea
Chronic renal failure
Congestive cardiac failure
Epileptic disorder
Hepatic impairment
History of alcohol abuse
History of left ventricular hypertrophy
History of torsade de pointes
Ischaemic heart disease
Pregnancy
Renal impairment
Respiratory failure
Second degree atrioventricular block
Severe chronic obstructive pulmonary disease
Third degree atrioventricular block
Ventricular arrhythmias

Correct electrolyte disorders before treatment
Reduce dose in patients with hepatic impairment
Reduce dose in patients with renal impairment
Advise patient not to drive/operate machinery within 24 hours of treatment
Perform ECG before and during treatment
Hypovolaemia occurring during therapy must be corrected
Monitor continuous pulse oximetry if risk of ventricular arrhythmia
Monitor patients at risk for signs & symptoms of thromboembolism
Monitor patients for signs and symptoms of Neuroleptic Malignant Syndrome
Monitor serum electrolytes
May potentiate effect of CNS depressants
Predisposition QT prolongation: Counsel patient on symptoms of arrhythmias
Discontinue if hyperthermia occurs
Discontinue if patient develops neuroleptic malignant syndrome
Reduce dose in elderly
Advise patient to avoid alcohol during treatment

Continuous pulse oximetry should be performed in patients with identified or suspected risk of ventricular arrhythmia and should continue for 30 minutes following single intravenous administration.

In the event of persistent hypotension, hypovolaemia should be considered and appropriate fluid replacement administered.

Pregnancy and Lactation

Pregnancy

Use droperidol with caution in pregnancy.

The manufacturer does not recommend using droperidol during pregnancy. At the time of writing, there is limited published information regarding the use of droperidol during pregnancy. If necessary during late pregnancy, monitor neonatal neurological functions. Briggs (2015) concludes that the limited animal and human data suggest that droperidol does not represent a significant risk to the foetus for major anomalies. Potential risks are unknown.

Lactation

Use droperidol with caution in breastfeeding.

The manufacturer does not recommend breastfeeding whilst taking droperidol. The presence of droperidol in human breast milk is unknown but is expected due to the low molecular weight of 379 Da (Briggs, 2015). The manufacturer therefore recommends that treatment with droperidol should be limited to a single administration, and repeat administration is not recommended. Single dose or short-term use during breastfeeding is unlikely to adversely affect the infant, especially if the infant is older than 2 months. In cases of multiple doses, monitor the infant for drowsiness, especially younger, exclusively breastfed infants and in combination with psychotropic drugs (LactMed, 2021). Effects on exposed infants are unknown.

Side Effects

Agitation
Akathisia
Altered consciousness
Altered temperature sensation
Amenorrhoea
Anaphylactic reaction
Angioneurotic oedema
Anxiety
Blood dyscrasias
Bronchospasm
Cardiac arrest
Cardiac arrhythmias
Changes of blood pressure
Coma
Confusion
Convulsions
Deep vein thrombosis (DVT)
Dizziness
Drowsiness
Dyskinesia
Dysphoria
Dystonia
Epileptic seizures
Extrapyramidal effects
Fever
Galactorrhoea
Gynaecomastia
Hallucinations
Hepatobiliary disorders
Hyperhidrosis
Hyperprolactinaemia
Hypersalivation
Hypersensitivity reactions
Hypotension
Inappropriate secretion of antidiuretic hormone
Laryngospasm
Mental status changes
Neuroleptic malignant syndrome
Oculogyric crisis
Oligomenorrhoea
Parkinsonism
Prolongation of QT interval
Psychomotor hyperactivity
Pulmonary embolism
Rash
Renal disorders
Restlessness
Sedation
Stiffness
Sudden death reported
Syncope
Tachycardia
Torsades de pointes
Tremor
Ventricular arrhythmias

Overdosage

It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.

The following number will direct the caller to the relevant local centre (0844) 892 0111

Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).

Further Information

Last Full Review Date: September 2022

Reference Sources

Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk, 10th edition (2015) ed. Briggs, G., Freeman, R. Wolters Kluwer Health, Philadelphia.

Summary of Product Characteristics: Droperidol 2.5mg/ml Solution for Injection. Panpharma UK Ltd. Revised April 2016.

NICE Evidence Services Available at: www.nice.org.uk Last accessed: 09 September 2022

US National Library of Medicine. Toxicology Data Network. Drugs and Lactation Database (LactMed).
Available at: https://www.ncbi.nlm.nih.gov/books/NBK501922/
Droperidol. Last revised: 19 April 2021
Last accessed: 09 September 2022