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Haloperidol information from DrugsUpdate  

See Available Brands of Haloperidol in India

P - Caution when used during pregnancy
L - Contraindicated in lactation

Haloperidol is a typical antipsychotic. It is in the butyrophenone class of antipsychotic medications and has pharmacological effects similar to the phenothiazines. Haloperidol is an older antipsychotic used in the treatment of schizophrenia and, more acutely, in the treatment of acute psychotic states and delirium. A long-acting decanoate ester is used as a long acting injection given every 4 weeks to people with schizophrenia or related illnesses who have a poor compliance with medication and suffer frequent relapses of illness, or to overcome the drawbacks inherent to its orally administered counterpart that burst dosage increases risk or intensity of side effects. In some countries this can be involuntary under Community Treatment Orders. Haloperidol is sold under the tradenames Aloperidin, Bioperidolo, Brotopon, Dozic, Duraperidol (Germany), Einalon S, Eukystol, Haldol, Halosten, Keselan, Linton, Peluces, Serenace, Serenase, and Sigaperidol. In medical slang, haloperidol is occasionally called vitamin H.

Pharmacodynamics

Pharmacokinetics

Haloperidol blocks postsynaptic dopamine D1 and D2 receptors in the mesolimbic system and decreases the release of hypothalamic and hypophyseal hormones. It produces calmness and reduces aggressiveness with disappearance of hallucinations and delusions.


Absorption Readily absorbed from the GI tract (oral).


Distribution Crosses the blood-brain barrier; enters breast milk. Protein-binding: 92%.


Metabolism Hepatic via oxidative N-dealkylation and reduction of the ketone group; undergoes enterohepatic recycling.


Excretion Urine and faeces; 12-38 hr (elimination half-life).

Haloperidol Indications / Haloperidol Uses

Information Not Available

Haloperidol Adverse Reactions / Haloperidol Side Effects

Tardive dyskinesia; extrapyramidal reactions. Anxiety, drowsiness, depression, anorexia, transient tachycardia, postural hypotension, leukopenia; anticholinergic side effects. Potentially Fatal: Neuroleptic malignant syndrome.

Precautions

Information Not Available

Special Precautions

Parkinsonism; epilepsy, allergy, angle-closure glaucoma, benign prostatic hyperplasia; severe cardiac or hepatic disease; extremes in temp (hot and cold weather); presence of acute infections or leucopenia; hyperthyroidism; pregnancy, elderly, children. Patients receiving anticoagulants. Discontinue upon signs of neurological toxicity in patients taking haloperidol and lithium.

Other Drug Interactions

Carbamazepine and rifampicin reduce plasma concentrations. Symptoms of CNS depression may be enhanced by CNS depressants e.g. alcohol, hypnotics, general anaesthetics, anxiolytics and opioids. May reduce antihypertensive action of guanethidine. May increase risk of arrhythmia when used with drugs that prolong QT interval or diuretics that can cause electrolyte imbalance. May increase plasma levels of haloperidol when used with clozapine or chlorpromazine. Potentially Fatal: Increases lithium blood levels and may predispose to neuroleptic malignant syndrome.

Other Interactions

Information Not Available

Dosage

Oral Psychoses Adult: 0.5-5 mg bid/tid, may increase up to 100 mg daily in severe or resistant cases. Usual maintenance: 3-10 mg daily. Child: >3 yr: Initially, 25-50 mcg/kg daily in 2 divided doses, increased gradually if necessary. Max: 10 mg/day. Oral Tourette's syndrome Adult: Initially, 0.5-1.5 mg tid. Up to 30 mg daily may be required in Tourette's syndrome; adjust dose carefully to obtain optimum response; usual maintenance: 4 mg daily. Oral Severe tics Adult: Initially, 0.5-1.5 mg tid. Up to 30 mg daily may be required in Tourette's syndrome; adjust dose carefully to obtain optimum response; usual maintenance: 4 mg daily. Oral Short-term adjunctive management of severe anxiety or behavioral disturbances Adult: 0.5 mg bid. Oral Restlessness and confusion Adult: 1-3 mg every 8 hr. Oral Alleviate intractable hiccup Adult: 1.5 mg tid, adjust according to response. Intramuscular Acute psychosis Adult: Doses range from 2-10 mg, may be given every hr or at intervals of 4-8 hr, until symptoms are controlled. Max: 18 mg/day. For emergency control of severely disturbed patients: Up to 18 mg may be given IV/IM Intramuscular Nausea and vomiting Adult: 0.5-2 mg daily. In palliative care, 1.5 mg 1-2 times daily via oral admin or 2.5-10 mg over 24 hr by SC infusion (via a syringe driver). Subcutaneous Restlessness and confusion Adult: 5-15 mg via SC infusion over 24 hr.

Food(before/after)

May be taken with or without food. (May be taken w/ meals to minimise GI irritation.)

List of Contraindications

Haloperidol and Pregnancy

Caution when used during pregnancy Category C: Either studies in animals have revealed adverse effects on the foetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the foetus.

Haloperidol and Lactation

Contraindicated in lactation

Haloperidol and Children

Do not use in children younger than 3 yr. Safety and efficacy of IM form not established.

Haloperidol and Geriatic

More susceptible to effects; consider lower dose.

Haloperidol and Other Contraindications

Severe toxic CNS depression; preexisting coma; Parkinson's disease; lactation.

Storage

Intramuscular Store at 15-30 ℃. Oral Store at 15-30 ℃. Subcutaneous Store at 15-30 ℃.

Lab interference

Intramuscular Store at 15-30 ℃. Oral Store at 15-30 ℃. Subcutaneous Store at 15-30 ℃.

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