Reintegrating droperidol into emergency medicine practice

Am J Health Syst Pharm. 2020 Oct 30;77(22):1838-1845. doi: 10.1093/ajhp/zxaa271.

Abstract

Purpose: After a long period of low utilization, droperidol has become easier to obtain in the US market. This comprehensive review discusses the safety, indications, clinical efficacy, and dosing of droperidol for use in the emergency department (ED) setting.

Summary: In 2001 the US Food and Drug Administration (FDA) mandated a boxed warning in the labeling of droperidol after reports of QT interval prolongation associated with droperidol use. Since that time, it has been difficult to access droperidol in the United States; as a result, many practicing clinicians lack experience in its clinical use. Multiple studies have been conducted to assess the clinical efficacy and safety of droperidol use in ED patients. Results consistently show the safety of droperidol and its clinical efficacy when used as an analgesic, antiemetic, and sedative. Now that droperidol is more widely available for use in the US market, pharmacists and prescribers need to reliably translate safety and efficacy data compiled since 2001 to help ensure appropriate and effective use of the medication.

Conclusion: Droperidol is an effective and safe option for the treatment of acute agitation, migraine, nausea, and pain for patients in the ED setting. Healthcare professionals can adopt droperidol for use in clinical practice, and they should become familiar with how to dose and monitor droperidol for safe and effective use.

Keywords: agitation; analgesia; antiemetic; droperidol; emergency medicine; migraine; nausea.

Publication types

  • Review

MeSH terms

  • Dose-Response Relationship, Drug
  • Droperidol / administration & dosage*
  • Droperidol / adverse effects
  • Drug Labeling
  • Drug Monitoring
  • Drug Utilization / trends*
  • Emergency Service, Hospital / trends
  • Emergency Treatment / methods*
  • Emergency Treatment / trends
  • Humans
  • Long QT Syndrome / chemically induced
  • Long QT Syndrome / prevention & control
  • Migraine Disorders / drug therapy
  • Nausea / drug therapy
  • Pain / drug therapy
  • Practice Patterns, Physicians' / trends*
  • Psychomotor Agitation / drug therapy
  • Treatment Outcome
  • United States

Substances

  • Droperidol