Droperidol amp. (solution d/i.v. and i.m. injection) 2.5 mg/ml 5 ml No. 10 Dalkhimpharm/Russia

Droperidol amp. (solution d/i.v. and i.m. injection) 2.5 mg/ml 5 ml No. 10 Dalkhimpharm/Russia

Important. If the location “Online Pharmacy” is selected in the site menu, ordering the product is possible only at the “Price to order” based on suppliers’ offers. If suppliers do not have goods, only the “Subscribe” option is available if the old price is known, or “To order” when there is no information on the old prices. We ask you to pay attention to the “Availability” Tab - you can order goods at the balances and prices of pharmacies, but to do this you need to select the desired pharmacy in the site menu (next to the “Your pharmacy” field).

This section provides answers to frequently asked questions from visitors to our site.
What is the minimum order amount?
The minimum order amount for regular customers when purchasing from a pharmacy is 400 rubles.
The minimum order amount for regular customers when delivering by courier is RUB 1,500. The minimum order amount for legal entities purchasing goods for their own needs is 400 rubles. Can I get an additional discount?
There are no discounts on the site.

We simply gave up discounts and set a minimum markup on goods, and try to keep prices at such prices that it turns out even cheaper than with the maximum possible discount, and these prices are for all our customers. Accordingly, the discount does not apply to online orders made through. These orders are already at the minimum price, since when ordering, the minimum price is automatically selected from the price at the pharmacy and the price to order. Usually the price “to order” is cheaper than in a pharmacy, it comes to order, with a guarantee of quick redemption, and accordingly the markup is lower than in a pharmacy, since there is no need to keep the goods in stock. If the product is available in the pharmacy and the price in the pharmacy is cheaper, then we take the pharmacy price for this item as a basis.

Can I change my order after I have submitted it?

Adjustment of goods, quantity, change of point of issue, etc.
after you send your order is possible only by the manager after we receive the order, when the manager contacts you to clarify the order. In the buyer's personal account, only the ability to cancel or repeat orders is available. To adjust your order, you need to contact the contact manager of the pharmacy - the order pick-up point indicated on the “Contacts” page of the website. Can I contact the pharmacy myself to find out if my order has arrived?
You can call the pharmacy using the numbers listed on the website.
OUR PHARMACIES, ADDRESSES, TELEPHONES What will happen to my order if I don’t buy it within 5 days, and when can I pick it up later?
If you have not purchased your order within 5 days, your order will be canceled and the product will be put up for sale at the retail price in the pharmacy. And you will have to make a new order on the website.

If you ordered a product on the website and did not come for it within 5 days from the date of receipt, your data will be blacklisted (emergency), and a new order will be possible only after making a deposit on the order in the amount of 30% of its cost. If you refuse to purchase your order, the deposit amount will not be returned.

When you first add to an emergency situation, a warning is sent that the next time you find yourself in an emergency situation again, you will not be able to place orders.

Those buyers who systematically do not redeem their orders on time, as well as those who do not buy all the goods from the order, but only part of them, also fall into emergencies.
If I cannot pick up my order on the day it arrives at the pharmacy, can I redeem it later?
Your order is stored in the Pharmacy for 5 days from the date of receipt, during which time you can pick up your order.
When can I receive my product after ordering?
After sending the order, an SMS message about the order will be sent to the mobile phone number you specified, for example: “Zdravstvujte, Vladimir! Vy oformili zakaz No. 1234 na summu RUR 2345.50 Ozhidajte zvonka iz apteki.”, then during the working day, from 9-00 to 17-30, the APTEKA-INFO.RU service manager will contact you to confirm your application, then the application will be sent to the supplier , will be collected there and delivered to the pharmacy of your choice on the next business day.

Important.

Applications are processed only on weekdays from 9-00 to 17-30.

Applications accepted and processed on Friday will be delivered to the pharmacy on Monday or Tuesday. It is possible to speed up the order readiness; the exact date of order readiness is agreed upon with the manager. Applications received on weekends (Saturday, Sunday) will be accepted and processed on the next business day, and delivered on Tuesday-Wednesday.

