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haloperidol

Pronunciation

Generic Name: haloperidol (HAL oh PER i dol)
Brand Name: Haldol, Haldol Decanoate

What is haloperidol?

Haloperidol is an antipsychotic medicine. It works by changing the actions of chemicals in your brain.

Haloperidol is used to treat schizophrenia. It is also used to control motor and speech tics in people with Tourette's syndrome.

Haloperidol may also be used for purposes not listed in this medication guide.

What is the most important information I should know about haloperidol?

Haloperidol is not approved for use in psychotic conditions related to dementia. Haloperidol may increase the risk of death in older adults with dementia-related conditions.

Slideshow: Flashback: FDA Drug Approvals 2013

You should not use this medicine if you have Parkinson's disease or certain conditions that affect your central nervous system.

What should I discuss with my healthcare provider before taking haloperidol?

You should not use haloperidol if you are allergic to it, or if you have:

  • Parkinson's disease; or

  • certain conditions that affect your central nervous system (such as severe drowsiness, or slowed thinking caused by taking other medicines or drinking alcohol).

Haloperidol is not approved for use in psychotic conditions related to dementia. Haloperidol may increase the risk of death in older adults with dementia-related conditions.

To make sure haloperidol is safe for you, tell your doctor if you have:

  • liver disease;

  • kidney disease;

  • heart disease, angina (chest pain);

  • a thyroid disorder;

  • epilepsy or other seizure disorder;

  • personal or family history of long QT syndrome;

  • an electrolyte imbalance (such as low levels of potassium or magnesium in your blood); or

  • if you take a blood thinner (warfarin, Coumadin, Jantoven).

FDA pregnancy category C. It is not known whether haloperidol will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medicine.

Taking antipsychotic medication during the last 3 months of pregnancy may cause problems in the newborn, such as withdrawal symptoms, breathing problems, feeding problems, fussiness, tremors, and limp or stiff muscles. However, you may have withdrawal symptoms or other problems if you stop taking your medicine during pregnancy. If you become pregnant while taking haloperidol, do not stop taking it without your doctor's advice.

Haloperidol can pass into breast milk and may harm a nursing baby. You should not breast-feed while using this medicine.

How should I take haloperidol?

Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Haloperidol can be taken with or without food.

Taking too much haloperidol can cause a serious heart rhythm disorder or sudden death. Never take more than your prescribed dose.

It may take several weeks before your symptoms improve. Keep using the medication as directed and tell your doctor if your symptoms do not improve.

Do not stop using haloperidol suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using haloperidol.

Store at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of haloperidol can be fatal.

What should I avoid while taking haloperidol?

Haloperidol may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall.

Drinking alcohol can increase certain side effects of haloperidol.

Avoid becoming overheated or dehydrated during exercise and in hot weather. You may be more prone to heat stroke while you are taking haloperidol.

Haloperidol side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • sudden mood changes, agitation, hallucinations, unusual thoughts or behavior;

  • twitching or uncontrollable movements of your eyes, lips, tongue, face, arms, or legs;

  • stiffness in your neck, tightness in your throat, trouble breathing or swallowing;

  • sudden weakness or ill feeling, fever, chills, sore throat, swollen gums, painful mouth sores, pain when swallowing, skin sores, cold or flu symptoms, cough, easy bruising or bleeding;

  • stabbing chest pain, feeling short of breath, cough with yellow or green mucus;

  • headache with chest pain and severe dizziness, fainting, fast or pounding heartbeats;

  • seizure (convulsions); or

  • severe nervous system reaction--very stiff (rigid) muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, feeling like you might pass out.

Common side effects may include:

  • headache, dizziness, spinning sensation, drowsiness;

  • tremors, restless feeling, uncontrolled muscle movements;

  • stiffness in the muscles of your neck or back, speech problems;

  • sleep problems (insomnia);

  • feeling restless or anxious;

  • breast enlargement, irregular menstrual periods, loss of interest in sex; or

  • overactive reflexes.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Haloperidol dosing information

Usual Adult Dose for ICU Agitation:

Haloperidol lactate:
IV, intermittent: 0.03 to 0.15 mg/kg IV (2 to 10 mg) every 30 minutes to 6 hours.
IV, infusion: 3 to 25 mg/hour by continuous IV infusion, has been used for ventilator patients with agitation and delirium.

Usual Adult Dose for Dementia:

For non-psychotic behavioral problems related to dementia:
Initial dose: 0.5 mg orally 2 to 3 times daily.
Maintenance dose: 0.5 to 3 mg orally 2 times a day.

Usual Adult Dose for Mania:

Oral:
Initial dose: 0.5 to 5 mg orally 2 to 3 times a day
Maintenance dose: 1 to 30 mg/day in 2 or 3 divided doses. Infrequently, haloperidol has been used in doses above 100 mg for severely resistant patients; however, the limited clinical usage has not demonstrated the safety of prolonged administration of such doses.

Parenteral:
Haloperidol Lactate:
2 to 5 mg IM or IV for prompt control. May repeat every 4 to 8 hours. Doses up to 8 to 10 mg may be given intramuscularly. Acutely agitated patients may require hourly injections.

