UMEM Educational Pearls

Category: Pharmacology & Therapeutics

Title: High-Dose Droperidol: Little, if any, Risk for QT Prolongation

Keywords: droperidol, QT prolongation (PubMed Search)

Posted: 12/31/2013 by Bryan Hayes, PharmD (Emailed: 1/4/2014) (Updated: 8/15/2014)
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46 patients treated with high-dose droperidol (10-40 mg) were studied prospectively with continuous holter recording.

What they did

Patients initially received 10 mg droperidol as part of a standardized sedation protocol (for aggression). An additional 10 mg dose was given after 15 min if required and further doses at the clinical toxicologist's discretion.

Continuous 12-lead holter recordings were obtained for 2-24 hours. QTc > 500 msec was defined as abnormal (with heart rate correction - QTcF).

What they found

Only 4 patients had abnormal QT measurements, three given 10 mg and one 20 mg. All 4 had other reasons for QT prolongation. No patient given > 30 mg had a prolonged QT. There were no dysrhythmias.

What it means

There was little evidence supporting droperidol being the cause and QT prolongation was more likely due to pre-existing conditions or other drugs.


Calver L, et al. High dose droperidol and QT prlongation: analysis of continuous 12-lead recordings. Br J Clin Pharmacol. 2014;77(5):880-6. [PMID 24168079]

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