Ondansetron Is Similar to Droperidol in Causing QT Prolongation

Ondansetron appears to cause QT prolongation similar to that with droperidol; this finding raises serious questions about the basis for the FDA's black box warning about droperidol.

Data analyses that have been performed since the FDA’s controversial “black box” warning about droperidol in 2001 have strongly challenged the basis for the warning. Although the adverse cardiac events occurred at doses greatly exceeding those used for postoperative nausea and vomiting (PONV), the warning was issued in blanket fashion, and use of droperidol, an inexpensive and highly effective antiemetic and sedation agent, effectively ceased.

In a prospective study from France, researchers evaluated the electrocardiographic effects of standardized doses of droperidol and ondansetron in 85 consecutive patients undergoing elective general anesthesia who experienced PONV in the recovery room. At the attending anesthesiologist’s discretion, pat…

Reviewing Author

Ron M. Walls, MD, FRCPC, FACEP, FAAEM