Adult Dosing
Perioperative nausea and vomiting
- Initial dose: 2.5 mg IM/slow IV
- May give additional 1.25 mg (with caution) to achieve desired result
- Note: QT prolongation to be ruled out before use
Pediatric Dosing
Perioperative nausea and vomiting
- <2 yrs: Safety and effectiveness in pediatric patients have not been established
- 2-12 yrs: Max. initial dose 0.1 mg/kg IM/slow IV
- Administer additional doses with caution and only if potential benefit outweighs potential risk
Note: QT prolongation to be ruled out before use
[Outline]
- For intravenous or intramuscular use only
- Dose-dependent prolongation of QT interval may occur
- Torsade de pointes, ventricular arrhythmias, cardiac arrest occurred during therapy can be fatal
- Some cases have occurred in patients with no known risk factors for QT prolongation and some cases have been fatal
- Monitor ECG for arrhythmias prior to treatment, if prolonged QT interval do not give the drug, but if the potential benefit outweigh the risk monitor ECG at base line and continue for 2-3 hrs after completing treatment
- Maintain appropriate parenteral fluid therapy and other countermeasures on occurrence of hypotension
- Limit use of opioids in reduced doses
- If increases in temperature, heart rate or carbon dioxide production occur immediately administer dantrolene
- Reduce initial dose in geriatrics, debilitated and other poor-risk patients and consider therapeutic effect in titrating a dose to the desired effect
- Reposition the patient to improve venous return to the heart, avoid tilting the patient into a head-down position in spinal and peridural anesthesia as it may result in higher level of anesthesia and impair venous return to heart
- Administer pressor agents other than epinephrine if hypotension is not recovered with appropriate levels of fluid and other measures, as epinephrine decreases blood pressure in droperidol treated patients
- Pulmonary arterial pressure may decrease
- Periodically monitor ECG and vital signs
- Severe hypertension and tachycardia may occur in pheochromocytonia diagnosed patients treated with droperidol
Cautions: Use cautiously in
- Renal impairment
- Hepatic impairment
- Pheochromocytoma (may cause severe hypertension and tachycardia)
- Risk factors for prolonged QT syndrome (use with extreme caution)
- Bradycardia (<50 bpm)
- Treatment with class I and class III antiarrrhythmics
- Cardiac disease
- Concomitant use of monoamine oxidase inhibitors
- CHF
- Cardiac hypertrophy
- Hypotension
- Seizures (may cause lowering of seizure threshold)
- Prostatic hyperplasia
- Respiratory insufficiency
- Intestinal obstruction
- Concomitant use of drugs known to prolong QT interval
- Electrolyte imbalances (e.g. hypokalemia, hypomagnesemia)
- Alcohol abuse
- Concomitant use of diuretics
- Geriatric population
Pregnancy category : C
Breastfeeding: An alternate drug may be preferred over long-term use of droperidol, especially while nursing a newborn or preterm infant. Single-dose or short-term use during breastfeeding, such as during surgery, is unlikely to adversely affect the breastfed infant, especially if the infant is older than 2 months. This information is based upon LactMed database http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 21 October 2010). Manufacturer advised caution while administering nursing mother.
