DROPERIDOL 2.5 mg/mL (Droperidol INJECTION, SOLUTION) 2.5 mg/mL

Droperidol 2.5 mg/mL is a butyrophenone derivative and dopamine antagonist used to prevent and treat postoperative nausea and vomiting (PONV).

• Postoperative nausea and vomiting (PONV): Reduces the incidence of nausea and vomiting during and after surgical procedures.
• Chemotherapy-induced nausea and vomiting (CINV): Manages nausea and vomiting associated with chemotherapy treatments.
• Sedation and control of acute agitation: Provides tranquilization and sedation in various medical settings.
• Adjunctive treatment of psychotic disorders: Used as an adjunct in the management of psychotic disorders.

• Droperidol works primarily by antagonizing dopamine D2 receptors in the central nervous system. This action blocks the effects of dopamine, leading to its antiemetic and antipsychotic effects. Additionally, droperidol antagonizes serotonin and histamine receptors, contributing to its sedative and tranquilizing properties. The drug also produces mild alpha-adrenergic blockade, which can result in peripheral vascular dilatation and a reduction in blood pressure.

Droperidol may cause various side effects, ranging from common to serious or rare.

Common Side Effects

• Drowsiness: Mild to moderate sedation and drowsiness.
• Hypotension: Mild to moderate decrease in blood pressure.
• Dry mouth: Reduced saliva production.
• Extrapyramidal symptoms: Muscle stiffness, tremors, or restlessness.
• Dizziness: Lightheadedness or vertigo.
• Constipation: Slowed bowel movements.
• Blurred vision: Temporary visual disturbances.
• Confusion: Mental disorientation or cognitive impairment.

Serious or Rare Side Effects

• QT prolongation: Prolonged QT interval, which can lead to serious cardiac arrhythmias.
• Neuroleptic malignant syndrome (NMS): A rare but life-threatening condition characterized by high fever, muscle rigidity, and altered mental status.
• Torsade de pointes: A type of ventricular tachycardia that can be fatal.
• Severe hypotension: Significant drop in blood pressure that may require medical intervention.
• Respiratory depression: Reduced breathing rate and depth, which can be dangerous in some patients.

Droperidol should be used with caution in certain patient populations and conditions.

• QT prolongation: Avoid use in patients with known or suspected QT prolongation or congenital long QT syndrome.
• Hypersensitivity: Do not administer to patients with known hypersensitivity to droperidol or other butyrophenones.
• Elderly patients: Use with caution in patients over 65 years old due to increased risk of side effects.
• Alcohol abuse: Administer with extreme caution in patients who abuse alcohol.
• Concomitant use with CNS depressants: Monitor closely when used with benzodiazepines, volatile anesthetics, and IV opiates.
• ECG monitoring: Perform ECG monitoring prior to treatment and continue for 2 to 3 hours after completing treatment to monitor for arrhythmias.
• Store at 20 to 25°C: Keep in the original packaging, protect from light, and do not freeze.

Droperidol may interact with other medications, leading to potential adverse effects or altered drug efficacy.

Major Interactions (Avoid)

• QT-prolonging drugs: Avoid concomitant use with other drugs that prolong the QT interval, as this can increase the risk of serious cardiac arrhythmias.
• CNS depressants: Avoid use with other CNS depressants, such as benzodiazepines and opioids, due to the risk of excessive sedation and respiratory depression.
• Antiarrhythmic drugs: Avoid use with drugs that can cause cardiac arrhythmias, as droperidol may exacerbate this risk.

Moderate Interactions (Monitor Closely)

• Antihypertensives: Monitor blood pressure closely when used with antihypertensive drugs, as droperidol can cause hypotension.
• Antipsychotics: Monitor for increased side effects when used with other antipsychotic drugs, as this can enhance the risk of extrapyramidal symptoms and sedation.
• Anticholinergics: Monitor for increased anticholinergic effects, such as dry mouth and constipation, when used with other anticholinergic drugs.