Haloperidol
Tranquilizer, Sedative/Hypnotic · Butyrophenone
Indications
Adjunct to short-term management of anxiety. Schizophrenia, mania and hypomania, organic psychosis, agitation in psychotic illness. Childhood behaviour disorders.
Dosage
Adults: ORAL: Initially 1.5-3 mg daily, increasing as required for control, then decreasing for maintenance, usually 3-10 mg daily. Max, 30 mg daily. Adults: INJECTION: Nausea and vomiting: 1-2 mg by IM. All other indications: Initially 2-10 mg by IM; repeat every 4-8 hourly according to response, max 18 mg daily. Long-term maintenance treatment in schizophrenia, other psychosis (especially paranoid), other mental or behavioural problems: Usually 50-300 mg by deep IM every 4 wk; Elderly: Initially 12.5-25 mg every 4 wk. Children: Schizophrenia: ORAL: 3-13 yr, initially 500 mcg daily in 2-3 divided doses; usual target dose 1-4 mg daily in 2-3 divided doses, max 6 mg daily in 2-3 divided doses; 13-18 yr, initially 500 mcg daily in 2-3 divided doses; usual target dose 1-6 mg daily in 2-3 divided doses, max 10 mg daily in 2-3 divided doses. Childhood behavioural disorders, especially when…
Administration
Administered by IM, although IV administration has been performed. Give haloperidol decanoate (long-acting form prepared in sesame oil to produce slow, sustained release) by deep IM injection into gluteal muscle using Z-track technique and 21G needle. Don’t give more than 3 mL per site. Compatibility: Dextrose 5%, NaCl 0.9%, 0.45%. Stability: Stored at controlled room temperature and protect from light, freezing and temperature above 40 degree centigrade should be avoided.
Adverse Effects
Leucopenia, hyperprolactinaemia, acute dystonias and dyskinesias, akathisia, Parkinsonism, drowsiness, psychotic disorder, tardive dyskinesia, oculogyric crises, somnolence, dizziness, visual disturbances, tachycardia, arrhythmias, ECG changes, altered LFTs, hypotension, weight changes, GI upset, anticholinergic effects (e.g. dry mouth, blurred vision), rash, photosensitivity, impaired temperature regulation, convulsions, sexual dysfunction, extrapyramidal symptoms, hyperkinesia, insomnia, agitation, headache, depression. Reports of neuroleptic malignant syndrome, hypoglycaemia, SIADH, sudden death.
Risk Factor (Pregnancy/Lactation)
Pregnancy: Risk cannot be ruled out. Lactation: Contraindicated or not recommended. Contraindications: Comatose states, CNS depression, Parkinson's disease, lesions of basal cell ganglia, dementia with Lewy bodies, progressive supranuclear palsy. Recent MI, heart failure, arrhythmias, QT prolongation, 2nd or 3rd degree heart block, bradycardia, hypokalaemia. Elderly. Precautions: Renal or hepatic impairment, epilepsy, hyperthyroidism, severe cardiovascular disease, predisposing factors for ventricular arrhythmias or venous thromboembolism, stroke or convulsions, pheochromocytoma, depression. Monitor serum electrolytes periodically. Family history of QT prolongation, history of heavy alcohol exposure, hypotension. CYP2D6 poor metabolisers. Withdraw gradually. Elderly or debilitated.
Interactions
Adrenaline, alcohol, barbiturates, CNS depressants, other antipsychotics, anticholinergics, antacids, dopaminergics, lithium, oral hypoglycaemics, antihypertensives, anticonvulsants, rifampicin, propranolol, drugs that prolong the QT interval (e.g. anti-arrhythmics), diuretics, metoclopramide. Inhibitors of CYP3A4 or 2D6, TCADs, phenindione.
Advice to Patient
Take with or without meals. To reduce GI upset, take with meals. Dilute oral concentration with water or juice. Do not take medication within 2 hours of taking an antacid. Contact prescriber if there is severe dizziness, fast heartbeat, chest pain, palpitations, increased sleepiness, trembling in fingers, change in gait, seizures, anxiety, unusual movements, abnormal thoughts, confusion, changes in personality, changes in urinary pattern, change in menstrual pattern, change in libido, changes in vision, swelling or pain in breasts (male/female), skin rash, yellowing of skin or if there is worsening of condition. Avoid alcohol and caffeine during therapy. Empty bladder before taking medication. Avoid medication contact with skin. Wash immediately with warm, soapy water if contact occurs. Take sufficient amount of fluids (2-3 litres per day) to maintain hydration, unless restricted by the…
Pharmacokinetics
Metabolism: Hepatic. Bioavailability: Oral: 60%-70%. Half-life elimination: Decanoate: 21 days. Lactate: IM: 20 hrs. IV: 14-26 hrs. Oral: 14-37 hrs. Time to peak, serum: Decanoate: 6 days. Lactate: IM: 20 mins. Oral: 2-6 hrs. Excretion: Urine (30%, 1% as unchanged drug).
Brands with this active ingredient
Compiled by Healify Pharmacy from published drug references. How we compile it →
Always consult a pharmacist or doctor.