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droperidol (Rx)Brand and Other Names:Inapsine

 
 
 

Dosing & Uses

AdultPediatricGeriatric

Dosage Forms & Strengths

injectable solution

  • 2.5mg/mL
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Antiemetic

Initial: No more than 2.5 mg IV/IM; additional doses of 1.25 mg may be given if benefit outweighs potential risk

Delirium (Off-label)

5 mg IM

Renal Impairment

Use caution; safety and efficacy not established

Hepatic Impairment

Use caution; safety and efficacy not established

Other Information

Monitor: EKG, cardiac function

Other Indications & Uses

Prevention of nausea/vomiting during surgery

Off-label: Adjunct to general anesthesia, prevention of CINV, sedation

Dosage Forms & Strengths

injectable solution

  • 2.5mg/mL
more...

Antiemetic

2-12 years: 0.03-0.07 mg/kg IV/IM over 2-5 minutes q4-6hr PRN 

Not to exceed 0.1 mg/kg IV/IM, additional dose (no more than 2.5 mg) may be given ONLY IF benefit outweighs potential risk

Other Information

Monitor: EKG, cardiac function

Antiemetic

Initial: No more than 2.5 mg IV/IM; additional doses of 1.25 mg may be given if benefit outweighs potential risk

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Interactions

Interaction Checker

droperidol and

No Results

     
     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            >10%

            Restlessness

            Anxiety

            Extrapyramidal Symptoms

            Dystonic reactions

            Pseudoparkinsonian signs and symptoms

            Tardive dyskinesia

            Seizure

            Altered central temperature regulation

            Sedation

            Drowsiness

            Prolonged QT interval (dose dependent)

            Swelling of breasts

            Weight gain

            Constipation

            1-10%

            Hallucinations

            Persistent tardive dyskinesia

            Akathisia

            Orthostatic hypotension

            Tachycardia

            ECG: abnormal T waves

            Hypertension

            Nausea

            Vomiting

            Dysuria

            Frequency Not Defined

            Serious, potentially fatal cardiac effects: prolonged QT interval, torsades de pointes, cardiac arrest, ventricular tachycardia

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            Warnings

            Black Box Warnings

            Patients with dementia-related psychosis who are treated with antipsychotic drugs are at an increased risk of death as shown in short-term controlled trials. The deaths appeared to be either cardiovascular (eg, heart failure, sudden death) or infectious (eg, pneumonia) in nature

            This drug is not approved for the treatment of patients with dementia-related psychosis

            Contraindications

            Hypersensitivity

            Known or suspected prolonged QT interval; QTc interval >450 msec in females or 400 msec in males

            Cautions

            May cause potentially fatal QT interval prolongation/torsades de pointes at or below recommended doses; should be used only in patients who have failed to respond to other drugs

            Use as sedative or anesthesia adjunct no longer recommended

            Shares the toxic potentials of phenothiazines

            Risk factors for prolonged QT interval

            • Use with extreme cautions in patients at risk for development of prolonged QT syndrome
            • CHF, bradycardia, diuretic use, hypokalemia, hypomagnesemia, cardiac hypertrophy
            • Use of drug known to cause prolonged QT interval: class I or III antiarrhythmias, some antihistamines, antimalarials, calcium channel blockers, neuroleptics, antidepressants or drugs which may induce hypokalemia or hypomagnesemia
            • >65 years, alcohol abuse, concomitant use of benzodiazepines or IV opiates, impaired hepatic/renal function
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            Pregnancy & Lactation

            Pregnancy Category: C

            Lactation: distributed into breast milk; avoid

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

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            Pharmacology

            Mechanism of Action

            Antiemesis: dopamine receptor blockade in brain, predominantly dopamine-2 receptor & when reuptake is prevented, a strong antidopaminergic, antiserotonic response occurs

            Droperidol reduced motor activity, anxiety, and causes sedation; also possesses adrenergic-blocking, antifibrillatory, antihistaminic, & anticonvulsive properties

            Pharmacotherapy

            Half-Life elimination: 2 hr (parent drug), 8-12 hr (metabolites)

            Onset: 3-10 min

            Duration: 2-4 hr, may persist up to12 hr

            Peak Response Time: 10-30 min

            Peak Plasma Time: 60 min (IM)

            Protein Bound: extensive

            Metabolism: extensively in the liver

            Metabolites: [Benzimidazolone, p-Fluorophenylacetic acid, p-Hydroxypiperidine] (inactive)

            Vd: 2 L/kg (Adults); 0.58 L/kg (Children)

            Excretion: Urine (75%); feces (22%)

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            Administration

            IV Incompatibilities

            Syringe: fluorouracil, furosemide, heparin, leucovorin, methotrexate, ondansetron, pentobarbital

            Y-site: allopurinol, amphotericin B cholesteryl SO4, cefepime, fluorouracil, fascarnet, furosemide, heparin(?), leucovorin, methotrexate(?), nafcillin, piperacillin/tazobactam

            IV Compatibilities

            Solution: D5W, LR, NS

            Syringe: atropine, bleomycin, butorphanol, chlorpromazine, cimetidine, cisplatin, cyclophosphamide, dimenhydrinate, diphenhydramine, doxorubicin, fentanyl, glycopyrrolate, hydroxyzine, meperidine, metoclopramide, midazolam, mitomycin, morphine sulfate, nalbuphine, papaveretum, pentazocine, perphenzine, prochlorperazine, promazine, promethazine, scopolamine, vinblastine, vincristine

            Y-site: alatrofloxacin, amifostine, azithromycin, aztreonam, bivalirudin, bleomycin, cisatracurium, cladribine, cisplatin, cyclophosphamide, cytarabine, dexmedetomidine, docetaxel, doxorubicin, doxorubicin liposomal, etoposide phosphate, famotidine, fenoldopam, filgrastim, fluconazole, fludarabine, gatifloxacin, gemcitabine, granisetron, Hextend, hydrocortisone sodium succinate, idarubicin, linezolid, melphalan, meperidine, metoclopramide, mitomycin, ondansetron, paclitaxel, potassium chloride, propofol, remifentanil, sargramostim, teniposide, thiotepa, vinblastine, vincristine, vinorelbine, vitamin B/C

            IV/IM Administration

            Administered IM or slow IV (2-5 min)

            IV infusion has been used in high-risk pts

            Storage

            Controlled room temperature

            Protect from light

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            Images

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            Formulary

            FormularyPatient Discounts

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

            Adding plans allows you to:

            • View the formulary and any restrictions for each plan.
            • Manage and view all your plans together – even plans in different states.
            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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