Droperidol

5mg/2ml ampoules (IV, IM)

Executive Summary

(April 5, 2023)

Executive Summary

Droperidol is a first generation antipsychotic (so-called typical antipsychotics, same class as haloperidol) that acts as a D2 dopamine receptor antagonist. Droperidol also has some histamine and serotonin antagonist properties (17). 

 

Adult dose for undifferentiated agitation in the ED

5-10mg IM

Adult dose for migraine, acute vertigo, nausea or vomiting and cannabinoid hyperemesis
1.25-2.5mg IV or IM

Adult dose

Adult dose for undifferentiated agitation in the ED (7, 19)

5-10mg IM

Adult dose for migraine, acute vertigo, nausea or vomiting and cannabinoid hyperemesis (23, 3, 5, 16)

1.25-2.5mg IV or IM

Indications

Indications

Usage in the ED

Usage in the Emergency Department

Mechanism of action

Droperidol is a first-generation antipsychotic that has prominent dopamine antagonism. Its effects include(4, 8): 


Pharmacology

Pharmacology

Warnings and Precautions


Questioning of the US-FDA Black Box Warning

A copious amount of clinical data, review articles and society statements have emerged over the last decade defending droperidol safety when used properly and in the doses that usually are sufficiently needed in the ED (11, 18). 


Society positions, review articles, expert opinion:


Droperidol is Back by Reuben Strayer

Pregnancy and lactation

Pregnancy

Lactation

References

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EMDrugs Team