A plea for the cautious use of droperidol

摘要

I read with interest the recent retrospective investigation by Nuttall et al. regarding the safety of low-dose droperidol. Apparently to justify the use of droperidol at the Mayo Clinic, Nuttall et al. noted the minutes of an offsite Food and Drug Administration meeting where an employee stated that droperidol's. black box warning does not apply to the use of low doses of this drug.* At the same time, they quoted the following bold print excerpt from droperidol's extensive boxed warning: "Cases of QT prolongation and/or torsade de pointes have been reported in patients receiving droperidol at doses at or below recommended doses."f These two positions seem to be at odds. Also, they did not mention the statement from the boxed warning that if the QTc is prolonged, droperidol should not be administered or that the package insert states that it should be used with extreme caution if the patient has any significant heart disease.