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droperidol (Dridol / Xomolix)

✓ Approved

Kyowa Kirin Co., Ltd. · DRD2 · 小分子

什么是 droperidol？

droperidol 是一种小分子，由Kyowa Kirin Co., Ltd.研发。该药已获批，用于治疗相关适应症，给药途径：Injectable (Others)、Intravenous (IV)。

药物档案

商品名Dridol, Xomolix
公司Kyowa Kirin Co., Ltd.
药物类别小分子
分子靶点DRD2
给药途径Injectable (Others), Intravenous (IV)
状态Approved
来源： ClinicalTrials.gov, Kyowa Kirin Co., Ltd.

作用机制

分子靶点

droperidol 作用于 1 个分子靶点：

DRD2dopamine receptor D2 (D2DR, D2R)
需要更深入的分析？Noah AI 可解释复杂机制并与同类药物比较。

治疗适应症

droperidol 针对 1 个适应症，涉及 1 个治疗领域。

治疗领域疾病/病症分期
Surgical and medical proceduresProphylaxis of nausea and vomiting✓ Approved

相关研究文献

PubMedFederal practitioner : for the health care professionals of the VA, DoD, and PHS2026-09-10

Effectiveness and Safety of Droperidol Use in the VA Greater Los Angeles Healthcare System Emergency Department.

Minoda Emily E, Kono Shogo S, Pham My-Phuong MP, Acharya Hemang H et al.

Droperidol, a butyrophenone antipsychotic, is used for postoperative nausea and vomiting and as a sedative, anxiolytic, and analgesic. Concerns about potential QTc (corrected QT interval) prolongation led the US Food and Drug Administration (FDA) to issue a boxed warning and halt manufacturing. However, recent studies have supported droperidol's safety and it was reintroduced in 2019. Given the limited available options for managing acute agitation at the Veterans Affairs Greater Los Angeles Healthcare System (VAGLAHS), there has been interest in re-evaluating the risks associated with droperidol use for sedation, anxiolysis, analgesia, and as an antiemetic. This retrospective chart review examined patients who received droperidol in the VAGLAHS emergency department (ED) from February 2021 to April 2023. The primary outcome was all-cause mortality after droperidol administration within 24 hours. Secondary outcomes included the efficacy of droperidol, incidence of QT prolongation, incidence of extrapyramidal symptoms (EPS) such as akathisia, dystonia, parkinsonism or tardive dyskinesia, and incidence of respiratory depression. Of 207 patients receiving droperidol, 38 (18.4%) were adults aged ≥ 65 years. Droperidol was used for acute agitation in 183 patients (88.4%) and as an antiemetic in 24 (11.6%) patients. No deaths were observed following droperidol administration in a 24-hour period. The need for rescue medication occurred in 15 patients (7.3%). EPS such as tardive dyskinesia and dystonia occurred in 2 (1.0%) patients. No arrhythmias or respiratory depression were observed within 24 hours of administration. No clinically relevant QTc prolongation was observed. No fatalities were seen among patients who received droperidol in the VAGLAHS ED. Despite the boxed warning issued by the FDA, these findings suggest droperidol is safe and effective in managing agitation and as an antiemetic.

PMID 42719802
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PubMedInternational clinical psychopharmacology2026-08-25

Efficacy and safety of intramuscular and intravenous midazolam for acute agitation in emergency settings: a systematic review.

Bottaro Federico F, Nosari Guido G, Tesic Isidora I, Brambilla Paolo P et al.

Acute agitation often requires parenteral sedation in emergency care. Midazolam is widely used for its rapid onset, short duration of action, and availability for intramuscular and intravenous administration, but its efficacy and safety across emergency settings remain incompletely understood. Following Preferred Reporting Items for Systematic reviews and Meta-Analyses 2020 guidelines, we searched PubMed, Scopus, and Web of Science for original studies evaluating intramuscular or intravenous midazolam, as monotherapy or in combination regimens, for acute agitation in emergency department (ED), psychiatric emergency service (PES), and prehospital emergency medical service (EMS) settings. Twenty-three studies met the inclusion criteria. Intramuscular midazolam was generally associated with rapid early sedation in ED studies, although this advantage was sometimes offset by less sustained clinical effects and higher need for rescue or additional sedation. Intravenous midazolam monotherapy showed a greater need for active airway management in its main direct comparison with intravenous droperidol. Midazolam-droperidol combinations showed more consistent advantages for rapid early sedation in monitored ED settings. In PES and EMS, midazolam's role was more dependent on clinical context, operational constraints and postsedation monitoring. Midazolam appears a useful rapid-onset option, but should not be considered a consistently superior standalone strategy. Future multicenter studies should better elucidate its safest and most effective use.