Usual Adult Dose for Nausea/Vomiting:

Oral:
1 to 5 mg orally every 4 to 6 hours as needed.

Parenteral:
Haloperidol lactate:
1 to 5 mg IM or IV every 4 to 6 hours as needed.

Usual Adult Dose for Psychosis:

Oral:
Initial dose: 0.5 to 5 mg orally 2 to 3 times a day.
Maintenance dose: 1 to 30 mg/day in 2 to 3 divided doses. Daily doses of up to 100 mg have been used. Infrequently, haloperidol has been used in doses above 100 mg for severely resistant patients; however, the limited clinical usage has not demonstrated the safety of prolonged administration of such doses.

Parenteral:
Haloperidol lactate:
2 to 5 mg IM or IV for prompt control. May repeat every 4 to 8 hours. Doses up to 8 to 10 mg may be given intramuscularly. Acutely agitated patients may require hourly injections.

Haloperidol decanoate:
Initial dose: 10 to 15 times the previous oral daily dose intramuscularly every 3 to 4 weeks. The initial dose should not exceed 100 mg and the balance should be given in 3 to 7 days. There is limited experience with doses greater than 450 mg/month. Do not give IV.

Usual Adult Dose for Tourette's Syndrome:

Initial dose: 0.5 to 2 mg orally 2 to 3 times a day.
Maintenance dose: May increase every 5 to 7 days to 3 to 5 mg 2 to 3 times daily for more severe or resistant cases.

Usual Geriatric Dose for Psychosis:

Oral:
Initial dose: 0.5 to 2 mg orally 2 to 3 times a day.
Maintenance dose: 1 to 30 mg/day in 2 to 3 divided doses. Daily doses of up to 100 mg have been used. Infrequently, haloperidol has been used in doses above 100 mg for severely resistant patients; however, the limited clinical usage has not demonstrated the safety of prolonged administration of such doses. The lowest possible effective dose should be used since geriatric patients are more sensitive to the adverse effects of haloperidol (e.g., tardive dyskinesia).

Parenteral:
Haloperidol Lactate:
2 to 5 mg IM or IV for prompt control. May repeat every 4 to 8 hours. Doses up to 8 to 10 mg may be given intramuscularly. Acutely agitated patients may require hourly injections.

Usual Pediatric Dose for Psychosis:

Oral:
2 years or younger or less than 15 kg: Use is not recommended.
3 to 12 years and 15 to 40 kg:
Initial dose: 0.5 mg/day orally in 2 to 3 divided doses.
Maintenance dose: The daily dose may be increased every 5 to 7 days in 0.25 to 0.5 mg increments. The usual range is 0.05 to 0.15 mg/kg/day in 2 to 3 divided doses. There is little evidence that behavior improvement is further enhanced by doses greater than 6 mg/day.
13 to 18 years and greater than 40 kg:
Initial dose: 0.5 to 5 mg orally 2 to 3 times a day.
Maintenance dose: 1 to 30 mg/day in 2 to 3 divided doses. Daily doses of up to 100 mg have been used. Infrequently, haloperidol has been used in doses above 100 mg for severely resistant patients; however, the limited clinical usage has not demonstrated the safety of prolonged administration of such doses.

Parenteral:
Haloperidol lactate:
5 years younger: Use is not recommended.
6 to 12 years: 1 to 3 mg IM every 4 to 8 hours as needed (maximum 0.15 mg/kg/day). Patients should be switched to oral therapy as soon as possible.
13 to 18 years: 2 to 5 mg IM every 4 to 8 hours as needed.

Haloperidol decanoate:
17 year or younger: Safety and efficacy have not been established.

Usual Pediatric Dose for Tourette's Syndrome:

2 years or younger or less than 15 kg: Use is not recommended.
3 to 12 years and 15 to 40 kg:
Initial dose: 0.5 mg/day orally in 2 to 3 divided doses.
Maintenance dose: The daily dose may be increased weekly in 0.25 to 0.5 mg increments up to 0.05 to 0.075 mg/kg/day. There is little evidence that behavior improvement is further enhanced by doses greater than 6 mg/day.
13 to 18 years and greater than 40 kg: 1 to 2 mg orally 2 to 3 times a day.

What other drugs will affect haloperidol?

Before using haloperidol, tell your doctor if you regularly use other medicines that make you sleepy (such as cold or allergy medicine, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for depression or anxiety). They can add to sleepiness caused by haloperidol.

Tell your doctor about all medicines you use, and those you start or stop using during your treatment with haloperidol, especially:

  • cancer medicine--arsenic trioxide, nilotinib, toremifene, vandetanib, vemurafenib;

  • an antidepressant--citalopram;

  • anti-malaria medication--lumefantrine;

  • heart rhythm medicine--amiodarone, disopyramide, dofetilide, procainamide, quinidine, sotalol; or

  • medicine to treat a psychiatric disorder--iloperidone, pimozide, thioridazine, ziprasidone, others.

This list is not complete. Other drugs may interact with haloperidol, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Where can I get more information?

  • Your pharmacist can provide more information about haloperidol.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 13.01. Revision Date: 2014-06-26, 8:39:53 AM.

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