Haloperidol(ha loe per’ i dole)
Haloperidol
Apo-Haloperidol (CAN), Haldol, Haloperidol LA (CAN), Novo-Peridol (CAN)
Haloperidol Decanoate
Haldol Decanoate, Haldol Decanoate 50, Haldol Decanoate 100
Haloperidol Lactate
PREGNANCY CATEGORY C
Drug Classes
Antipsychotic
Dopaminergic blocker
Therapeutic Actions
Mechanism not fully understood; antipsychotics block postsynaptic dopamine receptors in the brain, depress the RAS, including those parts of the brain involved with wakefulness and emesis; chemically resembles the phenothiazines.
Indications
Management of manifestations of psychotic disorders
Control of tics and vocalizations in Tourette syndrome in adults and children
Behavioral problems in children with combative, explosive hyperexcitability that cannot be attributed to immediate provocation
Short-term treatment of hyperactive children with excessive motor activity, mood lability
Haloperidol decanoate and lactate: Prolonged parenteral therapy of chronic schizophrenia
Unlabeled uses: Control of nausea and vomiting, treatment of intractable hiccoughs
Contraindications and Cautions
Contraindicated with hypersensitivity to typical antipsychotics, coma or severe CNS depression, bone marrow depression, blood dyscrasia, circulatory collapse, subcortical brain damage, Parkinson disease, liver damage, cerebral arteriosclerosis, coronary disease, severe hypotension or hypertension, dementia-related psychosis.
Use cautiously with pregnancy; lactation; respiratory disorders (“silent pneumonia”); glaucoma, prostatic hypertrophy (anticholinergic effects may exacerbate glaucoma and urinary retention); epilepsy or history of epilepsy (drug lowers seizure threshold); tardive dyskinesia; NMS; breast cancer (elevations in prolactin may stimulate a prolactin-dependent tumor); thyrotoxicosis; peptic ulcer; decreased renal function; myelography within previous 24 hr or scheduled within 48 hr; exposure to heat or phosphorous insecticides; children younger than 12 yr, especially those with chickenpox, CNS infections (children are especially susceptible to dystonias that may confound the diagnosis of Reye syndrome); allergy to aspirin if giving the 1-, 2-, 5-, and 10-mg tablets (these tablets contain tartrazine).
Available Forms
Tablets—0.5, 1, 2, 5, 10, 20 mg; oral concentrate—2 mg/mL; injection—50, 100 mg/mL as decanoate, 5 mg/mL as lactate
Dosages
Full clinical effects may require 6 wk–6 mo of therapy. Children, debilitated and geriatric patients, and patients with a history of adverse reactions to neuroleptic drugs may require lower dosage.
Adults
Oral
Psychiatric disorders, Tourette syndrome: Initial dosage range, 0.5–2 mg bid–tid PO with moderate symptoms; 3–5 mg bid–tid PO for more resistant patients. Daily dosages up to 100 mg/day (or more) have been used, but safety of prolonged use has not been demonstrated. For maintenance, reduce dosage to lowest effective level.
IM, haloperidol lactate injection
2–5 mg (up to 10–30 mg) every 60 min or every 4–8 hr IM as necessary for prompt control of acutely agitated patients with severe symptoms. Switch to oral dosage as soon as feasible, using total IM dosage in previous 24 hr as a guide to total daily oral dosage.
IM, haloperidol decanoate injection
Maintenance, 10–15 times the daily oral dose in elderly patients stabilized on 10 mg/day or less; 20 times the daily oral dose in patients stabilized on high doses and tolerant to oral haloperidol. Do not exceed 3 mL per injection site; repeat at 4-wk intervals. Initial dose should not exceed 100 mg. If more than 100 mg is needed, divide into two doses of 100 mg on day 1 and give rest of dose 3–7 days later.
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