When agreeing on an order, we warn you about the approximate time frame for the entire order to be ready in order to avoid misunderstandings.
How will I know that my order has been delivered to the pharmacy?
When the goods arrive at the pharmacy, you will receive a letter about the readiness of your order and an SMS notification, then they will call you and inform you that you can come and pick up your order. If you do not redeem your order within 1-2 days from the moment it is ready, they will call you and remind you that it is ready.

Important.

All letters and SMS are sent automatically when the status of the order changes, but sometimes situations are possible when the letter and SMS are ahead of the delivery of your order to the pharmacy, mainly due to an error by the workers processing the order.

A phone call from the pharmacy is a 100% guarantee that your order has already arrived at the pharmacy and you can receive it. So please wait for this call.

If you want to clarify the status of your order, you need to call the pharmacy where the order is issued and provide your name and order number.
Is it possible to pick up the ordered goods?
Pickup is the main way to receive an order on our service, since most orders contain medications that we cannot deliver to you by courier.
You can independently pick up the ordered goods at our pharmacies - delivery points, this is convenient, we have 4 pharmacies in Tomsk and 1 in Seversk. How is delivery to the regions carried out?
Delivery to regions is not possible.
We work only in Tomsk and Seversk. Is it possible to order medicine to be delivered to your home?
The delivery of prescription drugs is prohibited by the current legislation of the Russian Federation.

Delivery of over-the-counter medicines is permitted only if there is a license for the remote sale of medicines.

APTEKA-INFO is working to resolve the delivery issue, but unfortunately we do not yet have the necessary license, so home delivery is not possible.

We deliver orders containing medications only to our pharmacies.

You can choose any pharmacy convenient for you from those presented on and redeem your order at the selected pharmacy.

There are prescription drugs on the site, can I order them and get them at the pharmacy?

You can order prescription goods, but when purchasing from a Pharmacy for any prescription drug, you have the right to require a prescription, and if you do not have a prescription, the Pharmacy has the right not to issue your order. When confirming an order by the buyer at the stage of its pre-processing, the service manager usually always checks whether the buyer has a prescription; if it is not available, prescription products are excluded from the order. The items in your order are not a single item, and you will be able to receive over-the-counter drugs included in your order.

Attention!

Buyers who regularly fail to redeem part or all of their orders risk being blacklisted. If a buyer is blacklisted, a restriction is included - when ordering rare drugs and goods, the pharmacy has the right to demand from the buyer:

1) making a deposit - if, when the buyer refuses to buy these goods, the service has problems with further sales, since the goods are very rare, are not in rare and everyday demand, or the supplier refuses to return such goods. The deposit amount in this case is not refundable.

2) making an advance payment - if the product is rare, but it is still bought by ordinary customers in pharmacies.
Making an advance payment in this case is an additional guarantee that the buyer really intends to purchase this product. In case of cancellation of the purchase, the advance payment is returned to the buyer in full. Why do “to order” prices on the website differ from prices in pharmacies?
We try to keep prices minimal for our clients, so prices for drugs on our website are usually lower than in pharmacies and apply only to online orders made on the website.

The “made to order” price is formed based on suppliers’ proposals. Prices in a pharmacy are individual, since prices from suppliers change every day, all pharmacies work independently and receive goods on different days and months, so prices in pharmacies are all different. If you urgently need medicine on the same day, and at a low price, you can find information about the availability and prices of the product on its page, in the “Availability” tab, there is information about stock and prices in our pharmacies.

How can an organization purchase medicines and goods?

Due to the introduction of labeling for drugs, a large number of labeled drugs, and the lack of profitability of this activity, we are forced to stop working with legal entities on drugs that have a labeling sign.

Therefore, on our website, legal entities can no longer purchase medicines and medical products by bank transfer.

The opportunity to register and place orders remains available for legal entities. But working by bank transfer and receiving sales and accompanying documents for orders is impossible.

We continue to accept applications from medical centers, hospitals, medical institutions, medical units, beauty salons, private offices, etc., who need medicines and over-the-counter medicines and other goods and medical products that do not have a label, as well as parapharmaceutical products for “own needs”, as well as from organizations that maintain their production first aid kits fully equipped.

