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Butyrophenone antipsychotic / antiemetic

Droperidol

Brand names: Xomolix

Adult dose

Dose: PONV: 0.625–1.25mg IV at end of surgery; PCA add-on: 15–50 micrograms/mg morphine
Route: IV
Frequency: Single dose

Clinical pearls

  • AAGBI / Society for Ambulatory Anaesthesia: low-dose droperidol is highly effective antiemetic for PONV, second-line to ondansetron/dexamethasone
  • MHRA QT prolongation warnings — pre-dose ECG and electrolyte review
  • Useful in PCA-PCA admixtures (limited UK use)

Contraindications

  • Hypokalaemia / hypomagnesaemia
  • Bradycardia <55 bpm
  • QT prolongation (congenital or acquired)
  • Phaeochromocytoma
  • Parkinson's disease
  • Concurrent QT-prolonging drugs
  • Hypersensitivity

Side effects

  • Sedation
  • Hypotension
  • QT prolongation / torsades
  • Extrapyramidal effects
  • Neuroleptic malignant syndrome (rare)

Interactions

  • QT-prolonging drugs (avoid)
  • Other CNS depressants
  • Levodopa (antagonism)

Monitoring

  • ECG (QT)
  • Electrolytes
  • Sedation
  • BP

Reference: BNF; AAGBI; SAMBA PONV guideline; MHRA Drug Safety Update; https://bnf.nice.org.uk/drugs/droperidol/. Verify against your local formulary and the latest BNF before prescribing.

Related

Curated clinical cross-links plus same-class fallbacks.