II. Indications
- Psychosis
- Delirium
- Schizophrenia
- Tic Disorders (including Tourette's Syndrome)
- Acute Mania
III. Contraindications
- Pregnancy and Lactation
- Phencyclidine (PCP) Overdose
- Anticholinergic Syndromes
- Alcohol or Benzodiazepine Withdrawal
- Hepatic Insufficiency
- Neuroleptic Malignant Syndrome
IV. Class
- First Generation Antipsychotic
V. Dosing: Haloperidol
- Dose
- Adult: 5-10 mg PO, IM, or IV
- Peds: 0.5-1 mg PO, IM or IV
- Adolescent: 1-5 mg PO, IM or IV
- Elderly: 0.5-2 mg PO, IM or IV
- Intervals: Scheduled and repeated dosing intervals
- May repeat every 30-60 minutes
- Maximum: 300 mg/24 hours (avoid cummulative dose over 100 mg in 24 hours)
- May dose regularly every 6-8 hours
- Typical effective dose: 5 mg PO, IV, or IM tid (lower doses in the elderly)
- Total dose >3 mg/day is associated with Extrapyramidal Side Effects
VI. Dosing: Haloperidol decanoate (depot form)
- Haloperidol decanoate 100 mg IM every 4 weeks
- Cost effective (may be as low as $19 generic)
VII. Precautions
- Intravenous doses have a much shorter duration of action than other routes
- Antipsychotics are associated with increased mortality in the elderly
VIII. Adverse effects
- Serious
- See Extrapyramidal Side Effects (EPSE)
- Neuroleptic Malignant Syndrome
- Hypotension
- Dystonia
- Seizures
- Prolonged QT interval
- Risk of Torsades de Pointes
- Dose related effect with higher risk at higher doses
- Common
- Insomnia
- Restlessness
- Anxiety
- Sedation
- Headache
- Weight gain
- Hyperprolactinemia
- Blood dyscrasia
IX. Monitoring
-
Serum Prolactin
- Obtain if indicated
-
Complete Blood Count (indicated if history of Leukopenia)
- Baseline
- Monthly in first 3 months of therapy
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Related Studies
haloperidol (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
HALOPERIDOL 0.5 MG TABLET | Generic | $0.24 each |
HALOPERIDOL 1 MG TABLET | Generic | $0.28 each |
HALOPERIDOL 10 MG TABLET | Generic | $0.40 each |
HALOPERIDOL 2 MG TABLET | Generic | $0.35 each |
HALOPERIDOL 20 MG TABLET | Generic | $0.86 each |
HALOPERIDOL 5 MG TABLET | Generic | $0.37 each |
HALOPERIDOL DEC 100 MG/ML AMP | Generic | $29.05 per ml |
HALOPERIDOL DEC 100 MG/ML VIAL | Generic | $21.31 per ml |
HALOPERIDOL DEC 500 MG/5 ML VL | Generic | $28.42 per ml |
HALOPERIDOL DECAN 50 MG/ML AMP | Generic | $19.70 per ml |
HALOPERIDOL LAC 2 MG/ML CONC | Generic | $0.19 per ml |