Our conditions and a brief procedure for working with legal entities:

1. The minimum order amount for legal entities was previously 3,000 rubles, now it is 400 rubles.
2. The purchasing organization registers on the website apteka-info.ru, where it can then create an order.
3. To receive information about the order and its approval, the purchasing organization sends a request to the email address and also provides the order number.
4. A supply agreement is not concluded with a legal entity, since the purchasing organization buys the online order in cash, at retail, in the same way as ordinary buyers - individuals.
5. After receiving the order and agreeing on the terms of sale of medicines and other goods, APTEKA-INFO LLC accepts the online order and orders the goods from suppliers.
6. After receiving the goods from the supplier, the order is collected and prepared for delivery.
7. The delivery of the goods occurs after its preparation and assembly, pick-up at the addresses of the pharmacies of APTEKA-INFO LLC. The purchase period for the order by the buyer is 7 days from the date of readiness. Only cash receipts and sales receipts are provided with the goods. Certification documents for goods are provided upon special prior request.

You can also place an order:

• by sending a letter to
• by calling 8-3822-609-839.

Our specialist will advise you on the products, check their availability and calculate the cost of the order.
Is the price of the product on the website inclusive of VAT?
LLC "APTEKA-INFO", operating under the brand "APTEKA-INFO", applies a simplified tax regime (without VAT).

Didn't find the answer to your question?
Contact us and we will provide the necessary information.

Effect of droperidol on the QT interval

QT prolongation is one of the primary predisposing factors in a patient for the development of TdP. Droperidol causes QT prolongation secondary to its effect on potassium output during the repolarization stage (phase 3) of the action potential [4]. There are many variations of potassium channels. However, blockade of HERG-type potassium channels ("human-ether-a-go-go-related") appears to be a specific channel involved in the prodysrhythmic effect of potassium channel blockade [18]. QT prolongation and TdP are thought to be caused by a lack of normal, complete membrane repolarization [14].

Interest in prescribing butyrophenones for critically ill patients began to rise prior to this FDA warning. It is currently recommended that baseline QTc interval, serum magnesium levels, and potassium levels be assessed before initiating droperidol administration. Patients who have received or will receive butyrophenones at a dose of 50 mg/24 hours (haloperidol and/or droperidol) have an increased risk of developing conduction disorders. In patients whose QTc interval is prolonged by 25% or more of baseline, therapy should be discontinued immediately [19].

Reiley et al [20] reviewed ECGs obtained from 101 healthy referred patients and 495 psychiatric patients to assess QTc abnormalities. Droperidol has been confirmed to cause a dose-dependent prolongation of the QT interval. Previously, the oral route of droperidol has not been reported to have a specific effect on the QT interval. The authors also noted that if the QTc interval is to be adapted as a risk factor for the development of dysrhythmia, its relationship with dose should be understood and studied [20].

In a prospective, double-blind, controlled study of 40 patients undergoing general anesthesia for head and neck surgery, investigators looked at the effect of droperidol on the QTc interval. Patients were divided into three groups and received one of the following doses of droperidol: 0.1 mg/kg, 0.175 mg/kg, or 0.25 mg/kg. For a 70 kg patient these doses would be 7.0 mg, 12.25 mg and 17.5 mg. Exclusion criteria were as follows: QTc > 0.44 sec, known history of malignant dysrhythmia, heart failure, hypokalemia, pregnancy, Parkinson's disease, or epileptic disorders. The authors found significant prolongation of the QT interval in patients who did not have a history of heart disease. Dysrhythmias were not noted in this study. It should be noted that the doses used in this study are much higher than those typically used for antiemetic purposes in the perioperative period.

Kao et al [5] performed a comprehensive review of the literature regarding case reports of droperidol use and QTc prolongation. Seven case reports were reviewed. 4 of 7 patients in these cases developed TdP. 2 of these 7 did not develop TdP but did experience QTc prolongation. In one of the cases, it was not reported whether TdP or QT prolongation occurred. It is certain that every case reported had factors known to contribute to QTc prolongation or the development of TdP. Each of these cases involved one or more of the following factors: electrolyte disturbance, known prolongation of the QTc interval, cardiac disease, or concomitant pharmacological treatment with drugs known to prolong the QTc interval [5].

