Droperidol (also known by its brand name, Inapsine) is an antiemetic used to prevent nausea and vomiting for people undergoing a procedure. While some hospitals still stock droperidol, it's not commonly used because of its potential to cause serious heart rhythm problems. When it's used, droperidol is given as an injection into the veins or muscle by a healthcare provider. Some common side effects of droperidol low blood pressure, fast heart rate, and sleepiness after the procedure. It's available as a lower-cost, generic.
Prevention of nausea and vomiting during procedures
Droperidol is a typical antipsychotic. But it's only used as an antiemetic (nausea medication). While the exact way droperidol works to prevent nausea and vomiting isn't clear, but it's thought to block the actions of dopamine in the part of your brain that causes nausea and vomiting.
Source:Â DailyMed
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor or nurse immediately if any of the following side effects occur:
More common
Blurred vision
confusion
dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
sweating
unusual tiredness or weakness
Less common
Chills
difficulty with breathing
difficulty with swallowing
dizziness
fast heartbeat
noisy breathing
puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
tightness in the chest
Incidence not known
Chest pain or discomfort
fainting
fast, pounding, or irregular heartbeat or pulse
irregular or slow heart rate
low blood pressure or pulse
severe confusion or loss of consciousness
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Incidence not known
Difficulty with speaking
loss of balance control
muscle trembling, jerking, or stiffness
seeing, hearing, or feeling things that are not there
shuffling walk
stiffness of the limbs
twisting movements of the body
uncontrolled movements, especially of the face, neck, and back
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Works well to prevent nausea and vomiting
Can be used in children as young as 2 years old
Starts to work after 3-10 minutes
Needs to be given by injection
Can cause a serious and life-threatening irregular heart rhythm problem called QT prolongation
Can lower blood pressure and raise heart rate
Your provider will routinely monitor you for side effects and your vital signs during and after you receive droperidol. They'll also check your heart rhythm before and after your procedure with an electrocardiogram (EKG) to make sure you're not experiencing any heart rhythm problems.
Taking certain medications, such as barbiturates (e.g., phenobarbital), sedatives, opioid pain medications (e.g., morphine), and antihistamines (e.g., diphenhydramine (Benadryl)), can make you more sensitive to sleepiness and dizziness from droperidol. Let your provider know about all the medications you're taking before starting droperidol because they might adjust your droperidol dose.
People with certain medical conditions (e.g., liver problems, kidney problems, pheochromocytoma) should receive droperidol with caution. Make sure your provider knows about all of your medical conditions before receiving droperidol.
Droperidol can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Risk factors: Electrolyte levels out of balance | Taking other medications that cause QT prolongation | History of heart problems or abnormal heart rhythms (arrhythmias) | Slow heart rate
Although rare, droperidol can affect your heart rhythm (QT prolongation), which can be life-threatening (a black box warning of this medication). To lower your risk for QT prolongation, your provider will check your heart rhythm with an electrocardiogram (EKG) before giving you droperidol and for 2-3 hours after your procedure. Make sure to tell your provider about all the medications you're taking and don't start any new medications while taking droperidol without talking to your provider or pharmacist first. People who were born with QT prolongation or have a history of arrhythmias should avoid taking droperidol. If you feel your chest pounding, have trouble breathing, chest pain, or feel lightheaded while taking droperidol, call 911 right away.
Medications similar to droperidol have caused uncontrolled body movements, such as eye-twitching or lip-smacking. If you experience these symptoms after receiving droperidol, your provider can help you control them with certain anticholinergic medications.
Risk factors: Low blood pressure | Taking medications that lower blood pressure | History of medical conditions that can lower blood pressure | High droperidol doses | Liver or kidney problems | 65 years or older
Droperidol can make you tired, lower your blood pressure, or cause you to lose your balance, which can lead to falls after your procedure. When standing from a sitting or lying position, make sure to get up slowly and hold onto something.
Risk factors: Taking antipsychotic medications
Medications similar to droperidol have caused a rare, but life-threatening condition called neuroleptic malignant syndrome (NMS). Symptoms include fever, sweating, stiff muscles, confusion, not aware of your surroundings, and fast or irregular heartbeat. Because it might be hard to tell if you experience NMS during a procedure, your provider will keep a close eye on any changes in your temperature, heart rate, and carbon dioxide production.
Droperidol is given as an injection into the muscle or into the veins by a healthcare provider before a procedure. Your provider will determine your dose based on various factors, such as your age, body weight, and what health conditions you might have.
Adults: The typical starting dose is up to 2.5 mg given as a single dose. Additional 1.25-mg doses can be given if needed.
Children (ages 2 to under 12 years old): Your child's provider will calculate the dose based on your child's body weight. The typical starting dose is up to 0.1 mg/kg of body weight as a single dose. The provider will determine whether your child needs more than one dose.
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Known or suspected QT prolongation
Use other than for the treatment of nausea and vomiting from procedures when other medications can't be used or haven't worked
Prevention of nausea and vomiting due to cancer medications (chemotherapy) or radiation therapy
Prevention of nausea and vomiting after surgery
Delayed stomach-emptying caused by diabetes (diabetic gastroparesis)
Severe acid reflux (gastroesophageal reflux disease or GERD) when other medications haven’t worked
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Farzam, K., et al. (2023). QT prolonging drugs. StatPearls.
Gaw, C. M., et al. (2020). Effectiveness and safety of droperidol in a United States emergency department. The American Journal of Emergency Medicine.
Kramer, K. J. (2020). The surprising re-emergence of droperidol. Anesthesia Progress.
Nageotte, M. P., et al. (1996). Droperidol and diphenhydramine in the management of hyperemesis gravidarum. American Journal of Obstetrics & Gynecology.
National Cancer Institute. (2020). Pheochromocytoma.
Quinlan, J. D., et al. (2003). Nausea and vomiting of pregnancy. American Family Physician.
Storrar, J., et al. (2014). Droperidol for treatment of nausea and vomiting in palliative care patients. The Cochrane Database of Systematic Reviews.
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