The Surprising Re-emergence of Droperidol

In February 2019, the pharmaceutical manufacturer, American Regent, Inc (Shirley, NY) reintroduced droperidol to the US drug market. Droperidol is a butyrophenone, the same drug class as the typical antipsychotic agent haloperidol, and acts as a dopamine D2 receptor antagonist producing antiemetic and sedative-hypnotic effects. Not only has it been used along with fentanyl to produce a state of neuroleptic analgesia, previously marketed in combination as Innovar (Janssen Pharmaceutica, Beerse, Belgium) and since discontinued, but it also has a compelling history as an antiemetic agent. In fact, anesthesia providers who treated patients in the late 20th century likely remember it as an affordable and effective prophylactic antiemetic agent that carried minimal risks of QT prolongation or extrapyramidal side effects when administered in small doses. Despite its long track record of success, the drug has had a convoluted history since its...