IV. Class

  1. First Generation Antipsychotic

V. Dosing: Haloperidol

  1. Dose
    1. Adult: 5-10 mg PO, IM, or IV
    2. Peds: 0.5-1 mg PO, IM or IV
    3. Adolescent: 1-5 mg PO, IM or IV
    4. Elderly: 0.5-2 mg PO, IM or IV
  2. Intervals: Scheduled and repeated dosing intervals
    1. May repeat every 30-60 minutes
    2. Maximum: 300 mg/24 hours (avoid cummulative dose over 100 mg in 24 hours)
    3. May dose regularly every 6-8 hours
      1. Typical effective dose: 5 mg PO, IV, or IM tid (lower doses in the elderly)
    4. Total dose >3 mg/day is associated with Extrapyramidal Side Effects

VI. Dosing: Haloperidol decanoate (depot form)

  1. Haloperidol decanoate 100 mg IM every 4 weeks
  2. Cost effective (may be as low as $19 generic)

VII. Precautions

  1. Intravenous doses have a much shorter duration of action than other routes
  2. Antipsychotics are associated with increased mortality in the elderly

VIII. Adverse effects

  1. Serious
    1. See Extrapyramidal Side Effects (EPSE)
    2. Neuroleptic Malignant Syndrome
    3. Hypotension
    4. Dystonia
    5. Seizures
    6. Prolonged QT interval
      1. Risk of Torsades de Pointes
      2. Dose related effect with higher risk at higher doses
  2. Common
    1. Insomnia
    2. Restlessness
    3. Anxiety
    4. Sedation
    5. Headache
    6. Weight gain
    7. Hyperprolactinemia
    8. Blood dyscrasia

IX. Monitoring

  1. Serum Prolactin
    1. Obtain if indicated
  2. Complete Blood Count (indicated if history of Leukopenia)
    1. Baseline
    2. Monthly in first 3 months of therapy

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Related Studies

Cost: Medications

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