Horowitz et al [23] analyzed 271 voluntary reports to the FDA between November 1997 and December 2001 regarding droperidol and deaths. Interestingly, 71 of the 271 voluntary reports, which included 55 deaths, were reported on July 9, 2001. In an attempt to eliminate reports from multiple sources regarding the same incident, cases were analyzed by age, gender, and medication history. 93 messages left. Of these 93 reports, 13 deaths occurred at doses <10 mg. Of the 13 reports, 10 reported standard doses used in the United States. 3 out of 10 reports were related to anesthesia. In 5 of the remaining reports, a dose of droperidol equal to 5 mg was administered. Of the remaining reports, one case used a dose of droperidol equal to 0.625 mg, and the other 0.25 mg.

Medwatch is a voluntary system, so the actual number of deaths associated with droperidol may be underestimated [23]. A contemporary FDA review found that from the marketing of droperidol to October 2003—a period of approximately 33 years—there were 89 cardiac dysrhythmias associated with droperidol. QT interval and TdP were responsible for 22 of these cases, 5 of which were fatal. The use of droperidol in doses <2.5 mg is considered “off label” [2]. When droperidol is evaluated at the recommended dose or less than the recommended minimum dose of 2.5 mg, there were 18 cardiac arrests, 10 deaths, 6 cases of QT prolongation, and 3 cases of TdP. To help put the risk of mortality and morbidity associated with droperidol prescription into perspective, it should be noted that more than 25 million units of droperidol were sold in 2000 [5].

Currently, scientific research related to the antiemetic dose of droperidol in relation to QTc prolongation is limited. However, there are two contemporary publications following the FDA warning. The effects of droperidol at doses ranging from 0.625 to 1.25 mg were prospectively studied by White et al [21]. 60 outpatients undergoing general anesthesia were randomly assigned to one of three groups. Patients were administered droperidol in doses ranging from 0.625 to 1.25 mg or saline placebo after induction of general anesthesia but before surgical incision. No statistically significant differences were found between the placebo group and the droperidol group in terms of QTc interval prolongation. In addition, there was no evidence of postoperative QTc prolongation following droperidol alone [21]. The authors pointed to the small sample size as a possible limitation of the study. Charbit et al [22] studied the effects of droperidol and ondansetron in patients recovering from general anesthesia. 85 patients with postoperative nausea and vomiting (PONV) were randomly divided into two groups. One group received 0.75 mg of droperidol, and the second group received 4 mg of ondansetron. It was found that 21% of patients had a prolonged QTc interval before administration, which correlated with lower body temperature and longer duration of general anesthesia. Both droperidol and ondansetron produce similar clinically significant prolongation of the QTc interval. The QTc interval was found to be significantly shorter at 90 minutes in both groups. This study showed that the use of 5-hydroxytryptamine type 3 (5 HT 3 blockers) may not be superior to droperidol in prolonging the QTc interval [22].

Contraindications

• Coma;
• Extrapyramidal disorders;
• Increased QT interval on ECG;
• Severe depression;
• Hypokalemia;
• C-section;
• Arterial hypotension;
• Age up to 2 years;
• Hypersensitivity to the components of the drug and morphine derivatives.

The use of Droperidol by pregnant women is possible only in cases where the expected benefit to the health of the mother is higher than the potential risk to the fetus. If it is necessary for women to use the drug during lactation, breastfeeding should be stopped.

Indications for use

• Surgery: induction of anesthesia, premedication, potentiation of general and regional anesthesia; neuroleptanalgesia (simultaneously with fentanyl); providing a sedative effect, eliminating vomiting and pain in the postoperative period, vomiting and nausea during surgical and diagnostic procedures;
• Therapy: shock and pain in injuries, severe attacks of angina, myocardial infarction, hypertensive crisis, pulmonary edema;
• Psychiatric practice: hallucinations, psychomotor agitation.

Drug interactions

When using Droperidol simultaneously with certain medications, undesirable effects may occur:

• Drugs that have a depressant effect on the central nervous system (benzodiazepine derivatives, anesthetics, opioid analgesics, hypnotics): increased depressant effect on the central nervous system;
• Antihypertensive drugs: potentiation of their action;
• Epinephrine and other adrenergic and sympathomimetic drugs: manifestation of antagonism in their relation;
• Dopamine agonists, including bromocriptine, lisuride and levodopa: inhibition of their action.