PMID 42640630
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PubMedInternational journal of clinical pharmacology and therapeutics2026-08-18

Palonosetron-induced anaphylaxis during general anesthesia in a patient with multiple drug hypersensitivity.

Shi Meiyi M, Quan Zhefeng Z

Palonosetron, a second-generation 5-HT3 receptor antagonist, is widely used for postoperative nausea and vomiting (PONV) prophylaxis. Anaphylaxis induced by palonosetron during general anesthesia is extremely rare, and the risk of severe anaphylaxis upon re-exposure in polysensitized atopic patients is inadequately recognized. A 50-year-old female underwent an uneventful hepatectomy, receiving palonosetron without adverse reaction. Ten weeks later, during pre-induction for laparoscopic rectal cancer surgery, she received oxycodone, palonosetron, and penehyclidine hydrochloride. One minute after completion, she developed generalized rash (> 60% body surface area), hypotension (81/50 mmHg), and tachycardia (125 bpm), requiring vasopressor support; surgery was cancelled. Subsequent skin testing was positive for ondansetron (++), cisatracurium (+), and propofol (+), while negative for chlorhexidine, rocuronium, and etomidate. Prior uneventful exposure to palonosetron does not guarantee future safety. Atopic patients with polysensitization are at significantly increased risk of severe anaphylaxis upon re-exposure. Positive ondansetron skin testing provides indirect evidence identifying palonosetron as the culprit. All 5-HT3 receptor antagonists should permanently be avoided in such patients, and alternative antiemetics (e.g., dexamethasone, droperidol, NK1 antagonists) should be selected.

PMID 42610559
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PubMedDrug design, development and therapy2026-08-16

Glycopyrronium Bromide versus Droperidol for Prophylaxis of Postoperative Nausea and Vomiting in Hysteroscopic Day Surgery: A Randomized, Double-Blind, Non-Inferiority Trial.

Wang Xiaoqian X, Sun Nenghong N, Xiao Ming M, Chen Ziyuan Z et al.

To investigate the efficacy of glycopyrronium bromide in preventing postoperative nausea and vomiting (PONV) in patients undergoing gynecological hysteroscopic day surgery. This study is a prospective, randomized, double-blind, non-inferiority trial. The non-inferiority margin was set at 15%. Patients scheduled for elective gynecological hysteroscopic day surgery under general anesthesia from November 2025 to February 2026 were selected. A total of 260 eligible patients were randomly assigned to receive glycopyrronium bromide (Group G) or droperidol (Group F). Patients in Group G received intravenous glycopyrronium bromide 0.2 mg, while those in Group F received intravenous droperidol 1 mg. Surgery was performed under general anesthesia with remimazolam combined with alfentanil. The primary outcome observed was the incidence of PONV within 24 hours after surgery in both groups. Within 24 hours postoperatively, the incidence of nausea and vomiting in Group G was non-inferior to that in Group F (37.1% vs 34.1%, risk difference 3.0%; 95% confidence interval -9.0 to 14.7; upper limit < non-inferiority margin of 15%). In the PACU, the incidence of nausea and vomiting in Group G and Group F was 22.6% vs 17.9%, respectively (risk difference 4.7%; 95% confidence interval -5.4 to 14.6). Regarding perioperative adverse reactions, there was no statistically significant difference in the incidence of hypotension between the two groups(30.6% vs 39.8%, P=0.130). The incidence of bradycardia was higher in Group F than in Group G (7.3% vs 1.6%, P=0.030). Furthermore, the incidence of parched mouth was higher in Group G than in Group F (67.7% vs 15.4%, P=0.001). This study found that glycopyrronium bromide is non-inferior to droperidol in preventing PONV within 24 hours after gynecological hysteroscopic day surgery.

