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droperidol (Dridol / Xomolix)

✓ Approved

Kyowa Kirin Co., Ltd. · DRD2 · Small Molecule

What is droperidol?

droperidol is a small molecule developed by Kyowa Kirin Co., Ltd.. It is approved for therapeutic indications via injectable (others) or intravenous (iv).

Drug Profile

Brand NamesDridol, Xomolix
CompanyKyowa Kirin Co., Ltd.
Drug ClassSmall Molecule
Molecular TargetDRD2
RouteInjectable (Others), Intravenous (IV)
StatusApproved
Sources: ClinicalTrials.gov, Kyowa Kirin Co., Ltd.

Mechanism of Action

Molecular Targets

droperidol acts on 1 molecular target:

DRD2dopamine receptor D2 (D2DR, D2R)
Want deeper analysis?Noah AI can explain complex mechanisms and compare to similar drugs.

Therapeutic Indications

droperidol is developed for 1 unique indication across 1 therapeutic area.

Therapeutic AreaConditionPhase
Surgical and medical proceduresProphylaxis of nausea and vomiting✓ Approved

Related Research Articles

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 United States Food and Drug Administration regarding the risk for QTc prolongation and torsades de pointes but is experiencing a resurgence of use for agitation in emergency medicine (EM) 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 RCTs, 3 non-randomized trials, 19 observational studies, 7 case reports/series and 2 Cochrane meta-analyses - with 41,878 individuals taking droperidol. Data was 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 arrythmia, alternative agents may be preferred in patients with other risk factors for arrythmias. Consultation-liaison and emergency psychiatrists should be familiar with these risks.

PMID 42398766
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PubMedEmergency medicine Australasia : EMA2026-06-10

Droperidol for the Management of the Undifferentiated and Agitated Trauma Patient.

Williamson Frances F, Bertenshaw Claire C, Roffey Shea S

Droperidol is increasingly used for agitated behaviour in emergency settings, and whilst Acute Behavioural Disturbance (ABD) guidelines exist for the general population, the use in trauma patients is not defined. This study aimed to explore the frequency of droperidol use in undifferentiated trauma patients, document adverse events and alignment to the general ABD guideline. A retrospective convenience sample of all adult patients between 1/12/21 and 1/12/23 who met trauma activation criteria and received droperidol either pre-hospital or in the emergency department was analysed. Data including patient characteristics, adverse events and alignment with the state ABD guideline were analysed using descriptive means. Over the three-year study period, 87 patients met inclusion criteria, with most patients being of male sex, middle-aged, and sustaining blunt trauma. Adverse events were common, with 9/87 (10%) having hypoxia (sats < 90%, oxygen applied), hypotension (SBP < 90 mmHg), or extrapyramidal symptoms (dystonia). Adverse events were more common with concurrent alcohol/drug use (78%) or more than one sedative agent (67%). Thirteen patients required multiple sedative agents. Younger patients (< 65 years) were more likely to receive a sedative dose aligned with local and state ABD guidelines (OR 4.5, 95% CI 1.51-13.40). Droperidol is used in undifferentiated trauma patients with ABD. Adverse events were common, and more frequent in patients who report concurrent alcohol or illicit drug use. Wide variation in dose and use of additional medications for sedation of this diverse group was identified in the study and supports the need for further research to define optimal strategies to avoid potentially preventable adverse events.

PMID 42267846
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PubMedPrehospital emergency care2026-05-27

Incidence of Adverse Events with Prehospital Use of Droperidol for Nausea or Vomiting.

Keller Aleksander W AW, Galie Michael P MP, Miller Benjamin J BJ, Martin-Gill Christian C

In 2019, droperidol was re-introduced for the treatment of nausea or agitation among emergency medical services (EMS) agencies. Despite a reduced dose used for nausea/vomiting compared to agitation, patients may still experience unwanted sedation. Some protocols recommend an even lower dose for certain patients, such as older adults (age ≥65 years), to avoid oversedation. However, there are limited data to support this practice. We aimed to identify the incidence of adverse events following the use of droperidol for nausea and vomiting and secondarily whether older patients had an increased likelihood of adverse events. We performed a retrospective observational cohort study of a convenience sample of patients treated by 29 EMS agencies for nausea/vomiting with droperidol and transport to one of 9 hospitals between March 2022 and December 2023. We identified the incidence of adverse events including hypotension (systolic blood pressure <90mmHg), hypoventilation (respiratory rate <10 or end tidal carbon dioxide >50mmgHg), hypoxia (pulse oximetry <90% or need for supplemental oxygen), or decreased mental status (GCS <15) either prehospital or in the emergency department. Additionally, we performed a multivariable logistic regression to evaluate the association of adverse events with older age, controlling for sex, weight, route of administration, and if any other sedative was given. A total of 284 cases were included and most (90.1%) received a dose of 1.25 mg. At least one adverse event was experienced by 44 (15.5%) patients, most commonly decreased mentation (GCS <15; n = 24, 8.5%). Hypoxia was experienced by 19 (6.7%) patients, mostly in older adults (n = 12, 13.2%) while hypotension or hypoventilation was experienced by <5%. In multivariable analysis, older patients had a similar odds of adverse events compared to other adults (OR 1.79, 95% CI 0.91-3.51). We identified an adverse event in about 15% of prehospital patients receiving droperidol for nausea and vomiting, most commonly mild sedation, with very limited serious adverse events. Incidence of sedation was similar among older patients and other adults. Further investigation is warranted to evaluate effectiveness versus adverse events with different droperidol doses and compared to other antiemetics.