Links

1. United States Food and Drug Administration. Inapsine dear doc letter, December 4, 2001. Available at: https:// www.fda.gov/medwatch/safety/2001/inapsine.htm. Accessed March 07, 2002.
2. Young D. FDA advisory panel discusses droperidol concerns. Am J Health Syst Pharm. 2004; 61: 219-222.
3. American Regent Laboratories, Inc. Droperidol Injection, USP product insert. Reference number IN9702. Revised 1/02.
4. Drolet B., Zhang S., Deschenes D., et al. Droperidol lengthens cardiac repolarization due to block of the rapid component of the delayed rectifier potassium current. J Cardiovascular Electrophysiol. 1999; 10: 1597-1604.
5. Kao LW, Kirk MA, Evers SJ, et al. Droperidol, QT prolongation, and sudden death: What is the evidence? Ann Emerg teed. 2003; 41: 546-558.
6. Pandit SK, Kothary SP, Pandit UA, et al. Dose-response study of droperidol and metoclopramide as antiemetics for outpatient anesthesia. Anesth Analg. 1999; 68: 789-802.
7. Caldwell MA Pharmacology of intravenous agents. In: LW, ed. McIntosh Essentials of Nurse Anesthesia. St Louis: McGraw-Hill; 1997: 61.
8. Moss A. QTc interval prolongation: is it beneficial or harmful? Am J Cardiol. 1993; 72:23B-25B.
9. Lischke V., Bhene M., Doelken P., et al. Droperidol causes a dose-dependent prolongation of the QT interval. Anesth Analg. 1994; 79: 983-986.
10. Viskin S. Long QT syndromes and torsades de pointes. Lancet. 1999; 354: 1625-1633.
11. Morganroth J. QTc interval prolongation: Is it beneficial or harmful? Am J Cardiol. 1993; 72: 1B-3 V.
12. Faigel DO, Metz DC, Kochman ML Torsades de pointes complicating the treatment of bleeding esophageal varices: Association with neuroleptics, vasopressin, and electrolyte imbalance. Am J Gastroenterol. 1995; 90:822-824.
13. Gbadebo TD, Trimble RW, Khoo MSC, et al. Calmodulin inhibitor ?-7 unmasks a novel electrocardiographic parameter that predicts initiation of torsades de pointes. Circulation. 2002; 105: 770-774.
14. Tan HL, Hou CJY, Lauer MR, et al. Electrophysiologic mechanisms of the long QT interval syndromes and torsades de pointes. Ann Intern Med. 1995; 122: 701-714.
15. Moss A, Schwartz PJ, Crampton RS, et al. The long QT syndrome prospective longitudinal study of 328 families. Circulation. 1991; 84: 1136-1144.
16. Holmberg S., Chamberlain DA Cardiac arrest and cardiopulmonary resuscitation. In: Julian DG, Camm AJ, Fox KA, eds. Diseases of the Heart. Philadelphia: Saunders; 1996: 1459-1481.
17. White RD Cardiopulmonary resuscitation: Basic and advanced cardiac life support. In: Miller RD, ed. Anesthesia. Philadelphia: Churchill-Livingstone; 2000: 2533-2559.
18. Buckley NA, Sanders P. Cardiovascular adverse effects of antipsychotic drugs. Drug safety. 2000; 23: 215-228.
19. Lawrence KR, Nasraway SA Conduction disturbances associated with administration of butyrophenone antipsychotics in the critically ill: A review of the literature. Pharmacotherapy. 1997; 17: 531-537.
20. Reilly JG, Ayis SA, Ferrier IN, et al. QTc-interval abnormalities and psychotropic drug therapy in psychiatric patients. Lancet. 2000; 355: 1048-1052.
21. White P.F., Song D., Abrao J., et al. Effect of low-dose droperidol on the QT interval during and after general anesthesia. Anesthesiology. 2005; 102: 1101-1105.
22. Charbit B., Albaladejo P., Funck-Brentano C., et al. Prolongation of QTc interval after postoperative nausea and vomiting treatment by droperidol or ondansetron. Anesthesiology. 2005; 102: 1094-1100.
23. Horowitz BZ, Bizwi K., Moreno R. Droperidol-behind the black box warning. Acad Emerg Med. 2002; 9: 615-618.
24. University of Arizona Center for Education and Research on Therapeutics. Drugs to be avoided by congenital long QT patients. Available at: https://www.torsades.org/. Accessed March 15, 2005.