Droperidol

INAPSINE

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Droperidol ballicule: receptor binding, kinetics and half-life diagram — Mechanism of action: Droperidol ballicule

Droperidol INAPSINE mascot mnemonic cartoon — Visual mnemonic: Droperidol mascot
**“Drop a doll In a scene”**
spooky mascot → antipsychotic
greyscale → high potency first-gen antipsychotic
rainbow spray → antiemetic

What it isButyrophenone D2 antagonist used parenterally for severe nausea, acute agitation, and perioperative sedation.

Why this oneRapid, reliable control of agitation and refractory emesis in small IM or IV doses.

What limits itQT prolongation, hypotension, and extrapyramidal reactions constrain use; screen for QT risk and monitor when indicated.

Droperidol molecular structure (skeletal formula) — Molecular structure: Droperidol

FDA-approved for

nausea/vomiting (~1970)

Off-label

migraine in the emergency department
acute agitation

FDA label

Read the full label on DailyMed ↗

BOXED WARNING QT prolongation/torsade de pointes reported at or below recommended doses, some fatal; reserve for patients failing other treatments; 12-lead ECG before use.

FDA dosing	Population	Start	Target	Max
Perioperative nausea/vomiting (refractory)	Adults	2.5 mg IM or slow IV	—	Additional 1.25 mg PRN
Perioperative nausea/vomiting (refractory)	Children 2-12 yr	0.1 mg/kg IM or IV (max initial)	—	0.1 mg/kg initial

Renal Undefined

Hepatic Undefined

Instructions

Give IM or slow IV
Perform 12-lead ECG before dosing and monitor 2-3 hours after treatment
Initiate at a low dose and titrate upward with caution

Available strengths

inj 2.5 mg/mL

Contraindications

Known or suspected QT prolongation, including congenital long QT syndrome

Cautions

Risk factors for prolonged QT (CHF, bradycardia, diuretic use, hypokalemia, hypomagnesemia, QT-prolonging drugs)
Extrapyramidal symptoms (dystonia, akathisia, oculogyric crisis)
Mild-moderate hypotension and tachycardia
Caution with other CNS depressants

Adverse reactions

QT prolongation
Torsade de pointes
Cardiac arrest
Ventricular tachycardia
Hypotension
Tachycardia
Dysphoria
Postoperative drowsiness
Restlessness/anxiety
Extrapyramidal symptoms

Pregnancy Pregnancy Category C; use only if potential benefit justifies risk to fetus.

Lactation Undefined

Cost

Droperidol (INAPSINE)

Strength		#/mo	generic $/unit	CostPlus
2.5 mg/mL	inj	per unit		not offered

NADAC is a voluntary CMS survey of what retail community pharmacies pay for the drugs they stock. Droperidol is administered under clinical supervision and dispensed outside retail pharmacies, so it rarely appears on surveyed invoices.

Generic entry1986

⚠ BOXED WARNINGS

QT prolongation and torsades, including fatal cases, have occurred at or below recommended doses
Reserve for patients who do not respond acceptably to alternatives; obtain a pre-dose ECG and monitor for arrhythmia

Classes and tags

Clinical profile

Therapeutic safety burden3 / 4

Overdose danger2 / 4

Weight-gain liability1 / 4

Sedation liability3 / 4

QT / Torsades3 / 4

Direct muscarinic antagonism0 / 4

Embryofetal risk2 / 4

Legacy pregnancy categoryC

Defining liabilityMetabolic effects, extrapyramidal symptoms/tardive dyskinesia and agent-specific QT or orthostatic risk.

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Memory aids: interaction avatars

CYP3A4 substrate

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