PMID 42603901
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PubMedDrug design, development and therapy2026-07-19

Dexamethasone Alone versus Combined with Droperidol for Preventing Postoperative Nausea and Vomiting in Gynecological Day Surgery Under Ciprofol-Alfentanil Anesthesia: A Randomized Double-Blind Controlled Trial.

Sun Xiaohan X, Xiao Hongyi H, Li Mengge M, Yin Bingzhe B et al.

To compare the efficacy and safety of dexamethasone alone versus dexamethasone combined with droperidol for the prevention of postoperative nausea and vomiting (PONV) in patients undergoing gynecological day surgery under ciprofol-alfentanil general anesthesia. A total of 268 patients scheduled for gynecological day surgery were randomly assigned to the DD group (dexamethasone-droperidol, n=134) or the DN group (dexamethasone-normal saline, n=134). Before induction of anesthesia, the DD group received 5 mg dexamethasone plus 1 mg droperidol, while the DN group received 5 mg dexamethasone plus normal saline. Anesthesia induction: ciprofol 0.5 mg/kg, alfentanil 20 μg/(kg·h), and mivacurium 0.2 mg/kg. Anesthesia maintenance: ciprofol 1.25 mg/(kg·h), alfentanil 40 μg/(kg·h), with bispectral index (BIS) maintained at 40-60. The primary outcome was the incidence of PONV within 24 h postoperatively. Secondary outcomes included the incidence of adverse events within 24 h postoperatively, patient satisfaction, hemodynamic changes during anesthesia, BIS changes during anesthesia, and the incidence of intraoperative adverse events. The incidence of PONV within 24 h postoperatively was significantly lower in the DD group than in the DN group (17.2% vs 31.9%), with a statistically significant difference. No significant differences were found between the two groups in the incidence of postoperative adverse events within 24 h, patient satisfaction, hemodynamic changes during anesthesia, BIS changes during anesthesia, or the incidence of intraoperative adverse events. No specific adverse effects of droperidol were observed in the DD group. For patients undergoing gynecological day surgery under ciprofol-alfentanil general anesthesia, the combination of dexamethasone and droperidol is significantly more effective than dexamethasone alone in preventing PONV, with no significant difference in safety between the two regimens.

PMID 42472077
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PubMedJournal of the Academy of Consultation-Liaison Psychiatry2026-07-04

Cardiovascular Effects of Droperidol: A Clinically-Focused Review for the Consultation-Liaison and Emergency Psychiatrist.

Baig Mirza M, Gunther Matthew M, Celano Christopher M CM, Morfin Rodriguez Alejandra E AE et al.

Droperidol carries a black box warning from the US Food and Drug Administration regarding the risk for corrected QT (QTc) prolongation and torsades de pointes but is experiencing a resurgence of use for agitation in emergency medicine settings. This structured review aims to investigate effects of droperidol on cardiac conduction and risk of arrhythmias when used at standard doses. We searched PubMed from inception through February 2025. We included studies describing cardiac effects or changes in vital signs in the setting of droperidol usage, excluding those involving other QTc-prolonging medications that lacked independent examination of droperidol effects. Two reviewers assessed articles and extracted data. Forty-nine articles were included-18 randomized controlled trials, 3 nonrandomized trials, 19 observational studies, 7 case reports/series, and 2 Cochrane meta-analyses-with 41,878 individuals taking droperidol. Data were highly heterogenous, but QTc prolongation was observed in all levels of literature. Several randomized controlled trials suggested QTc prolongation of 10-25 ms at doses less than 10 mg. Evidence of increased risk for arrhythmias or sudden cardiac death was not present. Mixed effects were seen on vital signs. Despite practical advantages for agitation, the use of droperidol is associated with moderate- to high-risk QTc prolongation, comparable to ziprasidone and greater than intravenous haloperidol. Although droperidol use does not appear to be associated with an increased risk for arrhythmia, alternative agents may be preferred in patients with other risk factors for arrhythmias. Consultation-liaison and emergency psychiatrists should be familiar with these risks.

PMID 42398766
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