PMID 42202162
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PubMedThe American journal of emergency medicine2026-05-12

Successful use of intravenous droperidol in hyperemesis following failure of sequential antiemetic therapy.

Matekel Ryan R, Schunk Paul P

Nausea and vomiting in pregnancy is a common affliction, especially in the early trimesters. This is typically managed at home with doxylamine-pralidoxime or other home remedies. Many women, however, require additional adjuncts to control their symptoms. In this case we present a G2P0 female at 7 weeks gestation who arrived in the emergency department with persistent vomiting for several days. This patient already had a home medication regimen of multiple antiemetics. Additional treatment with ondansetron, prochlorperazine, and metoclopramide via IV administration as well as fluid administration resulted in minimal improvement in her symptoms in the emergency department. After stepwise escalation of antiemetic therapy and fluid resuscitation failed to provide relief, droperidol administration resulted in the rapid and complete resolution of her symptoms. This allowed for a safe discharge rather than admission for hyperemesis gravidarum. This case highlights the utility of droperidol as a rescue antiemetic in pregnancy when conventional therapies prove to be ineffective. This adds to the evidence supporting consideration of droperidol for refractory cases of nausea and vomiting and hyperemesis gravidarum in pregnancy. The purpose of this case report is to describe the safety and efficacy of droperidol in the treatment in refractory nausea and vomiting in pregnancy.

PMID 42119226
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PubMedToxicology reports2026-04-20

National survey of Dutch emergency physicians on pharmacological sedation practices for extreme agitation.

Ouwerkerk J J J JJJ, Kraaijvanger N N, van der Wee N J A NJA, Gresnigt F M J FMJ

Extreme agitation in the emergency department (ED) is a high-risk scenario requiring rapid, safe sedation. International evidence and guidance on first line and rescue agents are variable, however current practice has not been systematically described. To characterise pharmacological sedation practices reported by Dutch emergency physicians (EPs) for the management of extreme agitation in the ED, including agent selection, dosing, determinants of choice, perceived performance, and rescue strategies. National cross-sectional web-based survey among Dutch board-certified EPs (and EPs in training), was distributed to all Dutch Society of Emergency Physicians (DSEP) members through a newsletter, at the yearly DSEP conferences, to colleagues from prior collaborations, and via LinkedIn. Of the 679 eligible board-certified EPs, 293 responded (43.2%); after excluding 42 incomplete responses, 251 were analysed (37.0%). Among this group, 39.0% reported that prehospital midazolam sedation, administered by ambulance services, was often insufficient upon patient arrival in the ED. Without available intravenous (IV) access, the initial choices of sedative most often were midazolam (34.7%), droperidol (23.1%), the droperidol-midazolam combination (14.3%), and esketamine (10.4%), with intramuscular (IM) being the preferred route in these situations; The median IM doses were 10 mg for droperidol and midazolam, 5 mg each for the droperidol-midazolam combination, and 150 mg for esketamine. With IV access, the same ranking applied, with IV being the preferred route, although a small proportion of respondents still opted for alternative routes such as IM and intranasal (IN). The most cited reasons for agent choice, were the DSEP pocket card on sedation for behavioural disturbance (43.0%), perceived effectiveness (37.8%), and residency training (30.3%). When asked about personal experience with sedatives, droperidol and esketamine were frequently described as effective and rapid, whereas midazolam was more often linked to side effects. When initial sedation failed, 85.7% escalated the initial sedative to a certain dosage before switching; esketamine (32.7%) and propofol (27.5%) were the most common rescue medications. Dutch EPs primarily use a recommended set of sedatives based on national guidelines, but their approach to managing extreme agitation varies within that framework. Emergency physicians reported midazolam as the most frequently used first-line agent, although respondents generally rated droperidol as more effective and better tolerated. Given these perceptions and the available evidence supporting droperidol's efficacy and safety, it may be reasonable to reconsider the prominent role of midazolam, particularly since prehospital midazolam sedation was often judged to be insufficient.

PMID 42006044
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