Section 02 · Monograph
Droperidol
Reviewed Nov 2026FDA label
InapsineButyrophenone antiemetic
- Forms
- IV/IM: 2.5mg/mL
- Dose
- Acute migraine/nausea (off-label): 1.25-2.5mg IV with ECG monitoring
- MOA
- D2 blockade at the chemoreceptor trigger zone
Black Box Warning
- QT prolongation and torsades de pointes (including fatal cases) have been reported at or below recommended doses; contraindicated in known or suspected QT prolongation; obtain a 12-lead ECG before use and continue monitoring for 2-3 hours after administration
Indications
- Reduction of nausea and vomiting associated with surgical and diagnostic proceduresFDA-labeled
Off-Label Uses
- Acute migraine and agitation in the emergency departmentOff-label
Mechanism of Action
- Butyrophenone D2 receptor antagonist acting at the chemoreceptor trigger zone
Full Dosing
Adult / usual
- Initial dose 2.5mg IM or slow IV; additional 1.25mg may be given cautiously if needed; migraine/nausea use often 1.25-2.5mg IV
- Reduce dose in older, debilitated or renally impaired patients
Contraindications
- Known or suspected QT prolongation (including congenital long QT syndrome)
- Hypersensitivity to droperidol
Drug Interactions
- QT-prolonging drugs (antiarrhythmics, macrolides, methadone, antipsychotics) and electrolyte disturbances increase arrhythmia risk
- Additive CNS depression with opioids and benzodiazepines
Adverse Effects
- QT prolongation and torsades de pointes
- Hypotension
- Dystonia and akathisia
- Sedation
Monitoring Parameters
- Baseline and post-dose ECG with continuous cardiac monitoring
- Potassium and magnesium
- Extrapyramidal symptoms
Pregnancy & Lactation
- Limited data; use only if benefit justifies risk
- Unknown whether present in milk